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Understanding changes in behavior; the first step in caring for patients with ADHD and OCD

Understanding changes in behavior; the first step in caring for patients with ADHD and OCD
Behaviors and habits can change a lot throughout life – from the time a person is a child to when they are an adult. But understanding when these changes impact the ability to function day-to-day is an important first step to identifying specific behavioral conditions and when someone may need higher levels of care.

As young kids develop and start getting ready for school, sports and other childhood activities, experts say it is not uncommon for parents to notice big changes in their child’s behavior.

These changes can include heightened energy, a tendency to disrupt others and – often most notably – not paying attention. Some children have trouble paying attention whether it is in the classroom, somewhere like the doctor’s office or even in a place a child might desire – like summer camp.

Experts say it is important to always keep a close eye on a child’s changes in behavior. However, in many instances, these changes are very normal for their age and not necessarily associated with behavioral disorders like Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder (ADHD) or Obsessive-Compulsive Disorder (OCD).

“ADHD is one of the most common neuro-developmental disorders in childhood,” Keila Sierra-Cintron, MD, Carle Health Certified Child and Adolescent psychiatrist said. “But attention is not just what we use to diagnose ADHD. We don’t diagnose symptoms – it is a constellation of things that we look into. There is a lot of overlap in symptoms that apply to mood disorders, affective disorders – it is our role to peel that onion and come up with the correct diagnosis. If not, children and adolescents will continue to struggle.”

Dr. Sierra-Cintron adds it is common for parents to assume their child may need an ADHD diagnosis or medication when they see them acting out.

However, she says oftentimes it is actually the well-behaved child who might still exhibit symptoms in other ways.

Teen-ADHD.jpg“We always talk about disorders and treatment. Just because someone develops symptoms doesn’t mean we have to jump immediately into prescribing medication,” Dr. Sierra-Cintron said. “There are a lot of behavioral interventions we can put into place to alleviate some symptoms. The bottom line is someone’s level of function – that will guide into whether you treat or do not treat.”

Dr. Sierra-Cintron says a strong indicator of a child’s level of function is their routine at home – for parents, keeping an eye on this is key to determining if one should seek a diagnosis.

For parents with multiple kids, noticing the differences, challenges and comparisons between siblings can help make behavioral changes become very clear.

“It is about spending the time of understanding the kid’s environment, empowering the parents and guiding,” Dr. Sierra-Cintron said. “Medication is not always the solution. Sometimes you have to spend a few months doing something, come back and reassess.”

Dr. Sierra-Cintron says it is important to recognize the additional steps one needs to take in determining if their child is actually in need of medication or a medical diagnosis.

ADHD diagnosis is often determined when a child enters primary school – around the age of six – but earlier is a possibility. Dr. Sierra-Cintron says it is important for a parent to recognize points in a child’s life and consider them when deeming what is developmentally appropriate.

“If your two-year-old is running around in the house, enjoy it – this is the time when kids are curious. That doesn’t mean we do not treat ADHD before kindergarten - if there are seriously concerning warning signs, parents can consult a pediatrician. If that doesn’t work, they can refer to a psychiatrist,” Dr. Sierra-Cintron said.
Some children can grow out of their ADHD symptoms by the time they reach adulthood, although this is not always the case. “Effective treatment of ADHD and OCD can be life changing at almost any age,” said Luke Pro, MD, Adult Psychiatry. “People deserve and benefit from proper medical care at any age!”

Adult-ADHD.jpgDr. Pro has also seen a rise in the number of patients seeking an evaluation for adult ADHD, anxiety and autism spectrum disorder in recent years, as well as OCD. “The majority of adult patients I diagnose with OCD hadn’t seriously considered OCD in the past. A lot of them think they had anxiety or just feel out of control,” said Dr. Pro. “As people with ADHD age, they tend to become less hyperactive and more inattentive. Difficulty with organization, planning, impulsivity, forgetfulness, distractibility are common symptoms for both adults and children.”

Adults with OCD will often experience intense thoughts that are so urgent if they don’t perform some responding action, they experience overwhelming anxiety.

“Developmentally, we have to define the expectations of a kid compared to an adult. You’re not often going to see an adult coming over and tapping you,” Dr. Sierra-Cintron said. “How a school setting would translate to a kid is how a work setting translates to an adult. The ability to turn in projects, submit paperwork on time, get ready in the morning.”

Recognizing these symptoms alone does not always necessarily mean that a person has OCD or ADHD. It may be due to another condition. The COVID-19 pandemic has also proven to worsen symptoms or led some to experience symptoms for the first time.

“There are medications that are proven in children that aren’t proven in adults. Sometimes, we need to get creative,” Dr. Sierra-Cintron said. “In general, we look at an umbrella of categories – stimulants and non-stimulants. Some can lead to misuse, so we have to be creative in how to treat different cases.”

“I encourage anyone who is having persistent and significant symptoms to talk to their doctor,” said Dr. Pro. "Talking to your doctor is an opportunity to gain a better understanding of how your symptoms are affecting your quality of life and also to understand the risks and benefits of different treatment options.”

“Social media has done a lot to increase awareness of these conditions and I think that naturally leads to more people wondering ‘Do I have this condition?’”, said. Dr. Pro. “I hope to see more people motivated to speak with mental health professionals about their concerns when they arise because there is a lot of misinformation out there, too.”

For more information about these conditions and Carle Health services of support near you, visit

Categories: Redefining Healthcare

Tags: ADHD, Anxiety, Attention, Behavioral, Compulsive, Deficit, Disorder, Health, Hyperactivity, Obsessive, OCD, Psychiatry