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I'm a 'honorary Uncle' for a child who is 5 years old. The child has not been diagnosed by a doctor yet, but as someone who is ADD himself and has some experience volunteering with kids, including ADHD kids, I'm about 98% confident the child is ADHD. It's a particularly severe, and obvious, case! He can't even play hide & seek with his friends because he forgets he is suppose to be seeking kids and wanders off seconds after he says he wants to play. The son's sperm donor also has ADHD so the child was already at a higher risk of having it. I've already informed his parents of this.

I first told them a few years ago, and their response was that he is too young to test, but they will be ready if he is ADHD. I've more recently mentioned it to his father in passing during a visit. His father's general response was that it doesn't really matter until the child is in school so he can worry about it then, though I think I also caught a hint of doubt (denial?) that his son was ADHD as well. I know he hasn't bothered to take his son to get an official diagnosis on rather he was ADHD.

My honest opinion is that waiting is a bad idea. It can take some trial and error to find the right ADHD medication for a child and it seems to me that it would be best to do that trial and error now, before he is in school, so they know he has a good medication when school starts rather then trying to find the right meds and dosage while he is struggling in school. In addition his ADHD is severe enough that I can see it interfering a bit with his playing with other children, both because they don't know how to deal with his level of hyperactivity and because he is too distracted to stick to playing one game with the children for long. As such I feel getting his ADHD a bit better managed would help him with developing social skills now. It would also likely make his father's life a little easier, but that's less of a concern to me then the child's well being.

On the one hand I'd really like to encourage the father to put some serious thought into doing something about his son's ADHD, as I think it would be best for the kid to start sorting out medication now. On the other hand I don't want to impose on the father or make him feel I'm judging his parenting or trying to tell him how to raise his child. It's just that I do have a bit of experience with ADHD and feel I have some insights that could be useful for him, if I knew I could talk to him about it.

Ironically despite my visiting my 'nephew' semi often I don't get to talk with his father too often. Between the father being heavily introverted, to the point I don't feel like I should be forcing him to have a long conversation with me, and my nephew's excitement, and hyperactivity, when seeing me leading to him immediately dragging me away to play we don't get much one on one talking time during my visits. This means any real conversation about his sons ADHD would have to be premeditated and would feel out of place enough, relative to my usual visits/babysitting, that the father may feel I was putting him on the spot just by trying to get a moment to talk to him. The mother is no longer in the picture, so I can't speak with her instead.

So should I bring the child's ADHD up, or just let it go and wait until he starts school? If I do mention something how can I do it in a way that doesn't risk upsetting his father?

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As a parent who has had uncles/aunts/grandparents attempt to interfere in our handling of our childrens' healthcare, I can firmly say that you should not attempt to interfere here. Don't bring it up. Don't talk about it. Unless you are a specialist in the field, it is not your place to tell your friend what to do here.

Parenting is not an exact science, and there are as many ways to do it as there are parents; and there are twice as many people who want to tell you how to do it. Give advice freely when asked. Speak up if you see something immediately harmful. Offer a consultation in topics you are a certified expert in.

Otherwise, though, you're adding stress where it doesn't need to be added. You're telling the parent that you know better than they do - and that you think their decision-making is faulty. It might be, but unless there is a significant, immediate harm, it's not your place to correct it. We all - parents and children alike - learn from our mistakes; and while it might feel to you like this mistake will have permanent, lifelong consequences, they need to come to that decision themselves. You already brought up the subject, so they know about the issue - now let them come to their decision, themselves, without straining your relationship or (yes) judging them.

If they want to know more about it, they know you're willing to talk to them about it. They'll come to you when they're ready - or they won't, and you need to let them make that choice.

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I'm inclined to agree with Joe that this probably isn't an area where your good intentions are likely to be well received.

But in the event that you do proceed to raise the issue, or if it comes up anyway, I want to throw in that a lot of people with neuropsychiatric disorders (and this may already be obvious to you as you say you've got ADD yourself) feel that the disorder is strongly linked to who they are; that there isn't "real" version of themselves underneath the disorder that can be revealed with medication, but rather that them without the symptoms would be another person.

I get that medication does a great deal to give a lot of people a more functional life, so I'm not against it, but when approaching someone who doesn't have that mindset, I think any talk of medicating away what they see as personality traits will be alienating.

If you do end up discussing whether the child should be evaluated for ADHD, and you know the parent has some aversion to the concept, I think you're much better off stressing the immediate gains of the diagnosis, rather than of the medication. Such as the validation that the reason social interactions with other kids don't always work isn't because they're stupid, but can be explained by something tangible. And that a diagnosis may help them work with schools later on to accommodate the child's needs. Instead of saying he'll be able to get medicine so that he can be still and pay attention in school, say that with a diagnosis they're in a better position to explain to school teachers that they shouldn't force the child to be still during class.

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    I would give you a +100 if I could! Even as I was reading the question, I was thinking to myself how a diagnosis will be immensely helpful to both the parent and child even if they want to wait on the medication. But the way you put it - about it being his personality rather than whats wrong with his personality - an eye opener on a whole another level! I wish more people thought this way!
    – learner101
    Jan 21 at 5:37

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