Dr. Gaspar de Alba joined the University of Nevada School of Medicine in 2012. He attended medical school at the Universidad Autonoma de Guadalajara in Mexico and received his medical degree from New York Medical College. He practiced general pediatrics for two years before continuing his training at the University of North Carolina in the Developmental-Behavioral Pediatrics fellowship program. He was also an assistant professor and division chief of the Developmental-Behavioral Pediatrics Division at the Paul L. Foster School of Medicine in El Paso, Texas. On March 1, the father of seven will join the UNLV School of Medicine as associate dean of diversity and inclusion. Here are the highlights of his recent interview with Genevie Durano.
I picked this specialty because these kids are like a puzzle for me. The different things that can go on—the behavioral problems and the family dynamics and diagnoses such as autism or ADHD—it’s just like putting pieces of a puzzle together. I had a great mentor who got me interested in developmental pediatrics during residency, and his best advice for me was to pay attention to the family. You know you’re seeing the kid and the kid is your patient, but listen to the family. Understand what’s going on in the family, or else you’re not going to get all the information you need to help the child.
With autism, we are getting better at diagnosing. At the same time, there is more of it, and there are many theories for why this is happening. With ADHD, it’s more a reflection of a change in our environment and how kids are raised, everything from how families work to the way media affect their lives. That plays a bigger role in ADHD than it does in autism.
With ADHD, the most important thing is figuring out where the symptoms are coming from. Because you can get those symptoms from a whole lot of things—not sleeping enough, not eating right, being neglected, being abused, having a learning disability, having anxiety or depression. So once you figure out what’s behind it, that drives the type of treatment.
Schools are not structured to accommodate ADHD kids. One of the things we recommend is chunked learning, where you have a chunk of time to focus and a chunk of time where you can run around and be active. Our schools are not set up that way; it’s just a long day. Typical schools try to put everybody into one kind of learning mold, so kids who don’t learn that way have a hard time reaching their potential. When you do try to shove them into this lump they don’t fit into, well, guess what happens? You get behaviors, and then we try to medicate the behaviors. That might not be the problem. And we have to figure out what’s going on. Today, one in eight kids are diagnosed with ADHD; some places even more like one in six. So we have to figure out how we’re going to modify our learning environment so each child can meet their potential.
The most encouraging thing about treatment is watching kids improve, and watching how that improves their relationship with their family. That by itself makes the kids’ environment so much more supportive and they are so much happier, and it gets them on the right foot to be successful long-term.