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Warning Signs Your Child Has ADD: Valencia Pediatrics: Pediatrics

If your child is having problems academically or socially at school, it might be that a condition is impeding their ability to progress. Attention deficit disorder, or ADD, is a common diagnosis in children that can make school and home environments more challenging.

Getting an early diagnosis helps children with ADD get the treatment they need early, so they can learn coping skills and find success. If your child has any of these warning signs of ADD, board-certified pediatrician Rainilda Valencia, MD, from Valencia Pediatrics in Victorville, California, recommends your child get a full ADD consultation to determine if they have ADD.

What is ADD?

ADD is a common condition that makes it more difficult for children to concentrate and focus. Unlike the related condition, attention deficit hyperactivity disorder (ADHD), these children don’t usually have clinically significant challenges with impulsivity or hyperactivity.

Symptoms of ADD can emerge at any age, but it’s most common to start observing them during the early school years, before age 12. Without intervention and treatment, children with ADD can have problems completing homework, learning, staying organized at home and school, and with social relationships.

Over time, children with ADD that haven’t received support are at higher risk for developing mental health problems like anxiety or depression.

Warning signs of ADD in children

According to Dr. Valencia, these are some of the most common symptoms that can indicate your child has undiagnosed ADD.

Procrastination

Your child with ADD might have difficulty completing tasks, like their homework assignments and assigned chores. They can have trouble prioritizing which tasks are most important, which makes it hard to get started and complete a to-do list.

Disorganization

These children often have desks, lockers, or bedrooms that appear disorganized. They can have trouble keeping track of their belongings and schedules, and might find themselves losing things and being late to class.

Inattention and lack of focus

A child who has ADD might seem like they aren’t interested in paying attention in class or other activities. They’re often prone to daydreaming during structured activities, being easily distracted by external stimuli, and seeming disinterested or bored.

Forgetfulness

Children with ADD often forget to complete or attend to tasks or activities because of their disorganization. This can lead to forgetting to turn in homework assignments, go to activities, and turning in schoolwork they haven’t finished.

Social skills challenges

Some children with ADD also have trouble with social interactions. This can include difficulty focusing on conversations, remaining on topic when they talk, and paying attention to social rules.

What to do if your child displays ADD symptoms

When your child has ADD symptoms, our team at Valencia Pediatrics can evaluate them at an ADD/ADHD consultation. At your child’s consultation, Dr. Valencia discusses your concerns, reviews your child’s full history, and observes and evaluates your child. She also ensures your child’s symptoms don’t have a different cause.

Once your child has been diagnosed with ADD, Dr. Valencia, with Micaela Marin-Tucker, PA-C, and Megan Reynolds, C-PNP, develops and implements a plan to treat your child’s symptoms. This plan can include talk and behavioral therapies, coordinating with your child’s school and activities, and medications.

With treatment, our team can help you and your child manage their ADD and succeed at school and at home. To schedule your child’s ADD consultation, call Valencia Pediatrics today.

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Signs and Symptoms of ADHD in Toddlers

Mental health professionals do not diagnose attention deficit hyperactivity disorder (ADHD) in children under age 4. Certain behaviors associated with ADHD in school aged children may be considered typical in toddlers.

Professionals typically diagnose ADHD in school aged children 12 or younger. According to the American Academy of Pediatrics, doctors and healthcare professionals should not diagnose the condition in children before age 4.

ADHD is more than just typical toddler behavior. According to the National Institutes of Health (NIH), the condition must occur over a long period and impair functioning. This is part of the reason ADHD is not typically diagnosed in toddlerhood.

While toddlers may show some signs of ADHD, it does not necessarily mean they have the condition. At this age, they may have difficulty paying attention or be hyperactive or impulsive.

But some toddler behaviors may lead some parents to wonder whether or not their child has ADHD or has a chance of developing it.

Read on for a checklist of symptoms to watch out for.

What is ADHD?

ADHD is a neurodevelopmental disorder that may cause hyperactivity (constantly active behavior) and impulsive behaviors. People with ADHD, including children, typically have trouble focusing on one task. They may also have difficulty sitting still for long periods.

According to a 2019 study, some behaviors noted in toddlerhood could be related to the development of ADHD. However, considerably more research is needed.

According to the NIH, these are the three main signs of the condition in kids over age 3:

inattention
hyperactivity
impulsivity

These behaviors also occur in children without ADHD. A child won’t receive an ADHD diagnosis unless they have several symptoms that have been present for at least 6 months and that affect their functioning. These symptoms may affect their ability to participate in age-appropriate activities.

Great care must be taken in diagnosing ADHD in children, particularly when considering medication. A mental health professional or pediatrician will be the best at making a diagnosis at this young age.

Many mental health professionals will not make a diagnosis until the child has been in school. This is because a key criterion for ADHD is that the symptoms are present in two or more settings. For example, a child shows symptoms at home and school, or with a parent and with friends or relatives.

Several behaviors can indicate your child has difficulty with attention, a key sign of ADHD. In school aged children, symptoms of inattention may look like:

difficulty with sustaining attention, in play or completing work
difficulty listening and following directions
difficulty paying attention to detail and making seemingly small mistakes
challenges staying organized
avoiding tasks at home or school that require more sustained attention

Note, however, that these behaviors can also be typical in a toddler and expected for their developmental phase.

In the past, ADHD was called attention deficit disorder.

Many medical and mental health communities call the condition ADHD because the disorder often includes components of both hyperactivity and impulsivity. This is particularly true when diagnosed in preschool aged children.

Signs of hyperactivity that your toddler may display include:

being overly fidgety and squirmy when seated
being unable to sit still for calm activities like eating and having books read to them
talking and making noise excessively
running from toy to toy, or constantly being in motion
running around or climbing at inappropriate times

Another symptom of ADHD is impulsivity. Signs that your child has overly impulsive behaviors can include:

displaying extreme impatience with others
having difficulty waiting for their turn when playing with other children
interrupting when others are talking
speaking at inappropriate times
answering questions before they are fully asked or finishing other people’s sentences

Again, these can be expected behaviors in toddlers. They would only be a reason for concern if they’re extreme when compared to those of children of a similar age or if they’re affecting your toddler’s functioning.

A school aged child with ADHD may show other symptoms as well. These may include:

more frustration, anger, and outbursts than their peers
endangering oneself or others due to fearlessness
difficulty calming down
aggressive behaviors (toward self or others)
little need for sleep

While mental health professionals should not diagnose ADHD in toddlers, you may want to discuss your concerns with a pediatrician or mental health professional. This may help determine a diagnosis when your child reaches school age. These healthcare professionals may also offer suggestions to help with hyperactivity, impulsivity, and inattention.

Children can only receive an ADHD diagnosis when they have reached school age. Pediatricians and mental health professionals may base an ADHD diagnosis on the child’s behaviors and other symptoms.

It’s sometimes easy for parents and teachers to mistake certain behaviors for ADHD.

For example, toddlers sitting quietly and behaving in preschool may not be paying attention. Children with hyperactivity may have challenges listening to, understanding, or carrying out instructions.

Most toddlers may show hyperactivity, impulsivity, and inattention at times. This may look like excessive energy or trouble following directions.

If you’re concerned about your child’s behavior, you may want to speak with a pediatrician or mental health professional.

The NIH notes that ADHD can be very common among children. The CDC estimates that 2% of children ages 3 to 5 have ADHD.

If you think your toddler may be showing signs of ADHD, consider sharing your concerns with a pediatrician. They may be able to help you and your child manage the condition. They may also point out other signs to look for and guide the diagnosis process when your child is old enough.

While there is no cure for ADHD, treatment can help improve your child’s symptoms. This may include:

medication
psychotherapy, including family therapy, behavioral therapy, and cognitive behavioral therapy
lifestyle measures

For success at school, certain classroom management tactics may also help improve your child’s attention.

Doctors and healthcare professionals do not diagnose ADHD in toddlers. They may diagnose the condition in school aged children.

Many behaviors associated with hyperactivity, impulsivity, and inattention in school aged children may be typical behavior in toddlers.

If you have concerns about your toddler’s behavior, you may want to discuss them with a pediatrician or mental health professional.

Infant Reflux: Symptoms and Treatment

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Signs and what to do

Post-feed regurgitation is a common occurrence in the first few months of life. This is usually harmless and completely normal, but parents should read about gastroesophageal reflux (GER) and laryngopharyngeal reflux (LPR) in infants and how long it lasts to give them peace of mind.

We look at signs of reflux in babies, symptoms of different types of reflux, and how to help a child with signs of reflux. If you require further information, always contact your healthcare provider.

What is reflux in babies?

So we know reflux is common, but what causes reflux in babies? Because young children have not yet fully developed the lower esophageal sphincter (LES), that is, the muscle at the bottom of the esophagus that opens and closes to let food into the stomach and keep it there, food can easily pass back up the esophagus.

Acid reflux, also known as gastroesophageal reflux (GER), is a normal reflux that occurs in babies. This type of reflux is considered normal and occurs in 40-65% of babies.

How do I know if my child has acid (gastroesophageal) reflux?

If a baby is spitting up milk after a feed, it is most likely acid reflux. As babies get older, GER usually goes away on its own without any intervention. If a baby has complications beyond just spitting up a small amount of milk (such as feeding difficulties and discomfort), they may have gastroesophageal reflux disease (GERD).

Symptoms of GERD include:

baby arching during or after feeding;
crying more than three hours a day for no apparent reason;
cough;
gag reflex or difficulty swallowing;
irritability, restlessness after eating;
eating little or not eating;
poor weight gain or loss;
difficult breathing;
severe or frequent vomiting.

GERD usually occurs when LES muscles are not toned in time, causing stomach contents to back up into the esophagus.

How do I know if my child has Laryngopharyngeal Reflux?

Another type of reflux, laryngopharyngeal reflux (LPR), also called silent reflux, is when the contents of the baby's stomach leak back into the larynx, the back of the nasopharynx. This type of reflux does not always cause external symptoms, which is why it is called "silent". Babies can have GERD and silent reflux at the same time, but their symptoms are somewhat different.

The following are some of the symptoms of laryngopharyngeal reflux:

breathing problems;
gag reflex;
chronic cough;
swallowing problems;
hoarseness;
regurgitation;
poor weight gain or weight loss.

We have looked at the signs of reflux in infants, now we will move on to the treatment and duration of silent reflux in children, as well as the treatment of GERD.

How to deal with laryngopharyngeal reflux in babies while breastfeeding?

Breastfeeding mothers may need to review their diet if their babies show signs of reflux. The American Academy of Pediatrics (AAP) recommends breastfeeding mothers cut eggs and milk from their diet for two to four weeks to see if their baby's reflux symptoms improve or disappear. It may be worth eliminating acidic foods from your diet.

In most cases, GER and laryngopharyngeal reflux go away on their own. Typically, children outgrow reflux in the first year of life. If a child has persistent symptoms of laryngopharyngeal reflux, parents should consult a doctor. If your baby has severe vomiting, blood in the stool, or any of the symptoms of GERD listed above, parents should contact their pediatrician as soon as possible.

How can I help my child with reflux or GERD?

Reflux symptoms in babies usually go away on their own, but the following tips can help relieve symptoms:

Thicken food with rice or a special milk thickener.
Hold the bottle at an angle that fills the nipple completely with milk to reduce the amount of air your baby swallows. This can help prevent colic, gas, and reflux.
Try the AirFree anti-colic bottle, designed to reduce air swallowing during feeding.

4. Let the baby burp during and after feeding. If the baby is bottle fed, parents can let him burp after every 30-60 ml. If the mother is breastfeeding, she may let the baby burp when changing breasts.

5. Hold baby upright after feeding. As a rule, in order for the milk to remain in the stomach, after feeding the baby, it is necessary to hold it in an upright position for 10-15 minutes. But, if the child has reflux, parents should keep him upright a little longer.

These tips may help relieve symptoms, but they do not replace a doctor's advice.

Parents should not change their infant formula formula without first talking to their healthcare provider.

Don't panic! Reflux is very common in babies during the first three months of life, and most babies outgrow it without any consequences. Although GERD is a slightly more serious condition, there are many treatments, ways to manage it, and help newborns. Feel free to contact your doctor with any questions or concerns you may have.

⁴ Seattle Children’s Hospital

⁵ The National Institute of Diabetes and Digestive and Kidney Diseases - Treatment for GER & GERD in Infants

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Dehydration in children: how to prevent and recognize

Why are children at risk and more susceptible to dehydration?

Children, along with the elderly, are at risk and more than susceptible to getting dehydrated due to a combination of several factors:

First because they are a group of people who older adults are more likely to suffer from infections, which can cause fever and gastrointestinal symptoms such as vomiting or diarrhea that lead to fluid loss in the body. However, dehydration can occur not only with gastroenteritis, but with other infections, such as respiratory (colds, sinusitis, pneumonia, bronchitis) or urinary tract infections.

Second , because in the child's body a higher percentage of water . In a newborn, for example, about 70% of his body weight is water. This percentage gradually decreases as the child grows up, until it reaches 50-60% in adulthood, depending on age and gender.

Thirdly, , because with a smaller body volume, the ratio between body surface and weight is higher than . This means that in children, the loss of moisture through the skin and mucous membranes by evaporation is proportionally greater than in adults.

It should also be added that the compensation mechanisms that the body starts when it begins to lose moisture, more are insufficiently developed at an early age of life. The ability to concentrate urine and thereby reduce water loss is less in a newborn than in a school-age child or adult, making young children more vulnerable in these situations.

Finally, in the case of young children, they have limited access to fluids because they0007 cannot drink on their own and are dependent on adults to provide them with water to drink in situations of dehydration due to illness or hot weather.

Thus, newborns and infants are most at risk of dehydration.

Dehydration and medications for chronic conditions

Although children often need to take medications for chronic illnesses, some medications may make dehydration worse . An obvious example of this type of medication is the diuretics (furosemide, spironolactone...) which increase the loss of water through the urine to compensate for problems with the heart, kidneys, etc.

It should also be taken into account that if a child is taking any medications for chronic diseases, their blood levels, as well as their therapeutic effects (both beneficial and adverse), may temporarily change when a situation of dehydration occurs. This does not mean that we should be worried, but we should consider it, for example, in the case of children receiving antiepileptic drugs , since in a situation of dehydration, the drugs will no longer work and the epilepsy may temporarily decompensate.

What are the symptoms of dehydration?

On the one hand, symptoms are associated with the loss of fluid and electrolytes (mineral salts), and on the other hand, with compensation mechanisms that the body triggers to restore the loss of moisture. Some of the symptoms of dehydration: it is important to see a doctor as soon as possible .

How can dehydration be prevented?

In the situations of symptoms described above (fever, vomiting, diarrhea), it is very important to offer the child plenty of fluids to maintain a normal state of hydration. In addition to water, the liquid you offer your child should contain glucose (sugar) and mineral salts because not only water is lost during vomiting and diarrhea, but also sugar and minerals such as sodium, potassium and chlorine. These substances are vital for maintaining the functioning of the organs and systems of our body. Often their levels change in situations of dehydration (hyper or hyponatremia, hypoglycemia ...), which can aggravate the symptoms of the disease. Therefore , it is recommended to replenish fluid loss by using oral rehydration serum , which can be purchased at pharmacies.

In other situations where the loss of moisture in the body is increased due to perspiration, such as during summer and during prolonged physical activity, it is recommended to use water as the main rehydrator , accompanied by foods that contain carbohydrates, mineral salts and water, such as like fruits.

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