Adolescence Mimics AD/HD

Several times a month, I get a phone call from a parent, wanting to have a child evaluated for AD/HD (Attention-Deficit/Hyperactivity Disorder). I often do a good bit of the evaluation over the phone … How old is your son? 14. Has he ever had any trouble in school before? No. End of evaluation, he doesn’t need treatment for AD/HD right now. Why not? Because AD/HD shows itself in children before the age of 7. A kid with AD/HD is going to have some sort of trouble of some kind before age 14. If he has never had trouble before, it’s not very likely to be AD/HD starting at age 14. If a child actually did have AD/HD and coped with it and compensated for it for 7 years without any professional assistance, he’s brilliant, motivated, conscientious, and should very much be commended for his fantastic work. He’s probably tired and needs a break, but he probably doesn’t need medication or any other treatment for AD/HD. He might be so tired that he’s actually depressed, in which case, treatment for depression might be in order, but once restored to his original state, it is still fairly unlikely that the AD/HD will actually require elaborate treatment. Perhaps some advanced techniques could be taught, but chances are, the kid already has a handful of useful tools that helped him get this far without additional help and he’ll probably be okay doing the same from here on out. In the event that the child actually was showing signs of AD/HD as early as 7 years of age and no one ever got him any help until he was 14, he may very well have AD/HD, but that isn’t even the most important problem. What’s more important is the fact that no one got him adequate help for half of his life. He’s probably angry and has every right to be. That should be addressed before any AD/HD treatment should ensue. The problem, in all likelihood, could be the simple fact that the young man is 14. There is something terribly difficult about that age that I do not fully understand, but I would say that if you look at my child clients, a good 40% of the boys are 14 years old. For this age group, a drop in their grades often occurs for a variety of reasons including the increased difficulty of high school material, the complexity of the social scene, increasing awareness of and interest in girls, unpredictable or uncomfortable body transformations, or rejecting parental values. In summary, adolescence can easily mimic the symptoms of AD/HD and if you are seeking a first evaluation for AD/HD for a child in the 14-18 year-old range, AD/HD is not totally ruled out, but there are very likely other problems or issues that need to be addressed first.