Let's Talk About ADHD: Q&A With Dr. Mark Bertin

As the new school year approaches, some parents might have concerns that their child’s behavioral or academic struggles might be something different than typical distractibility or childhood rambunctiousness. 

If they are finding that their child’s “executive function”—a set of cognitive abilities that allows the brain to manage actions and organize thoughts effectively— is lacking and causing impairment across multiple settings, then it may be well worth the effort to have the child clinically evaluated for the disorder, said Dr. Mark Bertin, a developmental behavioral pediatrician.

Bertin, who lives in Katonah and practices in Pleasantville, specializes in ADHD care and also leads stress-reduction classes for parents.

According to the latest statistics in parent-reported data from the CDC, approximately 5.4 million kids in the United States ages 4-17 have ever been diagnosed with Attention Deficit Hyperactivity Disorder.

We met with Dr. Bertin to discuss the disorder, and his new book, The Family ADHD Solution,released in 2011.

Patch:  What is ADD or ADHD—and what is the proper acronym?

Dr. Bertin:  Well, the label has been evolving to better describe the particular presentation of the disorder. I think what is more important, however, is to understand what the issues are with your child and properly assess their individual needs. To answer the question though, ADHD is actually sub-categorized based on different symptom patterns regarding the hyperactivity component. ADD is an outdated term; it is now included with ADHD.

It is a neurological condition in which the parts of the brain responsible for a large group of skills that go beyond attention —like those in charge of organizing thoughts and self-regulation — are not fully doing their job. It is a real medical condition that is not the fault of the parents or a result of a child acting willfully.

Patch:  What would you like to tell parents who feel anxious about their child who may have attention issues as they enter the new school year?

Dr. Bertin:  There are so many ways that these executive function deficits can manifest—in areas like behavior and emotions, self-esteem, academics and memory, relationships, carrying out organizational tasks, planning and prioritizing, motor activities like handwriting and even in eating habits. Parents can feel overwhelmed when so many things are a struggle.

What is essential is to meet a child where they are in their abilities, without judgment, and adjust expectations while making accommodations to help them succeed. Often, these problems are attributed to a lack of motivation by the child, and parents may throw their hands up in frustration. The earlier the problems are identified and interventions are made, the better the outcomes.

Patch:  In your book, The Family ADHD Solution, you offer many strategies for the family as a whole in dealing with ADHD.

Dr. Bertin:  I wrote this book because there is a lot of misinformation about the disorder and parents are confused. The impact on parents is under-addressed. The stress, anxiety, marital problems and lack of confidence in parenting skills that go along with ADHD are very prevalent.

I wanted to take a common sense and accessible approach to help give families tools and resources to feel better. The book offers family members comprehensive support including behavioral techniques, as well as ways to manage reactivity and practice mindfulness, which are evidence-based interventions that have proven benefits.

Patch: Can you talk a bit about treatments and outcomes?

Dr. Bertin:   Once the research-based criteria are met in diagnosing ADHD—there is not a single ‘test’ for it—and other possible co-existing issues are evaluated, then recommendations are made for managing and treating it.

Treatment may start with non-medical interventions for your child. Further, those struggling with their own bio-chemistry can be given medications which have been around many years and can provide drastic improvements.

The analogy I would use is treating asthma —you might try getting rid of exposure to smokers, dust-mites and other things in the home to help the condition. But if the wheezing continues, you would likely opt for medication. With the appropriate fit, 75-90 percent of patients with ADHD see very positive results with medication.

As for the long-term, about a third of kids outgrow it, a third show some improvement and a third will retain ADHD into adulthood. The point is really to identify and address ADHD early, so that this impairment, by definition, does not cause many more difficulties later on in life. 

For further information and resources, visit Dr. Bertin’s website; he is also holding a free lecture on October 5 at 7:30 p.m. at in White Plains.

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