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Early Assessment for ADHD

Dr. Tami Moses Recommends Assessment for ADHD in Preschool

article by Osnat Opher in the newspaper, "For the Woman"

"Do you feel that your child is mischievous more than what's normal or accepted, but it was hinted to you that these worrisome signs will pass when he grows older, or they explained that it's not possible to diagnose ADHD before six years old? "If it seems to you that there's a problem, don't wait. The earlier you evaluate and treat, you'll prevent damage in the future", warns and recommends Dr. Tami Moses, child and adolescent psychiatrist. "Parents feel that when their child's behavior exceeds the realm of normal, then it's worthwhile to consult with the preschool teacher who sees the child with children of his own age".

"There are children who in infancy already show signs of ADHD, but many parents refrain even today from evaluating ADHD in preschool because of a lack of understanding or a lack of awareness regarding the problem", says Dr. Moses, director of the ADHD unit at Nitzan Israel, who previously directed the children's unit at the Psychiatric Hospital in Nes Tziona. There are children who it's possible to diagnose them already at a young age with difficulties and symptoms that other children begin to show only in kindergarten or first grade in the learning context. With the children who develop early, they learn to walk and even talk early relative to their peers.

"However, not every mischievous child is hyperactive, but if besides the mischievousness the child has difficulty sitting quietly and playing alone, isn't able to concentrate or pay attention to a short story, and mainly, if it is diagnosed that he has difficulty acquiring social skills, then it's likely that he's suffering from ADHD."

"With social skills the intention is, for example, the ability to play a social game with another child, to relate to the other's needs, to understand body language and facial expressions, to fit in with groups of children, and to cooperate with them. These are abilities that begin to develop around 3-4 years of age. If his frustration level is low, he's occasionally aggressive with other children, doesn't manage to wait in line, always has to be first, grabs toys and candies without permission or disturbs at preschool, then it's a good idea to check this out."

"It's important to stress that specifically when the symptoms start at a young age, then it's likely that the severity of the disorder is great and the difficulty to cope in the future will be greater because the child develops behavioral problems that result from a low self-image and from the difficulty to fit in socially."

What Can Be Done?

"It's important to stress, if ADHD is identified at a relatively young age, then it's possible to treat the child. In most cases, medication, such as Ritalin, is not recommended. The treatment is based on training the parents. Parents need to receive information, to understand that their child has a problem that he was born with, usually genetic, and that he's not just mischievous and doesn't listen for any reason. Understanding the problem brings to change. Besides working with parents, it's recommended to work with the preschool teacher as well. The training guides how to behave with the child, how to set limits, how to help him develop social skills, to develop behavioral strategies and so on.

Who Do I Turn To?

"The diagnosis in preschool-aged children is also clinical, in other words, it's based on the symptoms that characterize ADHD, but the evaluation is performed differently than the way it is done with older children. In centers for child development, there are experienced professionals in diagnosing ADHD in pre-school aged children; also most of the neurologists and psychiatrists know how to diagnose in the young ages. In Nitzan, we have a multi-disciplinary unit for learning disabilities and ADHD. We have parents' groups and offer individual training for parents as well".

What do you suggest to parents who have been told that it's impossible to diagnose ADHD before six years old?

"They should stubbornly insist. It's very important to diagnose and treat at a young age, and it's possible. If we don't help children develop social skills, then it won't be possible to fix this when they're older. Without social skills that are acquired at a young age, the child is likely to suffer in adulthood from difficulty forming intimate relationships, developing effective parenting skills, and developing social relationships and the like. We're speaking about many difficulties and much unhappiness, since in my eyes development of social skills is more vital than learning skills."

Information and further suggestions can be heard in Dr. Moses's lecture "ADHD in the Cycle of Life". The lecture will be given within the framework of the "University for Parents" which is a product of a partnership between Tel-Aviv University and Nitzan Israel.

Taken from an article by Osnat Opher in the "For the Woman" newspaper on 19/10/09