Often times "ADHD" is actually a symptom of something else - another disorder, or a kid just being a kid who is not thriving in the appropriate environment (especially boys).
Please note, this is NOT me saying ADHD doesn’t exist.
But as someone who works in a field where we see many children who have been diagnosed with ADHD, and then their ADHD disappear completely after treating the underlying cause, I have become very passionate about encouraging parents to learn more, ask questions, advocate for their child, and make informed and empowered decisions.
The following questions/criteria for officially diagnosing ADHD are from the DSM-5 (American Psychiatric Diagnostics and Statistical Manual), and adapted by Dr. Leonard Sax in chapter 8 of his book, Boys Adrift.
Are they hyperactive, impulsive, and/or inattentive?
This is a necessary symptom, HOWEVER not a sufficient enough criteria alone for the diagnosis of ADHD. Most children, especially boys, are hyperactive, impulsive, and/or inattentive. This, alone, does not justify an ADHD diagnosis.
Is the “diagnosis” of ADHD before the age of 12?
“Problems severe enough to cause significant impairment must have present before the age of twelve.” (Dr. Leonard Sax, Boys Adrift, Ch. 8)
Is the impairment due to hyperactivity, impulsivity, or inattentiveness present in multiple settings, not just one or two?
Even adults are inattentive and impulsive from time to time, so of course children are going to be as well. This is completely normal human behavior.
Things to look out for: If one teacher is saying your child has problems sitting still and focusing in their class, but others say they’re doing great, I would question a diagnosis of ADHD - gym included! Dr. Sax even goes as far to say if most or all teachers report signs of ADHD, but their Scout troop leader or sports coach says there’s no problems to question a diagnosis.
“Children who have problems only at school but not in other settings generally do not have ADHD. Moving that child to a different school (and if a boy, a boy-friendly or all-boy school) may fix the problem.” Dr. Leonard Sax, Boys Adrift
Have you ruled out your child’s “ADHD” symptoms are not attributable to another disorder?
Sleep-Breathing Disorder: The majority of Americans suffer from a sleep-breathing disorder - many don’t even realize it. SBD cause sleep deprivation, which perfectly mimics the symptoms of ADHD.
Childhood Depression
Pediatric Bipolar Disorder
Family Issues / Issues in the Home
Etc. Read Dr. Sax’s Boys Adrift for more info.
Sleep Disordered Breathing
Often times "ADHD" is actually a symptom of a sleep breathing disorder. The child (or adult) is not breathing properly, and therefore not sleeping properly. This puts them in a constant state of sleep deprivation, to which their brain must over-stimulate their body in order to stay awake - thus the hyperactivity symptoms. These kids are then diagnosed with "ADHD" and put on medication. (Or many times a child won’t have a SBD, but is sleep deprived due to staying up too late playing video games, on their phones, computers, etc.)
These medications are often times stimulants in and of themselves, therefore continuing to fuel the fire and create a vicious cycle. Initially, ADHD medications may appear to work. However, if the underlying problem is not addressed then you will often see the dosages needing to be slowly increased as time passes.
There are a few things you can look for at home:
Dark circles under the eyes
Blood shot eyes
Forward head posture (shoulders rolled forward)
Large tongue
Snoring
Bruxism (teeth grinding)
Do they wake up disheveled and looking like a tornado hit them/their bed while they slept?
Are they, or did they, experience prolonged bedwetting?
Are they, or did they, experience nursing/feeding issues?
Are they tongue or lip tied? (best diagnosed by an above dr)
Do they have an elongated face/underdeveloped jaw? (best diagnosed by an above dr)
Mouth breathing (watch your child during the day and while they sleep - their mouth should never be open while breathing!)
ADD/ADHD
Daytime sleepiness/fatigue
Headaches
Brain fog
Frequent night wakings
Restless leg syndrome
First and foremost you want to find a provider who specializes in pediatric sleep and airway dentistry. You will find lots of providers who claim they specialize in this, but I would beg to differ on many of these claims. A good place to start is to try and find a provider who has trained under The Breathe Institute or Airway Health Solutions. Or if you are in the DFW area Dr. Hal Stewart, Dr. Melissa Rozas, or Beyond Pediatric Dentistry.
Final Notes:
All in all, if your child has been diagnosed with ADHD I'm not saying they for sure don't have it. I would just encourage you to rule out all the other possibilities before resorting to medication - just to be safe! And if you and your trusted provider determine medication would be the best route, I would encourage you to read Ch. 8 (Detox) of Dr. Sax’s Boys Adrift to gain more information on the types of ADHD medication and dosages you should start off with, and which to avoid and why.
There is also the issue of the feminization of the American schooling system that is creating many false ADHD diagnosis’ for boys, especially. I saw this first hand as a public school educator.
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