Can you diagnose a child with ADHD? And what do you do next?

While it is one thing to talk fashionably about the DSM criteria, making a diagnosis of ADHD remains a challenge, not only to a dentist but also to Pediatricians and even experienced clinical psychologists. As Prof Malavika Kapur, one of India's leading psychologists told us, " We took a group of trained teachers and asked them to diagnose 300 students for signs of hyperactivity, of the 30 children diagnosed by them, only 10 had ADHD". It has often been reported that the chances of either under-diagnosing or over-diagnosing ADHD are indeed high. So what can we do.

Patients who are Known to suffer from ADHD

In such cases the dentist can gear up to treat the child and be prepared to handle the hyperactivity or absence of attention. See section on treating a child with ADHD

Patients whom you suspect of having ADHD

Telling any parent their child may not be normal can be a daunting task. Telling them this when there is a good chance you may be wrong makes the task even scarier. The anxiety of telling the parent can be greatly reduced by adding a few questions to your history.

"What Class is your child studying in?" This seemingly innocent question will give you a good idea if the child is having trouble keeping up with lessons. Or if the child is continuously fidgeting, then a ,"Is he like this in school?" is often enough to get the parent talking about the child's problem. A surprisingly large number of parents actually want to talk about the difficulty their child is having with a doctor. But it is important to note that a parental history of the child being a bit overactive is not diagnostic of ADHD.

If however you still feel the child has the signs and symptoms of ADHD then you are better off referring the child to an experienced clinical psychologist. In India a visit to the Psychiatrist or Psychologist is still viewed as a sign of madness. It is therefore better to put the matter as gently as possible and explain to the parent that ADHD is not mental retardation and in most cases it does not persist into adulthood. If all else fails then of course you can always point out the example of the  man who is arguably the most famous ADHD sufferer of all time : Micheal Phelps