Ask Dr. Ceren: Assessing a child’s concentration problem

By Sandra Levy Ceren

Q: My 7-year-old son has always been a bright, happy child, very easy to be around, but this year in school he was often sad and said he doesn’t like school anymore. I realize that this is the first time in school that he was challenged with tasks that he said were boring. The teacher told my husband and me that she thinks Troy has attention deficit disorder. This took us by surprise as we are vigilant parents and have never noticed any problem with him. Troy has playmates and is often asked to spend overnight sleepovers with one or two other little boys who also sleep over our house frequently. He always enjoys those times. Troy also can play well by himself. He loves arts and crafts and draws very well. He can spend hours on a project giving his full attention to it. I asked the teacher to explain her observations that led to her conclusion. She said he fidgets a lot and gets out of his seat more times than other children. He has a hard time concentrating in class. She suggested we should ask the pediatrician for medicine. Before we do this, I wanted your opinion.

A: It is difficult to make an assessment without observing your child in various situations, but from what you write, it appears that Troy is able to concentrate on things that interest him.

Not all children who exhibit concentration problems in school have attention deficit disorder and before considering medication it would be wise to have a specialist assess him. It is estimated that only 2 to 3 per cent of all children and juveniles suffer from ADHD. This disorder is frequently misdiagnosed in boys.

Sometimes a child is bored in school and may appear to have difficulty concentrating. He may fidget or get out of his seat to remove himself from what may appear to him as a mindless activity. According to your observation when he is challenged in an activity, such as a game, a puzzle, or artwork, does he fidget or does he concentrate?

Other possible maladies should be ruled out before any sort of treatment is considered.

According to Professor Andreas Warnke of the Berlin-based German Society for Child and Adolescent Psychiatry, concentration problems may be due to a developmental disorder such as dyslexia, which most often appears to be the case.

Warnke noted that attention disorders are frequently accompanied by anxiety, depression or tics. Does Troy have such symptoms? If so, such conditions should be taken into consideration if treatment is provided.

Insufficient sleep or impaired thyroid function should be also ruled out.

Attention deficit disorder may be inherited. If either you or your husband has the disorder, it may be possible that it could occur in your offspring.

Before any medicine is considered, please have Troy assessed by a well-trained child psychologist equipped with the appropriate testing material to determine if he has dyslexia and/or attention deficit disorder. This person should also determine if he has any learning disability that would make school a challenge. If so, there are state funds available to schools to provide for his educational needs.