Parents confronted with the prospect of a child suffering from Attention Deficit Disorder (ADD) or Attention Deficit/Hyperactive Disorder (ADHD) are dealing with extremely difficult behavior (such as inability to focus, finish tasks, organize, angry outbursts and with ADHD, cannot sit still).

These behaviors can become all consuming and disruptive to the family and classrooms. And it can be difficult to know for certain what to do, especially when psychotropic drugs may be involved.

Plausible diagnoses for ADD and ADHD types of behaviors range from chronic ear infections to bipolar disorder.

"The diagnosis of all mental disorders is behavioral," says Stephen Hinshaw, Ph.D., professor and chair of the psychology department at U.C. Berkeley.

A concrete diagnosis thus remains very tricky and drug therapy remains controversial. "[If] there is a careful diagnosis, the medications are quite effective (at least in the short term) in the vast majority of cases," Hinshaw responds when asked how parents can be sure drug therapy is warranted.

He stresses the importance of proper management of the medication from the prescribing physician and combining with behavioral therapy.

The decision to medicate for ADD or ADHD is a very personal one.

One parent had been asked by a couple of teachers to have her son treated for ADHD. He had a hard time sitting in the chair during class. But when given the opportunity to run errands and stand for some time during the lesson, he was able to participate in traditional classroom work. She chose not to have him tested and treated.

By contrast, another parent found that her daughter was having serious difficulty processing information in school. Her daughter became so anxious over the demands of academic assignments she started to panic. They hired a tutor and then tested and treated her with medication for ADD. While her daughter was very bright and could answer questions, she could not perform certain assignments, such as fill in the blanks. Tests showed it was clearly a matter of a processing function in her brain. The medication with tutoring made a dramatic improvement.

In another example, a mother sent her child to school with aromatherapy. She made arrangements for her child to excuse himself when he felt the urge to become disruptive in order to smell the aromatherapy. Her child would then rejoin the group. His behavior in class improved. While her son had not been formally diagnosed, the physician had offered to prescribe Ritalin, which was declined. She later learned that her son had a learning disability caused by impaired hearing from chronic ear infections as a small child. His coping behaviors had mimicked ADHD.

In "Avoiding A Dubious Diagnosis," and article in the March 2007 ADDitude Magazine, Larry Silver, M.D., cautions against the three major diagnostic mistakes resulting in over or under medication of patients:

Trying medication to see if it helps

Reliance on inconclusive evidence

Failure to consider coexisting conditions

Below are some additional considerations for addressing the possibility that your child may be suffering from ADD or ADHD:

Good communication and information exchange between the teachers, caregivers, psychologists and physicians regarding your child's condition and progress.

With your physician, explore possibilities to completely define the problem, diagnosis and treatment.

For example, Daniel G. Amen, M.D. offers brain-imaging diagnosis techniques, which may offer more concrete information about your child's condition. http://www.amenclinics.com/ac/about.php

Have your child tested for academic strengths and weaknesses to determine if there are some tips to help the teacher and your child.

Beware of Web sites sponsored by drugs manufacturers. The following site appears to be free of product manufacturer's influence www.helpguide.org.