The question: My child's teachers think he may have ADHD. Our family physician knows him best, but always refers these problems to a specialist. How can we trust a stranger will make a proper diagnosis?
The answer: If your child's teacher is concerned, then further evaluation is certainly justified, and the sooner the better.
The first step is to ask your child's teacher or school principal if they can refer your child for evaluation by the school board psychologist. Educational psychologists are able to screen for ADHD as well as learning disabilities. In many communities, educational psychologists can be hired privately to do this testing, but expect to pay as much as $2,000 for a full evaluation.
Next, I suggest that families seek their doctor's help. Although family physicians are well versed in pediatric care, ADHD is a complex problem that is often best referred on to an ADHD specialist, typically a community pediatrician like me. While you are waiting for the pediatric appointment, consider getting your child's vision and hearing tested. Hearing and vision problems are surprisingly common and can cause symptoms that mimic ADHD.
The fact that the specialist is new to your child is not really an issue. Expect the pediatrician to take a detailed history of your child's strengths and weaknesses in the classroom, as well as ask questions about your child's general health and any other psychological factors that may be affecting your child's ability to perform at school. I always appreciate it when parents bring report cards or other recent school correspondence to their first appointment in my clinic. Often I will ask for questionnaires to be completed by parents and teachers. These questionnaires are designed to identify both the extent and severity of ADHD symptoms. The questionnaires can also be helpful in monitoring the effectiveness of treatment.
Bottom line: Don't hesitate to get help for your child, even if it means evaluation by someone new.
Dr. Michael Dickinson is the head of pediatrics and chief of staff at the Miramichi Regional Hospital in New Brunswick. He's a staunch advocate for children's health in Atlantic Canada through his involvement with the Canadian Paediatric Society.
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