Understanding ADHD diagnoses in children

It may start with a series of meltdowns occurring under unexpected circumstances. Or noticing your child never stops talking and doesn’t seem to listen when others talk. It may be an inability to complete simple tasks at home or school. Or you might notice your child’s verbal, physical or social development are behind those of other kids the same age.

Sometimes, especially for new parents, it’s easy to miss certain behaviors in kids because they don’t have much to compare it to. Each child is different, and they develop at different speeds. But when a child displays one or more of these behaviors, it may be the first noticeable signs of Attention-Deficit/Hyperactivity Disorder (ADHD).

According to Erin Mack, LCSW, there’s no specific age when ADHD first appears. “Sometimes symptoms start as early as age 3,” she says. A Licensed Clinical Social Worker in Psychotherapy, Mack is a National Practice Team Lead at Talkspace, a provider of online behavioral health care. “With ADHD, there’s a spectrum from mild to severe symptoms, and around age 4 is generally the earliest a child can be clinically assessed and receive a diagnosis for ADHD.”

Mack says the first step for parents should be seeing their pediatrician. “It’s important to first rule out possible medical causes behind the child’s symptoms,” she says. “A pediatrician can assess the child and recommend next steps.”

Causes unknown, and no single test to determine ADHD diagnosis

According to the Centers for Disease Control and Prevention (CDC), ADHD’s causes are unknown. Complicating matters is the fact that there’s no single test for ADHD. Testing for the disorder requires a collaborative effort with the child’s family or guardians, teachers, other medical professionals, and caregivers the child may have. And, ADHD is usually more than just the inability to give attention and control one’s impulses; people with ADHD are likely to have one or more co-occurring condition, such as a learning disability, behavior or conduct problems, anxiety, depression or speech problem.

What parents of children with ADHD should do

As if parenting wasn’t already challenging, raising a child with ADHD can make it more difficult.

What should parents do if they learn their child has ADHD? “Breathe,” says Mack. “Be kind to yourself, give yourself time to learn about the disorder while considering treatment options and gathering available resources.”

She also recommends seeking support and insights from organizations such as Children and Adults with Attention Deficit & Hyperactivity Disorder (CHADD). "If not already meeting with a therapist, consider finding a therapist for yourself as part of your own well-being and self-care."

Therapy and treatment for ADHD

“Since diagnoses can start as early as age 4, treatment can start at that age too,” says Mack. The CDC recommends starting with parent-led behavior therapy for children up to 12, with parents learning skills to help improve the child’s behavior and self-control at school and home.

Cognitive Behavior Therapy (CBT) is also useful for treating ADHD. Based on helping people recognize unhelpful thoughts and behaviors, CBT teaches problem-solving skills and confidence to help patients cope with difficult situations. Mack says CBT can be tailored for children of all ages to help them better understand behaviors that need improvement.

Medications—most commonly stimulants Adderall and Ritalin—are some of the most effective medications in pediatric psychiatry and should be considered for moderate to severe ADHD in combination with other treatments. A licensed psychiatrist or other licensed prescriber of psychotropic medication (e.g. psychiatric nurse practitioner) can assess if medication to treat ADHD symptoms is appropriate.

Mack says delivering therapy via telehealth—through the phone, video conferencing and text messaging—makes it easy for parents to get their kids to log in for an appointment. “At Talkspace, most insurance plans cover unlimited asynchronous (text) messaging between therapist and patient, which fits the way teenagers communicate.”

With Talkspace, clients have access to their treatment plans which they can choose to share with their other providers, such as their pediatrician. This option gives clients control of their information to best serve their treatment needs. And, when therapists collaborate with a patient’s pediatrician through the Talkspace app (available for clients 13+), they can discuss more advanced treatment options—such as medications—to better serve each patient.

We’re here to help

If you or your child need emotional support or mental health care, Regence can help you find the behavioral health care option that fits your needs. Most of our health plans offer virtual mental health treatment options from providers such as Talkspace, AbleTo Therapy+, Doctor on Demand, Charlie Health and more. No referral is needed; you can visit the provider’s website and fill out their intake form to request an appointment. Or, call us at the number listed on your member ID card to verify which virtual care and traditional behavioral health options are available through your health plan.