Worried your child might be ADHD? Start here.

At least 5 percent of American children have Attention Deficit Hyperactivity Disorder, or ADHD. Today, we’re speaking with pediatrician Dr. Rachael Fournet who takes us through some key points about ADHD in less than 30 minutes. If you’ve got a child who’s ADHD or think they might be, you may be just feel a little better after listening to what Dr. Fournet has to say.

Transcript:
Roland Wilkerson 0:06

At least 5% of American children have ADHD. According to the US government, it can wreak havoc in the classroom cause big problems at home and seriously damage a child's self-image, which can unleash a whole other set of problems. I'm Roland Wilkerson with Novant Health, Healthy Headlines. And today we're speaking with pediatrician, Dr. Rachel Fournet, who takes us through the key issues around this in less than a half hour. If you've got a child who's ADHD or you think they might be, you might just feel a little better have you here with Dr. Renee has to say here.

One footnote, for many years, there was a distinction between ADHD and ADD. But today, the formal name is ADHD. But it still gets called ADD and everyday conversation. And that's what we do in this discussion.

Dr. Rachel Fournet 1:09

So the way I describe it to parents is that everyone is born with a certain set of cards that makes up their temperament. So everyone is either an introvert or an extrovert, they are a high energy person or a low energy person, they are high intensity or low intensity. So when they feel happy, they're very, very happy, or when they feel sad, they're very, very sad. And then there's also children that are high at fast adapters, which means that they can kind of go from activity to activity very quickly, versus a slow adapter, which those kids don't do well going from activity to activity. And they need, they need more guidance and more mornings, "in five minutes, we're going to go get ready for bath," "in two minutes, we're going to get ready for bath." So these these different cards that make up your personality and your temperament can sometimes look very much like add. So a child might be fast adapting high energy, high intensity. So they are bouncing all over the place, they're going from activity to activity quickly. And they might be really loud and really excited. And that can look like a child who might have a hard time in a classroom setting. But it doesn't become ADD until their function is impaired. So that's the line that has to cross they need to actually fail to function in a classroom setting. So a lot of it might be that we've had warning signs, we've been wondering how they would do in kindergarten. But we're not going to know until they're there until we get those reports back from teachers when we start seeing that they're not keeping up with their peers, because their temperament is now impairing their functioning in a classroom setting. Okay, a lot of kids, it might be that the classroom is really hard, and they have a hard time functioning, but they're fine in the mornings at home, getting out the door on time, eating their dinner, going to bed, where their ADD maybe doesn't affect all aspects of their life. But then there's some kids where from sunup to sundown, their inability to rein it in and follow a task and stay on focus does start to affect how they function within their family unit as well.

Roland Wilkerson 3:20

And so typically, it sounds like you're saying it really presents itself or it really becomes evident to parents and teachers when the child starts school.

Dr. Rachel Fournet 3:32

Correct and usually sick 5,6,7 years old tends to be when these conversation starts happening. So what I do first with parents is really break down what part is the child's you know, inherent personality, what other things in their environment and in their lifestyle could be contributing. So I always go through a very thorough diet history asking about what are what are they eating for breakfast, lunch and dinner? How much sugar are they getting in their diet, there's been some more, I guess, subjective findings where parents have found that artificial dyes have kind of affected their child's add and made it made it worse, I think the main thing that they should look at is just clean eating. So where you tend to find dyes, you also tend to find sugars. And so is it the diet or is it the sugar either way, they probably shouldn't be eating that fruit snack, or the Starburst candy or, you know, cookies or a muffin for breakfast. So looking at their diet, looking to see if they have a good energy outlet. So every child wakes up with a certain amount of energy every day that they need to flush out of their system. When children are on iPads, and they're playing video games after school and they sit all day in a classroom, when they sit when they get home. They never flush out that energy from their system. And that can look a lot like ADHD, they're you know that they're pent up, they're bouncing all over the place. They're not listening, they're, you know, impulsive and hitting their brother. And sometimes you just need to like harness that energy, get them involved in sports, karate is fantastic ride their bike, even if they don't need to join a sport, have them like run laps around the house before dinner and time them with their siblings to have a race and see who's fastest. You know anything to say that you know that they're kind of burning it off. And then I also want to have a good sleep history. So poor sleep can look like add the next day. It is very hard to focus if your brain did not get to recharge the night before. And so finding out you know, does a child go to bed at a reasonable hour meaning usually before 9:30, 10:00pm? Are they getting good quality sleep? Are they snoring? Are they restless? Do they wake up after 10 hours but still seem really tired and groggy? Are they school age but still taking naps? Those are all signs that maybe there's something disrupting their sleep causing them to look like they have ADD in the classroom. And then the last piece of the puzzle is rolling out that there's an any other comorbidity happening like anxiety or depression. And in little kids, sometimes anxiety doesn't look like it does in adults. It doesn't always, you know, kids can't verbalize "Oh, well, I can't fall asleep tonight, because I'm worried about what's going to happen tomorrow in school." No, instead, they you know, they avoid going to school, they get stomach aches before school, they get headaches before bed. They physically feel their worries. And so if a kid has a lot of anxiety, especially about school, well, when they're in school, they can't focus because their brain is going a million miles a minute thinking about all the things they're worried about. So they can't do the task at hand. So by asking all of these questions, usually we're able to kind of paint a picture of, you know, do we need to work on some things first, and get out sugar from the diet, maximize exercise, maximize good quality sleep, make sure there aren't other anxieties and comorbidities, then we try to get feedback from the teachers. So the tool that we use is usually the Vanderbilt form. And that there's a parent and a teacher one. And what that is helpful with is knowing are these issues happening in both places. Because sometimes you'll have teachers raising the child very high on the Vanderbilt saying that they have a DD, but the parent who maybe is not ready to move forward with medication management, they rate that the child has zero symptoms. So that will then lead to conversations of readiness like are what are you worried about? Are you worried about a stigma? ...