- [Radio Host] Okay with me this morning is Dr. Laura Gerak,
and she is the Clinical Director of Psychology
at Akron Children's Hospital.
I reached out to Dr. Gerak to talk about ADHD.
We've heard more about ADHD in the last decade,
with diagnosis and treatment, than we ever have.
And there's so many questions about, hey,
what's under that spectrum of ADHD and when is it ADHD,
and when is it my youngster just growing up
and learning their way?
And, and Laura, thanks for accepting the invitation
this morning. Talk, I guess, first of all,
about the diagnosis and what ADHD is.
- [Laura] Absolutely, good morning.
So ADHD is attention deficit hyperactivity disorder.
Children and adults, adults can all be diagnosed with it,
but it is typically diagnosed in childhood.
And that stands for, some children have ADHD
that is an inattentive type, so they're not hyperactive,
but the intention is the prevalent symptom.
Others have ADHD, it includes hyper activity.
They also will have activity.
It's a neurodevelopmental disorder,
and most folks know it, or think of it with regards to
trouble paying attention. Kids can be easily distractible.
They can be impulsive, and sometimes overly active.
But again, that's not necessarily for everyone.
One of the things you like to remind
folks of is a medical diagnosis.
So I think sometimes you refer to a lot of things, and
somebody who looks inattentive, as though they have ADHD.
And you should not jump to that conclusion,
because it's not that simple, and it may or may not be that.
But it is one of the hallmark symptoms of it. Absolutely.
Do you want me to follow up with how you may know some
differences between ages in children?
[Radio Host] Yeah, go, yeah. Yeah, go right ahead Dr. Gerak.
[Laura] Yes, now I think as you said, the biggest thing is,
how do I know, is this my child, is this gender related?
You know, boys, may be more active than girls,
not to assume, but also just age appropriate.
So one of the things that we say is that usually onset,
although it's present before then,
we may really start looking at it around age four.
And then common diagnosis is between ages six and 10.
When I'm working with families, I often say,
if they're seeing signs earlier, they're questioning,
or they're wondering, certainly monitor, you know, you know,
be thoughtful or keep an eye on it,
but don't come to the conclusion.
You don't need to rush to be diagnosed.
It really, because those might be
developmentally appropriate. And so a two year old
having symptoms like that, very exultantly common.
Three, four year olds, again,
could still be truly within the normal range.
And I've also seen children make big advances
in just even over a summer potentially.
So in June, they would've looked very much,
you know, inattentive and overactive.
And then probably by September, sort of developmentally they
have caught up with themselves. They've settled in.
And so you don't want to be too quick or overreact.
When we actually do diagnosis, you know,
you want to go to your pediatrician.
I think that tends to be about 50% of cases
that are diagnosed. And certainly one of the most
common and easier known, go-to folks.
Psychologists can diagnose, psychiatrists can diagnose,
but it's usually done in tandem with a couple of different
folks, usually parents or caregivers, teachers in schools.
Cause some of the things that we're looking for just,
you know, in response to your overall question is,
are there symptoms across the environment? If somebody is
having troubles in just one area, you know,
just at school or just at home, it may or may not be ADHD.
So when we're doing our assessments,
we're looking to see if these symptoms are showing,
are, you know, showing up in more than one environment.
And so we also do checklists, we'll do reading skills,
and we'll get the input of folks who
are in their environment, in different areas.
So that way it may not just be one person
who's experiencing this, but being sure that the behaviors
and the experiences they're having are across the board.
And then the last piece that we look for is,
is this actually interfering with their development,
with their school, with their learning?
Sometimes, you know, kids may have symptoms,
they might be mild. Again, they may be sort of,
as they develop, mellowing out.
But if they're very bright, they're able to compensate,
they find the strategies.
It may not be interfering with their growth,
with their development, with their learning.
And so at that case, and that's one of the things
that deciding at which point do you really trigger,
this is now a medical diagnosis because it is interfering
with their growth and their ability
to learn and move forward.
- [Radio Host] With us is Dr. Laura Gerak
with Akron Children's Hospital,
she is the Clinical Director of Psychology there.
And Laura, the diagnosis, I think,
has just been terrific with these kids and it's important.
And I thought maybe you can go down this road for parents,
to really pay close attention to their kids,
because it can be life changing.
Instead of, that's just little John being little John,
if you notice this and you see those patterns
that you talked about, it can be
life-changing in a good direction for these kids.
So I think parents, certainly the medical profession,
we've all done a better job of being educated
on what ADHD is all about.
- [Laura] Absolutely. Absolutely, and part of it,
I think, exactly as you said,
it affects so many areas of a child. Their self-esteem,
you know, how they learn, you know,
their own experience the success. So when you see something,
you know, as opposed to just dismissing it, you know,
understanding it, assessing is this the right thing,
cause maybe it could be something else.
And then making sure that you're teaching them,
behaviorally working with them,
meeting them where their needs are, oh my heavens.
Like you said, you see a completely different child
when that's being addressed, as opposed to ignore it
and just being frustrated sometimes.
Or the children just feel like
they're just not getting it right all the time.
And that's just, that's heartbreaking for the little ones,
frustrating as they get older,
and then sometimes it can really turn young people off
to education and other things.
So checking it out early, getting the right assessments
and addressing it makes a huge difference for any,
like you said, young people,
but also teens and into adulthood.
- [Radio Host] Yeah. Laura what's treatment?
Talk about treatment for, for our parents, listening.
- [Laura] Treatments, a couple of front lines,
number one is usually behavioral,
and it is parent training.
A lot of times, families want to bring their children in
and fix them, or make them just be instantly better.
And it's like, no, no, it doesn't work that way.
With this diagnosis, it really is, you know,
the adults and the children working together.
So, parents, there's a lot of training
in terms of education, advocacy,
understanding what this is, because one of the things
parents always tell me is once they understand,
you hear this aha, like, oh, now I get it.
Kids who experience ADHD can be developmentally
behind their peers. Sometimes it's up to two or three years.
So if we have somebody who's a nine year-old,
who's doing six year-old things and you're just frustrated
and rolling your eyes, saying grow up,
is once you understand, like, no, no,
that's actually part of, you know,
what they're struggling with.
Then you just sort of can do the math in your head,
and be like, okay, this isn't a surprise.
You know, at six or seven, this isn't usual.
But they're going to keep growing,
and it'll even out over time. So that's our initial piece.
Medication treatment obviously can be very effective,
really makes a big difference.
But again, you know, when the timing's right,
if you really see that it's interfering with their,
especially with their learning.
Although, athletes also talk about,
if they're taking their medications during the day,
and they do better at school, than on the field
at night after a tennis practice.
You know, anything like that,
they notice that their focused attention,
ability to follow directions,
follow through with things, you know,
it makes a big difference in the medication treatments.
But again, we don't assume that right away.
And the first line still is to do some behavioral work,
to work on their environment, to make sure
we're accommodating them where they are at
and meeting their needs. And then always, whenever possible,
and as the kids grow up, including them in the treatment,
so that they're being understood, they feel heard.
And sometimes when you're giving them choices about
which way works better for you,
they come to understand that, you know,
this is not a judgment, a criticism. It's not a label.
It's just something that's part of them.
And just as much as I say, you put on your glasses,
you know, please stop and think, you know,
what's more helpful. We do it this way or this way.
So they can be part of not just the plan of their success
growing up, but then by adolescence,
you're teaching them how to be helping themselves,
what to look for in an environment,
how to be asking for the right things.
So they integrate that as they get older and,
and just don't see it as a negative all the time.
They get to see the one success.
- [Radio Host] I like What you had to say, Dr. Gerak.
It's, it's really a team effort.
You want to start by working with your doctor
and go from there. Team effort to see if this
really is an ADHD situation, just don't act on your own.
Get that professional help as Dr. Gerak mentioned.
Laura, thank you for the time.
Great information this morning.
We often see and start talking more about that,
as school cranks back up again.
So I wanted to have you on with us this morning,
and you were spot on. Thank you so much.
- [Laura] Well your timing was perfect.
Thanks for taking the time today. Bye.
- [Radio Host] Bye now. Dr. Laura Gerak again,
with Akron Children's Hospital, Clinical Director of
Psychology at Akron Children's Hospital.
Kind enough to join us this morning.