As many children head back to school or start school for the first time, some parents also learn that all may not be right with their child's ability to concentrate and learn.
One of the first questions from these parents is whether or not their child has attention-deficit/hyperactivity disorder, or ADHD, according to University of Colorado at Boulder research associate Nomita Chhabildas.
In fall 2004, Chhabildas and Associate Professor Erik Willcutt, both of CU-Boulder's psychology department, opened the Center for Attention, Behavior and Learning. Located within the Raimy Psychology Clinic, the center provides assessments to help families determine whether or not their child has ADHD, a learning disability, or another emotional or behavioral disorder.
"The last decade has seen a great increase in awareness of ADHD, which is one of the most common childhood disorders," Chhabildas said.
Symptoms of ADHD include extreme levels of inattention and hyperactivity-impulsivity that interfere significantly with a child's day-to-day functioning. Extensive research shows that ADHD is a highly genetic neurological condition caused by a chemical imbalance in the brain, according to Willcutt. Despite the extensive research it remains a controversial diagnosis.
"To begin with, several other disorders can sometimes mimic or co-occur with the symptoms of ADHD, including depression, anxiety, learning disabilities, or even reaction to a stressful life event," Willcutt said. "Therefore, in addition to carefully assessing ADHD, the assessments completed at the center also screen for these disorders."
Many parents also question whether ADHD is currently overdiagnosed.
"ADHD is probably both overdiagnosed and underdiagnosed," Willcutt said. "We have seen some children in our studies who had received a previous diagnosis even though they did not appear to meet all the diagnostic criteria. On the other hand, there is clear evidence that there are a lot of kids whose lives are dramatically affected by these symptoms who could really benefit from treatment, but have never received an evaluation."
Another common frustration is that there is no blood test or other objective measure to definitively diagnose ADHD, he said.
"We all hope that our research is going to find a 'smoking gun,' like a specific gene, that can be used to make a diagnosis with certainty," Willcutt said. "But it's becoming clear that it's much more complicated than that. ADHD is due to the combined effects of several genes and multiple environmental risk factors, so a simple genetic test isn't likely to be possible."
To address these issues, the center conducts comprehensive evaluations integrating behavioral ratings by parents and teachers, results of computerized tests and information about family and developmental history. To qualify for diagnosis children must exhibit difficulties that are more extreme than their peers in multiple settings, according to Chhabildas.
"Most importantly, these symptoms must lead to significant impairment of the child's functioning," Chhabildas said. "For example, recent studies show that children with ADHD experience greater rates of peer rejection, have significant academic difficulties and are more likely to sustain an inadvertent injury that requires a trip to the doctor."
If the diagnosis is ADHD, the most widely prescribed treatment is a stimulant medication such as Ritalin, Concerta or Adderall. Studies suggest these medications increase levels of dopamine in parts of the brain that are critical for organization, focusing attention and controlling impulsive behavior.
"Although drug treatments should always be used carefully with children, the largest treatment study of ADHD to date found that its symptoms improved significantly in most children when they took a stimulant medication," Willcutt said.
The center was founded with help from a local donor and recently received additional support from a CU outreach grant. The clinic is open to anyone and fees are charged on a sliding scale based on a family's annual income.
For more information about the clinic call (303) 492-6351 or e-mail nomita@colorado.edu.