ADHD: What You Need to Know Before and After a Diagnosis

My son was diagnosed with ADHD when he was 7 years old. It was the summer when he had finished first grade. His symptoms had appeared progressively since he was in preschool, but were often seen as normal behaviors of a young boy who was more interested in playing than sitting still in school.

He had started Kindergarten during the pandemic–such an unprecedented time for school-aged children, and even more for the youngest elementary school students. Like many other children, our son got used to wearing a mask and learning from a teacher with her mouth covered. Such generation of kindergarteners had to learn foundational reading skills without the visual cue of the teacher’s mouth movements to understand phonics.

Then, first grade started and masks became optional. As life slowly came back to normal, teachers began to share their concerns. At home, we started noticing differences between him and his younger sister in terms of compliance, attention, and follow through on given instructions.

The Signs

I get questions about symptoms from many parents and I always answer with caution, because in the case of our child, his were mild and easily overlooked and confused with child-like non-compliant behaviors or with other conditions. In fact, a study by the CDC conducted in 2022, the year of our son’s diagnosis, found that approximately 41.9% of children with a current ADHD diagnosis had mild ADHD. This is almost half of the kids diagnosed in that year.

I’m not an expert and I’m still learning, but I did have a strong feeling that something wasn’t right with our son. So I’m going to start by validating parents’ intuition. Take a look at the list of ADHD symptoms in children according to the CDC, and if you have observed any of these and feel something is off with your child, talk to your child’s pediatrician. That’s your first step.

In the case of my son, these are the signs teachers noticed in school and us at home, that prompted us to find a specialist to evaluate him:

• Difficulty focusing and maintaining attention. Easily distracted. If a pencil falls on the floor, children can lose focus for a moment, but rapidly come back to task. Our son’s attention got lost after a little incident like this, and he wouldn’t be able to finish what he started.
• Inability to complete a task. Teachers kept bringing to our attention incomplete classwork. At home, I would ask for simple tasks such as “clean up your room,” “pick up your toys,” “take a shower and put your pjs on,” and I would notice the difference between my daughter’s ability to follow instructions, and my son in the middle of the staircase playing with a toy he found on his way to obey Mom.
• This last one evolved into an inability to initiate a task. A concerning defining point came when the teacher showed us blank papers for almost all classwork. He wasn’t initiating any classwork at all. But when he was asked about any subjects taught in school, he would give accurate answers. He was learning, retaining the knowledge, but not delivering when he was expected to. At home, I clearly remember an afternoon after school. I had asked him to take a shower, and 15 minutes later, water was running and he was inside, dry. I’ll never forget the confused look in his eyes when he couldn’t explain why he hadn’t started taking a shower. Something was stopping him from doing what he needed to do.
• Frustration started building up quicker. As in class, everyone finished classwork, and peers started noticing and putting pressure on him. At home, I lost my patience more times than I would like to admit. To everyone around a child with ADHD, such a child seems careless and irresponsible. There’s a lot of questioning and pressure, so the child starts reacting with frustration. Tears, yelling, hiding, “get away from me” behaviors, anything to turn off from the discouraging voices of constant complaints.
• Forgetfulness and losing things frequently. This one is self-explanatory. All kinds of situations that, unfortunately, added to my child’s stress and mine, as a parent. 

Evaluation and Diagnosis

After two years of struggling in school and at home, we decided to speak to his pediatrician. She did a preliminary assessment that we then took to a licensed educational psychologist who conducted a comprehensive evaluation that included interviews with parents, teachers, pediatrician, hours of play and conversations with my son, and a variety of tests.

In a few weeks, we had a diagnosis in our hands: a 20+ page report with in-depth explanations of this condition and how it affects executive functions of his brain, and therefore, his daily life. The last pages were focused on recommendations to manage his symptoms at home and school.

Both my husband and I felt relieved, worried, and overwhelmed, all at the same time. Now what?

1. The first thing we did was research. Learn, learn, and learn about ADHD.

The parents become the spine of their child’s support system, so it is crucial to understand what ADHD is and what it is not. To start, I’m linking here a fact sheet with myths and facts about ADHD by the organizer of ADHD Awareness Month. This is not a learning disability. In fact, people with ADHD usually have a higher IQ and impressive intelligence. So well managed, a diagnosed child can thrive, grow, evolve, and succeed just like anyone else.

2. Understand the diagnosis, ask questions

The report specifies the level of the condition. It can be mild, moderate, or severe, and next steps depend on this. Our child didn’t receive a medication prescription because his type of ADHD is mild, but we got a “behavioral intervention plan,” which includes a list of goals and interventions to provide parent support at home and in the classroom to improve his attention skills. 

3. Become your child’s best advocate: discuss the diagnosis in a meeting with the teacher, parents, and school counselors

From the moment there’s a diagnosis in hand, parents become their child’s advocate. The voice that will ask, propose, work, negotiate, and fight, if necessary, for their child’s rights and needs.

This meeting became the beginning of a new life for our son. The school included its team of counselors, as well as a representative from the Miami-Dade Public Schools District, and us, the parents. We went over my son’s diagnosis and the recommendations included in his report.

4. Receive, understand, and support the implementation of a 504 Plan at school

This team met separately afterwards, developed what in Dade County Schools is called a 504 plan, and presented it to us. This plan is part of the rights of students with diagnosed disabilities and their parents, to “prohibit discrimination and assure that disabled students have educational opportunities and benefits equal to those provided to non-disabled students.”

From that moment on, that group of people became the school support system for our child. And guess what? In second grade, we started seeing A’s and B’s like never before. He received specific accommodations that provided the classroom environment he needed to succeed. The teacher and parents remained in constant communication.

This marked the beginning of a new journey for our family. Learning to live with our son’s ADHD.

To be continued…