What is Attention Deficit-Hyperactivity Disorder?
Attention deficit-hyperactivity disorder, or ADHD, is an affliction dealing with inattentiveness, impulsiveness, over-activity, or a combination of these traits. For children or adolescents to be diagnosed with ADHD they must be out of the range of normalcy for the child’s peer group.
ADHD is a behavioral disorder that affects approximately 3 to 15 percent of school age children. It is estimated that boys are three times more likely than girls to have this disorder based on diagnoses, though the reasons for this are as-yet-unknown.
ADHD Causes and Risk Factors
ADHD is the most common behavioral disorder affecting children today and is found among 3 to 5 percent (some sources report 8 to 10 percent or more) of school-aged children. ADHD may run in families but the cause is unknown. It appears to be present as the brain is developing in an early stage, and brain imaging studies are finding that the brains of children with ADHD are different from those of the children who don’t have the disorder.
Learning disabilities, depression, behavior difficulties, obsessive-compulsive disorder, and many other problems can be confused with ADHD. A child thought to have this problem should be examined by an expert to figure out exactly what is wrong. Children with ADHD often have other developmental problems, behavioral problems, or psychiatric problems.
Symptoms of ADHD
There are two main groups of symptoms for children with ADHD:
- Inattentiveness
- Doesn’t give adequate attention to details or makes careless mistakes
- Has difficulty paying attention
- Doesn’t listen when directly spoken to
- Organization difficulty with tasks and activities
- Avoids or dislikes activities that require sustained mental focus
- Often loses important things
- Is easily distracted
- Is very forgetful
- Hyperactivity
- Fidgets or squirms a lot
- Leaves seating when in situations where you’re supposed to remain seated
- Runs or climbs inappropriately
- Difficulty in playing quietly
- Is often on the go
- Engages in excessive talking
- Frequently displays impulsivity
- Answers questions before they are completed
- Has difficulty awaiting his or her turn
- Interrupts or intrudes into other’s conversations
Signs of ADHD
Many times children are incorrectly diagnosed as ADHD or remain undiagnosed, often leading to other learning disabilities or other mental health problems being missed completely.
The American Academy of Pediatrics (AAP) gives the following guidelines to diagnose this problem:
- Children must display at least six attentive symptoms or six hyperactive or impulsive symptoms, and some symptoms must appear before age 7
- Symptoms must last at least six months in 2 settings or more and cannot be a result of another problem
- Symptoms must be debilitating enough to cause severe difficulties in many settings (school, home, and among peers)
For older children, ADHD is considered to be in remission when they still exhibit symptoms but fail to meet the full definition of the problem.
ADHD Tests
A child exhibiting symptoms of ADHD should be given an evaluation by a doctor. Any evaluation must include a questionnaire for parents and teachers, and a psychological evaluation of the child and related family. This evaluation will include IQ testing, psychological testing, and a complete examination of the developmental, mental, nutritional, physical, and psychosocial aspects of all participants.
ADHD Treatment
Treating this should be a partnership between the healthcare provider and parents (or caregiver) and the child. For this to work it is very important that you:
- Set appropriate goals
- Have you child engage in behavior therapy
- Determine the appropriate medication for your chilkd
- Attend regular follow-ups with your child’s doctor that will include input from teachers, family, and the child
If treatment is unsuccessful you should make sure the child actually has ADHD. Check medications for alternatives and make sure the treatment plan is being followed or check for other medical conditions that could cause similar problems.
ADHD Medications
It is shown that a combination of medications and behavioral treatment works best. There are several different types of medications available. Psychostimulants are the most commonly used medications. Psychostimulants have a reverse effect on people with ADHD, including a calming effect. These drugs include:
- Amphetamine-dextroamphetamine (Adderall)
- Dextroamphetamine (Dexedrine, Dextrostat)
- Dexmethylphenidate (Focalin)
- Methylphenidate (Ritalin, Concerta, Metadate, Daytrana)
- Lisdexamfetamine (Vyvanse)
Atomoxetine (Strattera) is a non-psychostimulant that has proven to be effective in treating children with ADHD.
Note that some medications can cause death in children with heart problems. Be sure to talk to your doctor first before medicating your child.
Behavior Therapy to Treat ADHD
Therapy is an important component in helping the child and parents understand and control the stress related to this problem. A system of rewards has been shown to be an effective alternative to punishment of a child with ADHD-related behavioral problems. It is also important to handle disruptive behavior appropriately.
Tips for Parents of Children with ADHD
- Communicate regularly with your child’s teacher
- Keep a consistent schedule for your child’s activities (homework, meals, activities)
- Limit distractions to your child
- Make sure your child has a healthy diet
- Make sure your child gets adequate sleep
- Set clear rules and boundaries for your child with rewards for good behavior
Alternative treatments are popular, including focusing on herbs and supplements as well as chiropractic solutions, but there is little evidence to support that any of these work.
Expectations
ADHD is a long-term, chronic condition that can lead to substance abuse, failure in school, problems at work, and trouble with law enforcement.
Call your health care provider immediately if your school’s personnel suspect ADHD because early identification and treatment can avert many problems associated with ADHD. Currently there is no proven way to prevent ADHD.