Attention Deficit Hyperactivity Disorder, Autism Spectrum Disorder, and Learning Disabilities (Pediatric)
Attention Deficit Hyperactivity Disorder (ADHD)
What is attention deficit hyperactivity disorder?
Attention deficit hyperactivity disorder (ADHD) is a biological condition linked to inattention, impulsivity, and, in some cases, hyperactivity. Symptoms generally occur together and are diagnosed in childhood. ADHD occurs more often in males than females.
Symptoms of hyperactivity are often seen by age 7 yet attention deficit may not be evident until a child reaches elementary school.
ADHD may be related to differences in brain function, heredity, exposure to toxins before birth, or a brain injury.
What are the symptoms of attention deficit hyperactivity disorder?
There are three types of ADHD each with different signs and symptoms:
- Combined Type (most common) is characterized by impulsive and hyperactive behaviors, inattention, and distractibility.
- Impulsive/Hyperactive Type (least common) is characterized by impulsive and hyperactive behaviors without inattention and distractibility.
- Inattentive and Distractible Type is characterized by inattention and distractibility without hyperactivity.
Toddlers and preschoolers may show signs of hyperactivity, meaning their behavior is extreme. They are more active and unruly than their peers. Symptoms are:
- constant talking
- excessive running, jumping, and climbing
- fidgeting and restlessness
- inability to focus—even on a bedtime story—but focused on certain things such as a specific toy or video game
However, not all children with ADHD are hyperactive.
Elementary school children may have other symptoms besides being unable to focus, such as:
- acting without thinking things through
- emotional volatility
- difficulty keeping track of things like homework and books
- difficulty planning
- inability to finish homework or chores
- low threshold for frustration
- problems with sharing, taking turns, and letting others talk
- prone to accidents
- trouble making good decisions
How is attention deficit hyperactivity disorder diagnosed?
Our expert neurologists do a comprehensive examination and assessment of children to determine if a medically- or biologically-based problem contributes to their thinking, learning, or behavioral issues. The following tests may be ordered:
- Behavioral evaluations
- Blood tests reveal low levels of dopamine (a brain chemical) found in children with ADHD.
- Neurodevelopmental assessments
- Positron Emission Tomography (PET) scans are imaging studies that provide a picture of the brain at work. In children with ADHD, brain metabolism is lower in the areas that control attention, social judgment, and movement.
What is the treatment for attention deficit hyperactivity disorder?
Our neurologists work on treatment strategies with a multidisciplinary team of neuropsychologists, behavioral therapists, occupational therapists, and speech and language specialists. We design customized programs for children and may include:
- consistent and predictable daily scheduling for the child
- counseling and therapy
- guidelines for parents in setting limits and consistent rules
- medications, including stimulants
- occupational therapy
- special education
- support groups
- training in social skills and behavior modification
We monitor and provide ongoing support to children and families with ADHD and any associated learning disabilities.
Autistic Spectrum Disorder
What is autistic spectrum disorder?
Autism spectrum disorder (ASD) includes a range of developmental problems, such as restricted or repetitive behavior and difficulty socializing and communicating. The symptoms and severity of ASD vary.
- Classic autism is the most severe form.
- Asperger syndrome is a milder form.
- Rett syndrome is a rare form and a pervasive developmental disorder.
ASD affects children of all ages and ethnic and socioeconomic groups. As many as 6 of every 1,000 children are estimated to suffer from this condition. Males are four times more likely to be diagnosed with ASD than females.
What are the symptoms of autistic spectrum disorder?
The most common symptom is difficulty with social interactions.
Infants may be unresponsive to people or stare intently at one object for a long time. Older children may suddenly become withdrawn and unwilling to engage with others.
Other symptoms to watch for are:
- avoidance of eye contact
- failure to respond when called by name
- inability to play or interact with others
- inability to “read their peers” or understand social cues, such as tone of voice or facial expressions
- insistence on sameness and precise adherence to routine
- narrow range of interests and conversational topics
- repetitive movements such as rocking, twirling, and hand-flapping
- self-destructive behavior such as biting or head-banging
- speaking in a sing-song voice
How is autistic spectrum disorder diagnosed?
Our neurologists make a comprehensive assessment based on parental reports, direct observations of children, and neurological, behavioral, and psychological evaluations.
Our clinicians may also diagnose additional disorders that accompany autism, including attention deficit hyperactivity disorder (ADHD), intellectual disability, epilepsy and depression, certain genetic disorders, and tuberous sclerosis complex (TSC).
What is the treatment for autistic spectrum disorder?
Our neurologists collaborate with psychologists, psychiatrists, speech therapists, and other specialists to make customized treatment plans and provide ongoing support. We tailor a combination of therapies to the individual needs of children, including:
- Applied behavioral analysis to reinforce positive habits and helpful interactions. This therapy is often the most successful form of treatment.
- Medications to reduce symptoms such as irritability
- Occupational therapy
- Special education programs tested and validated for children with ASD
- Speech therapy
What are learning disabilities?
Learning disabilities affect the ability of children to speak or understand written language, perform mathematical calculations, coordinate movements, and concentrate on a particular task.
Learning disabilities occur in young children but usually aren’t apparent until they have to deal with the challenges of school.
As many as 10 percent of American children under the age of 18 are estimated to have some type of learning disability.
How are learning disabilities diagnosed?
Learning disabilities are usually spotted at first by teachers who perform their own evaluations.
However, a comprehensive medical evaluation—family history and neurological exam— is needed to identify or rule out other causes, such as emotional disorders, intellectual and developmental disabilities, and brain conditions.
Children may suffer from several overlapping learning disabilities. We identify them all through the most advanced neuropsychological testing.
How are learning disabilities treated?
We offer a host of treatment options for children with learning disabilities.
The PROMISE at Columbia program is the most comprehensive program in New York City for helping at-risk children to get the support they need to learn and have productive lives. For families already burdened, a one-stop program is the difference between getting lost and getting help.
PROMISE provides services that enable children to reach their full potential—all in one place. We address the emotional and behavioral consequences of learning disabilities and understand these issues can have the most devastating effects on families and school life.
We bring together an innovative team in world-renowned research facilities for our PROMISE program, which is poised to transform the way learning disabilities are treated and understood in the future. Our neurologists work with behavioral psychologists, special education experts, and speech-language pathologists to tailor treatments for children with varying needs. Treatments may include:
- advocacy to ensure schools provide recommended services
- behavioral approaches
- educational training that emphasizes children's abilities and strengths
- medications to help children concentrate
- ongoing support and guidance for parents, to help them understand their children’s needs
- psychological support
- special training in speech and language