Psy-Q: How should clinicians respond when a parent is seeking a new ADHD diagnosis for their child during COVID-19? Randy Bressler, PsyD, answers.

Randy Bressler, PsyD

Randy Bressler, PsyD

Answer: It’s important for clinicians to get the full picture of the child’s behavior in order to make an accurate ADHD diagnosis, says Randy Bressler, PsyD, an ADHD expert who practices in Milburn and Randolph, NJ. He stresses that ADHD is just one of many possible explanations for why a child or adolescent may be having trouble focusing during the pandemic, especially if learning is online and social outlets and recreational activities are changed or canceled.

His advice to clinicians when working with parents who are seeking an ADHD diagnosis (whether hyperactive, inattentive, or combined) and medication to treat the symptoms is to convey to them that it is important to review many factors that could be contributing to difficulties with attention, restlessness, frustration threshold, and disorganization. This conversation should be part of a multipronged process that includes:

  • interviewing parents/caregivers
  • meeting with the child
  • obtaining feedback about a child’s/teen’s behavior in multiple settings, including school.

Understanding the various influences that may be impacting a child’s functioning is essential to arrive at an accurate diagnosis, and educating caregivers is also an integral part of this process.

“I would tell parents that we want to ensure this is the right diagnosis,” says Dr. Bressler. He points out that in children and adolescents, ADHD often occurs along with a mood disorder like anxiety and/or depression and it is hard to separate out the symptoms. Even when a child does have ADHD, he says that they often won’t need medication, at least initially.

“ADHD can be treated with cognitive-behavioral therapy (CBT) interventions that can teach the child to self-regulate and manage impulses, and can provide strategies to help with organization,” notes Dr. Bressler. He also stresses that children and teens with ADHD often need some support from their school to manage academic workload and may also require some accommodations and/or in-class instructional support – with or without medication.

He adds that he likes to use standardized questionnaires to gather input from the students, the parents, and teachers to get the full picture of the behavior in order to make a diagnosis.

“Questionnaires can’t diagnose ADHD but they can tell you when someone presents with the signs,” he says. (See Dr. Bressler’s overview of current ADHD assessment tools, their benefits, and limitations.)

Finally, he stresses that it’s important for everyone to remember that ADHD is different than “Zoom fatigue.” The latter occurs when people are attending virtual meetings or classes for an extended period of time and their brain gets tired trying to make sense of the information they receive. In some children, this can cause them to do poorly in school or be less engaged in their work but in fact, it is not caused by ADHD.

 

 

Last Updated: May 3, 2021