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At what age should a bright child with attention deficit hyperactivity disorder (who is not taking medication) be told she has ADHD? Should she be told at all?
In many cases there would be no reason to tell a child who is not on medication that she has ADHD. Instead, parents should concentrate on encouraging the positive behaviors that she does manage to demonstrate. For example, if your daughter struggles with paying attention and staying on task, and you observe her working hard on schoolwork or crafts in which she is truly engaged, you could comment directly to her, or indirectly to your friends or family within her hearing (referential speaking), that she’s really learned to be attentive and work hard. If she hears that about herself, she will be more likely to think of herself as a child who perseveres and takes pride in doing good work.
ADHD is not a black and white diagnosis. Instead it can be a matter of degree or lie on a continuum of behaviors. Motivation and engagement make a great deal of difference in every child’s ability to concentrate and control impulses. For all of us, it’s harder to concentrate on things we don’t care about; but when we’re very interested, our concentration and learning improve. The same holds true for a child diagnosed with ADHD .
On the other hand, if your daughter has an official diagnosis based on testing and evaluation by a psychologist or psychiatrist, she will hear adults having conversations about that diagnosis. If she could overhear such conversations, it would be better to explain the diagnosis to her rather than letting her worry about, or misinterpret, something she hears people attributing to her.
Should you decide that your daughter would benefit from taking medication, it would be important to explain the reason — that the medication will help her to concentrate more easily. You could also emphasize that having a diagnosis does not mean she can’t concentrate; only that it’s a little harder. We don’t want your daughter to use a diagnosis or medication as an excuse to avoid taking responsibility or to lead her to assume she’s incapable.
If your daughter overhears the doctor explaining her problem behaviors to you, you may even need to clarify the doctor’s explanation so that it doesn’t disempower her. Doctors are often in a hurry, so sometimes they simply describe the characteristics of a disorder in ways that could cause a child to feel as if she lacks control over her behavior. I don’t think that always happens; but if you’re sensitive to what the doctor has said, you can explain further to reassure your daughter. If you have further questions you’d like to ask the doctor following your visit, it’s probably best to ask your daughter to go into the waiting room rather than cause her anxiety by listening to more information than she can handle.
Dr. Sylvia Rimm is a child psychologist and clinical professor at Case University School of Medicine, author, newspaper and magazine columnist, and radio/TV personality. For a free newsletter about ADHD (attention deficit hyperactivity disorder), send a self-addressed, stamped envelope and a note with your topic request to P.O. Box 32, Watertown, WI, 53094. Read Dr. Rimm’s Articles for Parents and Teachers and submit family questions online at www.sylviarimm.com. All questions are answered.