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Expert Q&A

	By John Dorsey, M.D. Pediatrician

I have a 10-year-old son. He is in fourth grade. He struggled through third grade with focusing on his class work and homework. He would say that it was too hard, but I observed that he just has trouble paying attention. He knows the concepts, but he can't seem to pay attention long enough to come up with the right answer. He is also very vocal. He sings a lot and hums a lot and makes loud crazy noises. He needs to be told many, many times in order to stop. Could he have ADHD? His teacher last year said she didn't think so, because he wasn't disruptive in class. He makes friends easily and is general a good kid.

Children who have ADD or ADHD symptoms do not necessarily have ADD. Most children who do have this disorder are picked up in kindergarten and first grade. It is uncommon to have tics connected with ADD. His vocalizations are a more severe form of a tic disorder and as such, may need more than reassurance that he might outgrow it. He should be seen by a pediatric neurologist if available to rule out other causes since these vocalizations may persist into adolescence. Tics can be considered habit problems, but when they interfere with social, physical and psychological functioning, they may be upgraded to a habit disorder and this needs looking into.

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