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Is your child having difficulties in school? Have you wondered whether it might be ADHD? Perhaps your child’s school psychologist, doctor, therapist, or neuropsych evaluator has diagnosed your child with this disorder.

According to a Centers for Disease Control and Prevention (CDC) study, the percentage of children with an ADHD (Attention-Deficit/Hyperactivity Disorder) diagnosis continues to increase. It is an issue that requires our attention, and now.

ADHD is a diagnosis that is frequently given to children who are struggling in school. Whether your child has some of the symptoms that we associate with this disorder, or whether you accept or dismiss this diagnosis, I urge parents and clinicians to continue to open the door to additional possibilities, rather than have any diagnosis, ADHD or otherwise, close doors to further inquiry.

As both a clinician and mother, I’ve observed and assessed children in the clinical setting, at home, and at school. I can attest to the fact that children can behave very differently given their circumstances. I’ve seen children’s behavior influenced by various factors on any given day.

Medical and mental health professionals can arrive at diagnoses in many ways. The clinician will usually use a combination of observation and a questionnaire, and sometimes a test for the child to take. The DSM 5 (the manual used to diagnose mental health issues) states that a child must exhibit, “in most situations,” at least six symptoms from either (or both) of the following lists in order for an ADHD diagnosis to be made:

List One

  • Often fails to give close attention to details or makes careless mistakes in schoolwork, work, or during other activities.
  • Often has difficulty sustaining attention in tasks or play activities (e.g., has difficulty remaining focused during lectures, conversations, or lengthy reading).
  • Often does not seem to listen when spoken to directly (e.g., mind seems elsewhere, even in the absence of any obvious distraction).
  • Often does not follow through on instructions and fails to finish school work, chores, or duties.
  • Often has difficulty organizing tasks and activities (difficulty managing sequential tasks; difficulty keeping materials and belongings in order; messy, disorganized work; has poor time management; fails to meet deadlines).
  • Often avoids or is reluctant to engage in tasks that require sustained mental effort (e.g. schoolwork or homework.)
  • Often loses things necessary for tasks or activities (e.g., doesn’t come home from school with his jacket.)
  • Is often easily distracted by extraneous stimuli.
  • Is often forgetful in daily activities.

List Two

  • Often fidgets with or taps hands or squirms in seat.
  • Often leaves seat in situations when remaining seated is expected.
  • Often runs about or climbs in situations where it is inappropriate.
  • Often unable to play or engage in leisure activities quietly.
  • Often “on the go” acting as if “driven by a motor.”
  • Often talks excessively.
  • Often blurts out answers before questions have been completed.
  • Often has difficulty awaiting turn.
  • Often interrupts or intrudes on others (e.g., butts into conversations, games, or activities. May start using other people’s things without getting permission).

You may know some children who have at least six of these behaviors. Perhaps they indeed have ADHD, but perhaps not.

Some examples of issues that have similar symptoms to ADHD are:

Auditory Sensitivities

Auditorily-sensitive children may act differently in a noisy restaurant or classroom. They suddenly cannot sit still, are jumpy, or may start climbing on things. Just a few moments earlier, when they were outside, they were fine. Sometimes the classroom may change – construction might’ve begun outside the window, or new, louder students joined the group. Imagine trying to concentrate on something while someone is playing a tambourine in your ear. A child with sensitivities can experience what we perceive as moderate sounds in this way.

Some auditorily-sensitive children may get more fidgety or fearful when in a car or plane. Their symptoms could be that they suddenly “talk excessively” and “butt in on” a conversation. The underlying cause could be a sensitivity to movement combined with auditory issues. This is called vestibular hypoacusis and is often overlooked.

Visual Sensitivities

Have you ever felt kind of “off” walking through a brightly-lit grocery store? Or noticed a “blinking” happening in a light above you? This could be a sensitivity to fluorescent lighting. Imagine this 100 times brighter while you’re trying to get school work done. A child who is acting agitated in the classroom and unable to focus could be experiencing this scenario without the ability to articulate what is bothering him or her.

Deeper visual developmental issues such as amblyopia (often known as “lazy eye”) or tracking issues are difficult to diagnose unless a child is seen by a developmental ophthalmologist. School screenings do not cover this, and children can have 20/20 vision in a regular vision test while the issues such as tracking or amblyopia remain undetected. These children can appear to have difficulty paying close attention to their written homework, or may appear to not be “paying attention” because they bump into other children or cannot follow a ball when playing sports.

Treatment of sensory processing disorders (SPDs)

Undergoing sensory integration therapy (through occupational therapists, vision therapists, and audiologists) could make a child become temporarily “unglued” while in therapy or after. For one child I worked with, the reintegration process manifested as extreme anxiety. Every child is different, but you might be able to check every item on the ADHD symptom lists (plus a few more!). 

Imagine having someone help you to reset how you use your eyes, ears, sense of balance, where your body is in space in relation to the world, how you taste, and how you feel things on your body. Not only are you having to get used to all of these new feelings independently, but your brain must work on integrating them all to work together. It can be very disorienting. Some practitioners who specialize in SPDs are finding innovative ways to more quickly and gently help children integrate their sensory issues and to prevent this “integration reaction” from happening at all.

Boredom and giftedness

Giftedness can include sensitivities and talents that are often misunderstood in the regular classroom setting. Giftedness may, ironically, create difficulties in the typical school setting and can make a child appear “not so smart or talented.”  A child who is bored with a topic may look like they have ADHD in the classroom. Because they are able to think so fast and digest information so easily, especially (and sometimes only if) they are interested in the topic, it makes other topics or going too slowly on a topic very painful.

Imagine someone explaining to you all the steps required to brush your teeth. Every detail of it. And then giving you a quiz on all the steps and marking you incorrect if you got the tiniest detail wrong. This is how a gifted child may experience the classroom setting. Giftedness exists on a spectrum. A common story of children in high school is that they take medication to get through homework that is monotonous and repetitive. These same children often have issues with anxiety and depression.

Learning style

Some children need to move when processing information. This type of child may fidget in his desk while trying to solve a problem in his head. A child like this may do better if he could get up and move around while trying to think or while listening to a lecture.

Other sensitivities

Some children can be sensitive to the feeling of clothing such as tags or the seams in socks. Others are particularly sensitive to what an adult or other children think of them. An example of this might be a child who gets jumpy or hides under a desk when an adult perceived as negatively judgmental is present. Others may have food sensitivities that might manifest as hyperactivity after eating a frosted cupcake. Still others might fall to pieces before lunchtime when their blood sugar takes a dive from not eating.

This is just a short list of examples of what can be causing ADHD-type symptoms. As with any diagnosis, a child can have one or many from the list above and ADHD.

Another consideration in the diagnosis of ADHD in children is that we are still trying to understand how and when parts of a child’s brain develop. An article in Medical News Today stated that the findings of a recent study show that, “[a]s children age into adolescence and on into young adulthood, they show dramatic improvements in their ability to control impulses, stay organized, and make decisions.”

The area of the brain most relevant to ADHD is the prefrontal cortex, which controls executive functioning. Executive functioning is the term used for the neurologically-based skills involving mental control and self-regulation, in other words, the skills needed to regulate the symptoms of ADHD. Some say that this area does not fully develop until after adolescence, others say there is a big boost at about age 12. Either way, we know that it is not fully developed in children and may, therefore, contribute to symptoms that are linked with ADHD.

Some examples of executive functioning skills are:

  • Being able to pay attention
  • The ability to control what one does or says (A child might observe “That kid smells!” then think, “Will I blurt something out, or will I think about how this will affect things?”)
  • Working memory
  • Reasoning
  • Cognitive flexibility (“I know she doesn’t like broccoli, but I do and that’s okay.”)
  • Problem solving
  • Planning
  • Following through on plans

These are all things that most children are working on at some level. What ADHD is diagnosing is the ability (or inability) to use our executive function. If some of the events from the “What else looks like ADHD” list above are happening while a child is trying to figure out their executive functioning skills, or if their prefrontal cortex is developing at a different rate, you can imagine how it could look like ADHD to parents and clinicians.

With these developing years being so crucial to setting the stage for the adults we are actualizing, I urge parents and clinicians to consider the additional or alternative explanations for behaviors we associate with ADHD. Some non-ADHD issues are easily detected and addressed and others may take more of our time and resources, but the results can be remarkable. Even when ADHD was an accurate diagnosis, I have seen profound and positive changes in children whose parents have dared to look further.

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Jessica Simpson celebrated her baby shower this weekend (after getting a cupping treatment for her very swollen pregnancy feet) and her theme and IG captions have fans thinking this was not just a shower, but a baby name announcement as well.

Simpson (who is expecting her third child with former NFL player Eric Johnson) captioned two photos of her shower as "💚 Birdie's Nest 💚". The photographs show Simpson and her family standing under a neon sign spelling out the same thing.

While Simpson didn't explicitly state that she was naming her child Birdie, the numerous references to the name in her shower photos and IG stories have the internet convinced that she's picking the same name Busy Philips chose for her now 10-year-old daughter.

The name Birdie isn't in the top 1000 baby names according to the Social Security Administration, but It has been seeing a resurgence in recent years, according to name nerds and trend watchers.

"Birdie feels like a sassy but sweet, down-to-earth yet unusual name," Pamela Redmond Satran of Nameberry told Town and Country back in 2017. "It's also just old enough to be right on time."

Simpson's older kids are called Maxwell and Ace, which both have a vintage feel, so if Birdie really is her choice, the three old-school names make a nice sibling set.

Whether Birdie is the official name or just a cute nickname Simpson is playing around with, we get the appeal and bet she can't wait for her little one to arrive (and her feet to go back to normal!)

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Mamas, if you hire a cleaning service to tackle the toddler fingerprints on your windows, or shop at the neighborhood grocery store even when the deals are better across town, don't feel guilty. A new study by the University of British Columbia and Harvard Business School shows money buys happiness if it's used to give you more time. And that, in turn could be better for the whole family.

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As if we needed another reason to shop at Target, our favorite store is offering some great deals for mamas who need products for baby. Mom life can be expensive and we love any chance at saving a few bucks. If you need to stock up on baby care items, like diapers and wipes, now is the time.

Right now, if you spend $100 on select diapers, wipes, formula, you'll get a $20 gift card with pickup or Target Restock. Other purchases will get you $5 gift cards during this promotion:

  • $20 gift card when you spend $100 or more on select diapers, wipes, formula, and food items using in store Order Pickup, Drive Up or Target Restock
  • $5 gift card when you buy 3 select beauty care items
  • $5 gift card when you buy 2 select household essentials items using in store Order Pickup, Drive Up or Target Restock
  • $5 gift card when you buy 2 select Iams, Pedigree, Crave & Nutro dog and cat food or Fresh Step cat litter items using in store Order Pickup
  • $5 gift card when you buy 3 select feminine care items using in store Order Pickup, Drive Up or Target Restock

All of these promotions will only run through 11:59 pm PT on Saturday, January 19, 2019 so make sure to stock up before they're gone!

Because the deals only apply to select products and certain colors, just be sure to read the fine print before checking out.

Target's website notes the "offer is valid using in store Order Pickup, Drive Up or Target Restock when available".

The gift cards will be delivered after you have picked up your order or your Target Restock order has shipped.

We won't tell anyone if you use those gift cards exclusively for yourself. 😉 So, get to shopping, mama!

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