Janice Rashbrook always knew her son Liam was not your average child - even before he was diagnosed with attention deficit hyperactivity disorder.
Rashbrook said Liam, now nine, didn't talk until he was three. Before that, he just growled, making a bear-like noise in the back of his throat that would startle elderly women in the shopping mall. "That's a bit different."
The Central Saanich woman said that by kindergarten, Liam would have four or five inconsolable crying jags every day. All kids cry, but not daily and with near-hysterical dread of something like playing with blocks and other kids. "Let's face it, nursery school is not that onerous."
So when Liam was diagnosed at the age of five with ADHD by a child psychiatrist he'd been referred to, Rashbrook said she wasn't really surprised. She knew her son was dealing with a disorder of some kind. It wasn't poor parenting or lack of family discipline or inbred bad temper. "He's really a good kid," she said. "[For] anybody who has a kid with ADHD, the diagnosis doesn't really come as a surprise. It was more like 'OK, Thanks. Now I can put a name on it.' "
The diagnosis provided new freedom for mother and son. They could pursue behavioral therapies with qualified counsellors. And they could make decisions about medication, gutwrenchingly hard but undertaken within a year of the diagnosis. "He is so much more comfortable in his own skin now that I feel so much better for him," said Rashbrook, who notes that an earlier diagnosis might have made her family life a whole lot easier.
"Some of that cognitive behavioral stuff would have been useful," she said. "It would have been nice to have somebody to tell me, 'OK, when you are looking for this result, you need to take things in smaller steps or you need to do this.' "
According to the Hospital for Sick Children in Toronto, about one in 20 kids in sa国际传媒 have ADHD. ADHD sa国际传媒 says about 35 per cent of children in sa国际传媒 referred for mental-health help have symptoms of the disorder.
Mental Health sa国际传媒 lists inattention, hyperactivity and impulsively as the main symptoms. While all three are normal in childhood, with ADHD, the symptoms become significant problems, affecting a child's learning, safety and relationships.
The disorder is most commonly diagnosed around the ages of six or seven, when the condition often becomes more noticeable in relation to classmates. But new research, mostly from the United States, suggests ADHD is based on a biological condition in the brain and its symptoms can be apparent as early as ages three or four.
Dr. Mark Mahone, director of neuropsychology at the Kennedy Krieger Institute in Baltimore - which specializes in injuries and disorders of the brain in children and teens - is using brain imaging to look for markers of the disorder.
Mahone said watching for behavioral indications in preschoolers can result in earlier diagnosis and treatment.
That doesn't just mean medication, however, he said. Behavioral psychologists have devised a series of therapies for children and strategies for parents to manage symptoms, change negative behaviors and improve school success.
With that approach, there's little downside to misdiagnosis, since the child simply learns new strate-gies to concentrate or remain focused. The benefits of earlier intervention for a child with real ADHD, however, are worth the extra effort.
"If you really do have the disorder, the longer you go without appropriate treatment, not just medication but a comprehensive care plan, the longer you go without that - the worse the outcomes are," said Mahone in a telephone interview with the sa国际传媒.
"Those who do have comprehensive treatment do a heck of a lot better."
Prof. Kimberly Kerns, a neuropsychologist at the University of Victoria who studies ADHD, said she has reservations about evaluating young children for the disorder.
Kerns said preschoolaged children vary widely in development and maturity, especially when it comes to things like attention span or concentration.
"Go to a typical preschool and there is a huge variation in how well they are able to sit in a circle and listen to the teacher telling a story," said Kerns.
She warned parents against using a list of 10 areas of concerns as a diagnostic tool. Instead, she called it a checklist to help parents decide whether to have their child assessed, something that should only be done by a qualified doctor, or mental-health specialist in child development.
For Laurie-Ann Timlock, of Colwood, an early diagnosis from a pediatrician for her son, Grayson, now eight, practically rescued her family. "We can all enjoy each other now."
She said Grayson was diagnosed by a pediatrician at the age of three and she and her husband, Geoff, made the difficult decision to try medication soon afterwards.
Her son went from a child who would never sit still to a little boy who would listen to a story, she said. As the parents began to read about the disorder on their own and seek advice from professionals, the daily battles at home started to get easier.
On the advice of a child psychologist, for example, the Timlocks stopped trying to make Grayson sit and eat supper with his parents and brother Mackenzie. Instead, they allowed him to stand and eat. If he ate a few mouthfuls, that was OK.
They learned strategies so they weren't always being negative with Grayson, recognizing and congratulating good behaviour instead.
"Before, we were always saying 'No,' " said Timlock " 'No, Grayson, you can't climb that. You have to get down you'll hurt yourself.' Or 'No, you can't run into the street.'
"[Now] when he has actually done something good, you can recognize that."
She is also able to share those strategies with childcare specialists and teachers - one of whom once told her it was her parenting that was to blame.
Timlock said the diagnosis gave her confirmation of something she had always known: Grayson is a good boy who deserves to be well-treated and loved.
"He is not a bad child. There is a reason why he acts the way he does," she said.
"That was a big thing for me because he isn't a bad boy, he really is a great kid. It's just his attention span is very, very low."
SIGNS TO WATCH FOR
10 possible indicators of ADHD. Concerned parents should seek help from a professional such as a family doctor or mental-health specialist.
1. Dislikes or avoids activities that require paying attention for more than one or two minutes.
2. Loses interest and starts doing something else after engaging in an activity for a few moments.
3. Talks a lot more or makes more noise than other children the same age.
4. Climbs on things when instructed not to do so.
5. Cannot hop on one foot by age four.
6. Nearly always restless -
wants to constantly kick or jiggle feet or twist around in his/her seat. Insists that he/she "must" get up after being seated for more than a few minutes.
7. Gets into dangerous situations because of fearlessness. 8. Warms up too quickly to strangers.
9. Frequently aggressive with playmates; has been removed from preschool or daycare for aggression.
10. Has been injured (for example, received stitches) because of moving too fast or running when instructed not to do so.
- Kennedy Krieger Institute
