Teen School Problems: Is It ADHD Symptoms?

Parents struggle to understand – and help – the child who’s done well academically in lower grades, then falters when the pressure’s on in high school.

What happened?

Today, and perhaps too often, we blame ADHD, (Attention-Deficit Hyperactivity Disorder), says Dan Becker, M.D., adolescent psychiatrist and medical director of Mills-Peninsula’s Behavioral Health Program.

“ADHD is a very real syndrome and, appropriately diagnosed, leads to meaningful treatment,” he said, “but we also need to look for other causes. ADHD typically starts by around age seven and is more pronounced in younger children.

• Getting to the Root Cause of
  Teen Behavioral Problems
• Learning Disorders
• Teen Depression
• Substance Abuse
• Communicate, Communicate, Communicate
• How to Get Help

Getting to the Root Cause of
Teen Behavioral Problems

“About 50 percent of children appropriately diagnosed with ADHD no longer carry the diagnosis at puberty, and two-thirds outgrow the syndrome by the time they are 18 years old,” Dr. Becker says. “That suggests we should be a little skeptical about diagnosing ADHD for the first time in high school-aged youth.”

There are several other possible causes of a parent’s perception of potential ADHD symptoms, including a lack of alignment of parent and child goals.

For example, if a parent insists her third child should follow his older siblings into law school but the child wants to be an artist, there’s a disconnect. The child may not see value in excelling in college-prep classes. Dealing with this issue falls back to communication and understanding between parent and child.

There are also clinical causes of poor academic function, Dr. Becker says. These behavioral problems include learning disorders, teen depression and substance abuse.

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Learning Disorders

“Learning disorders such as dyslexia (reading problems) can explain academic challenges,” he says, “but like ADHD, they usually exist from the beginning and are typically identified earlier.

“It is possible that a child with a learning disability has been able to compensate in lower grades, so the disorder isn't apparent.

For example, they might override a reading problem with strong listening skills. But when learning gets more complex and intense in high school, the disorder may become more apparent.”

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Teen Depression

Clinical depression is another potential cause of a change in academic performance.

“Teen depression may be evidenced by many things – loss of interest, poor concentration or lack of energy.” Dr. Becker says. “It commonly has its onset in adolescence, and depressed kids just don’t function well in a challenging academic setting.”

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Substance Abuse

Substance abuse may be the underlying reason many teens suddenly perform more poorly in school, Becker says.

“Everybody is different. Some people can use small amounts of psychoactive substances with little effect on performance,” he says, “but more often, if you use drugs, you’re likely to have a drop in academic – and other – cognitive functions.”

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Communicate, Communicate, Communicate

As in all aspects of parenting, the place to start understanding and improving academic function is for parent and child to communicate, to learn about and understand the child’s goals and how they may differ than the parent’s, Dr. Becker says.

“We begin with awareness that society today puts enormous pressure on kids to do well in high school, to get into the best colleges. That’s an issue in itself and demands constant communication to understand goals and life choices.

“Next, we should look to other causes rather than assume ADHD symptoms. If a teen with academic problems is smoking pot regularly, the first thing to do is to get him to stop, with help, if necessary. That simply eliminates one possible chemical cause of a change in function.”

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How to Get Help

“Talk to the teacher. They are experts in academic functioning,” Dr. Becker says. “If they agree that your child should be doing better, look for answers.

“Your pediatrician may offer suggestions or recommend consulting with a mental health professional to determine if learning disabilities, ADHD, substance abuse or clinical depression are the cause of behavioral problems.”

And above all, keep talking to your teen, Dr. Becker says. “Recognize your child is on the brink of adulthood and eager to make his or her own decisions. Support that goal with guidance, patience and understanding.”

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