We have often felt sorry for those impulsive children who blurt out the first thing that comes to their mind when asked a question, especially if they are about to get into trouble. As most parents know, that first thing that comes out as the answer is usually a lie. And then the child has to spend the rest of the hour covering up the lie, that both he and his parents know is a lie. This is a classic scene of a child with ADHD getting into trouble because of his impulsivity.

As a remedy, we encourage parents to warn the child that they are about to be asked a very serious question, and that their honesty is absolutely required. And that the child is not to answer the question for 30 seconds after being asked, so that they can clearly think about what they want to answer and get it right the first time. This works.

But it is not what this article is about...

Impulsivity in ADHD

Impulsivity in ADHD is seen in two ways: (1) either doing or saying something without thinking first; or (2) not saying "no" to yourself, inhibiting yourself, when you ought to do so.

It seems that a person with impulsivity as a part of their ADHD has a normal ability to say "Go" at the neurological level, but their ability to say "No" or "Stop" comes just a fraction of a second slower. As a result, things are often done, or said, without much self-control practiced.

Why does it seem that there are so many children today with the diagnosis of Attention Deficit Hyperactivity Disorder - ADD ADHD? As I get older the answer becomes clearer to me.

The reason there are so many children diagnosed with ADHD today is that physicians, psychologists, therapists, and/or parents, rush to this diagnosis without doing their "due diligence" in the diagnostic process.

Here is what happens...

• A physician, psychologist, or therapist is well versed in the diagnostic criteria for ADHD.
• A parent brings in a child for an evaluation because of behaviors at home or at school.
• The child meets the diagnostic criteria for ADHD.
• Therefore, the child has ADHD. Simple.
• Mission accomplished!

But this is absolutely the WRONG WAY to make the diagnosis of Attention Deficit Disorder.

So you have just returned home from your third meeting with your child's teacher. She tells you that your child is not getting his work done, he cannot sit still, and he is simply not going to have any success in school unless something changes. She suggests that you talk to someone to see if he has ADHD. What do you do next?

This can certainly be a difficult time in any family, so we would not want you to be uninformed as you take the next important steps. Here are the things that we recommend if you have a child that ought to be looked at for possible Attention Deficit Hyperactivity Disorder.

First, there should be an "adequate" physical exam by the child's pediatrician or family practice doctor. This doesn't have to be an extensive, expensive exam, but should be able to rule out possible problems like Mononucleosis, Thyroid problems, lead poisoning (if it is common in your area), and potential attention problems caused by medications, such as allergy medications. Then, with a clean bill of health, we move on to step two.

Second, get an evaluation for attention deficit hyperactivity disorder. Usually a psychologist or other mental health professional will do this evaluation for ADD ADHD. But please, only get counseling or therapy from professionals who have a lot of experience treating attention deficit hyperactivity disorder. Therapists who do not have a lot of experience with ADD ADHD will just take your money and then probably blame you, the parents, for the child's disorder. Find experts on attention deficit hyperactivity disorder in your area. Ask around at your local CHADD chapter. Call you local Psychiatric Hospital and ask for the Child or Adolescent Unit. Then ask for the "Charge Nurse." Ask the Charge Nurse who the best psychiatrists and therapists in your town are. They know.

The Evaluation

When you get an evaluation for attention deficit hyperactivity disorder, there should be a good parent interview. It's absolutely essential that somebody sits down with the parents and spends 45 minutes to an hour with them. The psychologist or therapist needs to find out what's going on now, why did the parents pick up the phone and call now instead of last week, and so on. A good developmental history on the child must also be taken. Important questions are: