| During the assessment process it is of great | | | | be ADHD, but rather a head injury. |
| importance for the physician or clinician to consider | | | | |
| other possible causes of inattention, impulsivity, or | | | | Mark my words, in the next five years you will see |
| hyperactivity in your child (or teen, or yourself). In | | | | lots of research showing that playing soccer causes |
| fact, this is probably the most important element of | | | | minor head injuries from "heading" the ball. A brain |
| a good assessment. There are several possible | | | | researcher friend of mine has seen this several times |
| causes of these behaviors, especially in children, and | | | | now in treating soccer players (professional and |
| the clinician must have great certainty that these | | | | collegiate) for memory problems and other cognitive |
| other possible causes have been ruled out before | | | | problems. |
| giving the label of "Attention Deficit Hyperactivity | | | | |
| Disorder" to your child. | | | | Every once in a while we see someone who has |
| | | | been exposed to toxins come down with cognitive |
| One of the first things to have ruled out is a thyroid | | | | problems. We live one of the biggest agricultural |
| problem. Only MD's can do this, so off they go for a | | | | areas in the world, and sometimes people get |
| physical. This is not a common problem, but it does | | | | sprayed by chemicals, or get exposed to pesticides |
| happen, even in children. Thyroid problems can cause | | | | other ways. This can result in all kinds of neurological |
| inattention, learning problems, even hyperactivity and | | | | problems. |
| impulsivity in some. Once that has been ruled out by | | | | |
| the doctor, then other environmental or emotional | | | | Tourette's Syndrome is also commonly misdiagnosed |
| causes of inattention, impulsivity, or hyperactivity | | | | as ADHD. Think of it as basically ADHD with tics, and |
| need to be ruled out. | | | | it is a close genetic cousin to ADHD. But it is |
| | | | important to know the difference, as the treatment |
| Depression in children often causes inattention, as in | | | | for ADHD is often stimulants, and sometimes |
| adults, and also often causes impulsivity and irritability | | | | stimulant medications can make Tourette's worse. |
| and excessive restlessness or agitation. Anxiety | | | | You can learn a great deal about Tourette's |
| disorders in children can result in agitation, impulsivity, | | | | Syndrome in a great book by David Comings, MD, |
| hyper- vigilance, motor restlessness, and excessive | | | | titled, "Tourette Syndrome and Human Behavior." It |
| startle responses, as well as inattention to task. | | | | should be available through your library. |
| Significant emotional traumas can also result in these | | | | |
| behaviors. Physical or sexual abuse, divorce or other | | | | What are the major things to look for then? The big |
| significant loss, or the death of a loved one. | | | | clue is in knowing whether the target behaviors |
| | | | (inattention, or impulsivity, or hyperactivity) have |
| Physical traumas can also cause the same behaviors | | | | always been apparent to some degree or other, or if |
| as ADHD, such as a minor head injury from an auto | | | | they just started one day. And if they just "started |
| accident, sports injury, falling as a child, and so on. For | | | | one day," then did they start as the result of some |
| example, one of my "ADHD" kids, who was | | | | event (traumatic or environmental) ? |
| extremely hyperactive and also very oppositional and | | | | |
| at times violent toward others, took part in one of | | | | ADHD is usually "always there" while the other things |
| our research projects. As part of the study we "brain | | | | tend to have a starting date. Tourette's is the |
| mapped" him (QEEG) at the onset of the study. We | | | | exception, as sometimes it has "always been there," |
| saw two small head injuries in the back of the head | | | | and sometimes it has a starting date. Realistically, if it |
| and one big injury in the front of the head. | | | | looks like ADHD, then it probably is, but as a clinician |
| | | | the other possibilities must always be ruled out |
| The frontal problem was expected, but the problems | | | | before making a diagnosis and developing a |
| in the back of the head were not. I simply asked the | | | | treatment plan. Information on the different types of |
| parents, "When did he bash the back of his head?" | | | | ADHD and specific treatment recommendations is |
| They thought for a minute and remembered that | | | | available at the ADHD Information Library.Douglas |
| when he was about six weeks old he had fallen out | | | | Cowan, Psy.D., is a family therapist who has been |
| of his crib onto a hard flood so hard that they had to | | | | working with ADHD children and their families since |
| call an ambulance to take him to the hospital. They | | | | 1986. He is the clinical director of the ADHD |
| had forgotten about the incident during the clinical | | | | Information Library's family of seven web sites, |
| interview, but the mapping showed a clear problem. | | | | including helping over 350,000 parents and teachers |
| He fell on the back of the head, causing those | | | | learn more about ADHD each year. Dr. Cowan also |
| injuries, and the brain "sloshed" forward causing the | | | | serves on the Medical Advisory Board of VAXA |
| frontal injuries. These injuries have resulted in a lack | | | | International of Tampa, FL., is President of the Board |
| of inhibition and cortical control, temper outbursts, | | | | of Directors for KAXL 88.3 FM in central California, |
| and learning problems. The diagnosis here would not | | | | and is President of NewIdeas.net Incorporated. |