ADHD

The school year is about to start and some parents are worried about their child's lack of attention, impulsivity and/or level of activity during the school year. They ask me things like: "should I get him/her tested?",   "should we medicate?"
It is difficult to differentiate between an active child who is able to pay attention when the subject is of interest versus a child who is hyperactive and unable to pay attention even when she/he wants. 
I suggest parents first try to implement behavioral modification changes to see if the issue can be resolved.  A good program that helps parents is "Behavioral parent training". Even if your child does not have ADHD the simple fact that you are worried he/she may have means that you could benefit from a change in how you are parenting.  
If the behavior continues then it is time to get a thorough diagnosis.  If the diagnosis is that the child has ADHD, then medication may be used by parents.
The decision to medicate a child who has an ADHD diagnoses is a difficult one. In order to make the best decision for your child I suggest parents consider the following steps. 
1- verify that your child has been diagnosed appropriately 
2- get a full physical of your child including levels that are related to attention/focus (e.g. iron, zinc, magnesium, B vitamins, etc). Some studies say that Omega 3 fatty acids  help ADHD symptoms so you might try using those for a while. 
3- see if symptoms are worse when your child has not had enough sleep or is hungry. If you notice a difference,then address those first. For instance, create sleep and eating schedules and stick to them.
4- consider the possible negatives of medication (e.g. decreased appetite, decreased weight, unknown side effects, financial, etc) versus the positive (e.g. higher attention, higher grades, less anger, less fights, etc). 
5- make a list of questions to ask your pediatrician and any other mental health professional (psychologist, clinical social worker, licensed mental health counselor or licensed marriage and family therapist).  Parents often feel overwhelmed by a diagnosis so having a list is the easiest way to not receive too much or too little information. 

It is important to know that just because a child is taking ADHD medication it does not mean that the parents should not be continuing with behavior modification programs. About two thirds of ADHD kids will continue to have symptoms throughout their lives so learning how to manage their symptoms is extremely important. This is the area where mental health professionals can help.  Also about 50% of parents who have an ADHD child fit the criteria for depression. Parents need to make sure they take care of themselves, in order to minimize and treat any depression that they may have.