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Diagnosing ADHD

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common neurological conditions that affects between 3 to 6 percent of school-aged boy jumping on couch children.  Children with this condition exhibit significant issues with their ability to pay attention to tasks, inhibit their impulses and/or regulate their behavior.   In order for the diagnosis to be made, one has to witness significant impairment in regards to attentional regulation and/or activity level within multiple settings.  This means that the child must exhibit the concerns within the home, school, after-school program, sports team, etc.  In reality, the diagnosis can be made by a pediatrician or health care provider that is able to ascertain levels of functioning in the various domains by observing behavior or collecting parent and teacher report forms.

In the Neuropsychology Department at North Shore Pediatric Therapy, we focus on a comprehensive evaluation of a child’s functioning, including cognitive functioning, academic achievement, attentional regulation, executive functioning and social/emotional functioning.  Now, if the diagnosis can be made by a parent and teacher report, one must ask why a comprehensive evaluation should be mandated.  The answer to this is that over 45% of children that have been diagnosed with ADHD meet clinical criteria for multiple neurodevelopmental conditions.  Children with ADHD often present learning disabilities, emotional concerns and deficits with social regulation.  Sole treatment of the inattention may improve attentional regulation; however, there are other unaddressed concerns that may still linger.

Research has continuously demonstrated that the most common treatment of ADHD is a combination of pharmacological intervention, behavioral therapy, parent training, and teacher education.  Pharmacological intervention consists of stimulant medications that help to improve the child’s ability to attend to tasks.  A recent research article, which was even reported in an October edition of the Chicago Tribune, indicated that the majority of children who have been diagnosed with ADHD and are prescribed medication report significant improvement within their daily lives.  In the past, the main identification of improvement within children with ADHD was based upon teacher report.  Parents can now feel comfortable when asking their child if medication is helping. Behavior therapy focuses on the modification of the child’s environment to improve the frequency and duration of positive, on-task behaviors while extinguishing negative behaviors.  Parent and teacher education has a primary intent on discussing expectations within the home and school settings as well as possible modifications to ensure success.


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What is Scoliosis?

Scoliosis can be a very scary diagnosis, especially if you aren’t exactly sure what it is or what can cause it. Scoliosis is a lateral curvature of the spine to the right or left as you are looking at the spine from behind. There is typically a rotation of the involved spinal segments as well.scoliosis

There are 3 different types of scoliosis, each the result of a different mechanism:

  • Congenital scoliosis– the child is born with the lateral curvature due to an atypical development of the spine in utero.
  • Neuromuscular scoliosis– caused by an underlying neuromuscular condition that results in abnormal muscular pull on the spine. Conditions such as cerebral palsy or spina bifida are examples of underlying diagnoses that may result in neuromuscular scoliosis.
  • Idiopathic scoliosis-this means that there is no known cause of the scoliosis. This is the most common form of scoliosis and can present in childhood, adolescence, or adulthood.

Adolescents, predominantly female, who are currently or have recently gone through a growth spurt are the most likely to develop scoliosis. Kids between the ages of 10-15 are therefore at the greatest risk. Except for more severe cases, scoliosis is typically not associated with back pain; however, kids with scoliosis are at an increased risk of having back pain during adulthood.

Treatment for scoliosis will depend on the severity of the curvature:

  • Conservative-for mild to moderate cases of scoliosis, treatments such as bracing, postural exercises, and physical therapy are used to prevent progression of the curve.
  • Surgical-for severe curvatures, surgical placement of rods to maintain a straight spine is often utilized.

Regardless of the type or severity of scoliosis, the key to optimal outcomes is early recognition. With early detection through school screenings or screening from a physician or physical therapist, treatment and monitoring can begin immediately. If you are concerned that your child may have scoliosis, or are looking for treatment for a child with a diagnosis of scoliosis, please see a physical therapist at North Shore Pediatric Therapy.

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