Docs Overlook After-School Treatment of ADHD
Many Treat ADHD as School-Day Disorder
"These study results are hopeful," Sumner tells WebMD. "Parents will feel validated because they have observed these findings all along. Physicians will find it helpful because learning better ways to interact with patients is valuable. The better the connection between the family and the doctor, the better the outcome for the patient."
The results underscore how important it is for parents of children with ADHD to communicate their observations to the physicians who treat their children, says Patricia Saunders, PhD, who was not involved in the study. "ADHD symptoms are not necessarily constant during the day," Saunders tells WebMD. "The behaviors that physicians measure and observe may not be the same as those that are seen at school and home." She is a child psychologist and ADHD specialist at Graham Windham in New York City, a child welfare services center where she is the director of the mental health clinic.
She points out that two issues can affect whether a child with ADHD will have symptoms during off-school times, the external structure provided, and the type of medication used to treat the ADHD. She says children with ADHD often do better with planned after-school activities, while time at home may be more fraught with sibling arguments and conflicts over setting the dinner table.
"Home is the most unstructured environment, and that's where the ADHD symptoms are going to come out," she tells WebMD. "Therefore, doctors should listen to parents when they offer observations about problems at home."
If the doctor treating the ADHD thinks that the child's condition is controlled, but the parent thinks otherwise, "the parent needs to ask the doctor, 'What are you looking at?' and 'How are you looking at it?'" she says. "In order to determine whether the child's condition is adequately controlled, the treating professional needs a triangle of information, which includes the teacher's report and the parent's report, as well as the physician's observation."
She encouraged parents to be assertive and proactive in the care of their children. "If you see something the doctor doesn't, spell it out for the doctor and raise questions," she tells WebMD. "Insist on being heard. Parents are the best observers of their children."