ADHD in the Preschool Setting: Interview with Dr. Sara J. Dorison

by Carla on February 1, 2010

Attention Deficit and Hyperactivity Disorder (ADHD) is a group of disorders that include inattentiveness, over-activity, and/or impulsivity. Daycare providers must recognize the signs of symptoms of ADHD as well as how to manage children diagnosed with the disorder.

Our interview with child neurologist Dr. Sara J. Dorison details the important aspects of ADHD in the preschool setting.

OwnADaycare: What is ADHD?

Dr. Dorison: Attention Deficit Hyperactivity Disorder is a syndrome characterized by the presence of clinically significant levels of hyperactivity, impulsivity, disorganization, difficulty staying on task, short attention span, and difficulty waiting on line, interrupting, and low frustration tolerance. The diagnosis is based on the DSM-IV criteria which outline the criteria necessary to make the diagnosis.  It is felt to be present in about 5% of children.

OwnADaycare: How is ADHD diagnosed?

Dr. Dorison: ADHD is a clinical diagnosis and is made by taking an appropriate history and physical examination of the child and their behavior.  Unfortunately, there is no blood test, genetic testing, brain wave test or brain imaging test that can currently make the diagnosis.  The diagnosis is often made with the assistance of psychoeducational testing, or with a clinical interview, generally with a child psychiatrist or child neurologist.  The clinical features must be present in at least two settings and over a period of time.   Often doctors or psychologists use the Connor Rating Scales which ask parents and teachers to fill out forms regarding behaviors.   It is important to rule out other disorders that can present similarly in a young child.  These include Asperger Syndrome, Developmental Delay, Pervasive Developmental Disorder, Autism, deafness, lead poisoning and severe anxiety.

OwnADaycare: Many times, diagnosis of ADHD comes sometime after the age of 6. Can you please explain why? In other words, why is early diagnosis difficult and when is the earliest that a child can be diagnosed with ADHD?

Dr. Dorison: Toddlers and very young children normally exhibit many of the features of ADHD.   Two year olds, for example, are impulsive and disorganized.  They can’t sit for an hour listening to a lesson.  So, it is difficult to discern whether a young child has a “normal” amount of impulsivity or disorganization or a clinically significant amount of these features.   Over time, however, children without ADHD mature and gain more control in these areas and the ADHD children are left behind in terms of their difficulty with their symptoms.   As their peers mature, children with ADHD generally become more obvious to both the teachers and the parents.   Also, as the academic demands of school increase, children with ADHD often begin to lag behind their peers and not perform to their potential.

About Carla

Carla Snuggs has written 88 post in this blog.

Carla is a freelance writer from Southern California. She has a B.A. in early childhood education and a Master of Library and Information Science degree specializing in public librarianship and youth services.

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