25.08.2011
Attention Deficit Hyperactivity Disorder
ADHD is a problem with inattentiveness, hyper-activity, impulsivity, or a combination of these issues. For these problems to be diagnosed as ADHD they must be out of the normal range for a child’s age and development and they must interfere with the child’s functioning at school and at home. ADHD is the most commonly diagnosed behavioral disorder of childhood. It affects about 3 – 5% of school aged children. ADHD is diagnosed much more often in boys than in girls. Imaging studies suggest that the brains of children with ADHD are different from those of other children. These children handle neurotransmitters (including dopamine, serotonin, and adrenaline) differently from their peers. ADHD may run in families, but it is not clear exactly what causes it. Whatever the cause may be, it seems to be set in motion early in life as the brain is developing.
The symptoms of ADHD are divided into inattentiveness, and hyperactivity and impulsivity. Some children with ADHD primarily have the inattentive type, some the hyperactive-impulsive type, and some the combined type.
Inattention symptoms:
1. Fails to give close attention to details or makes careless mistakes in schoolwork
2. Has difficulty sustaining attention in tasks or play
3. Does not seem to listen when spoken to directly
4. Does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace
5. Has difficulty organizing tasks and activities
6. Avoids or dislikes tasks that require sustained mental effort (such as schoolwork)
7. Often loses toys, assignments, pencils, books, or tools needed for tasks or activities
8. Is easily distracted
9. Is often forgetful in daily activities
Hyperactivity symptoms:
1. Fidgets with hands or feet or squirms in seat
2. Leaves seat when remaining seated is expected
3. Runs about or climbs in inappropriate situations
4. Has difficulty playing quietly
5. Is often “on the go,” acts as if “driven by a motor,” talks excessively
Impulsivity symptoms:
1. Blurts out answers before questions have been completed
2. Has difficulty awaiting turn
3. Interrupts or intrudes on others (butts into conversations or games)
The child should have an evaluation by a psychologist, psychiatrist, or other licensed mental health professional if ADHD is suspected. Evaluation may include:
• Parent and teacher questionnaires (for example, Connors, Achenbach)
• Psychological evaluation of the child including IQ testing and psychological testing
• Complete developmental, mental, nutritional, physical, and psychosocial examination
Children who receive both behavioral treatment and medication often display the most improvement. There are now several different classes of ADHD medications that may be used alone or in combination. Psychostimulants (also known as stimulants) are the most commonly used ADHD drugs. Although these drugs are called stimulants, they actually have a calming effect on people with ADHD. These drugs include:
• Adderall
• Focalin
• Dexedrine, Dextrostat
• Vyvanse
• Ritalin, Concerta, Metadate, Daytrana
The Food and Drug Administration (FDA) has also approved the nonstimulant drug Strattera for use in ADHD. In some cases, it may be as effective as stimulants, and may be less likely to be misused.
Both before and after a child is diagnosed, there is stress on the family. Families can experience blame, anger, and frustration. The child has often faced years of rejection from friends and teachers. Therapy for both the child and family can help everyone overcome these feelings and move forward. Parents should use a system of rewards to help guide their child’s behavior. It is important to learn to manage disruptive behaviors. Support groups can help you connect with others who have similar problems. Other tips to help your child with ADHD include:
• Communicate regularly with the child’s teacher.
• Keep a consistent daily schedule, including regular times for homework, meals, and outdoor activities. Make changes to the schedule in advance and not at the last moment.
• Limit distractions in the child’s environment.
• Make sure the child gets a healthy diet.
• Make sure the child gets enough sleep.
• Praise and reward good behavior.
• Provide clear and consistent rules for the child.
About half of children with ADHD will continue to have troublesome symptoms of inattention or impulsivity as adults. However, adults are often more capable of controlling behavior and masking difficulties.
Depression, lack of sleep, learning disabilities, tic disorders, and behavior problems may be confused with, or appear with, ADHD. Every child suspected of having ADHD should have a careful evaluation to determine what is contributing to the behaviors that are causing concern. Too often, difficult children are incorrectly labeled with ADHD. On the other hand, many children who do have ADHD remain undiagnosed. In either case, related learning disabilities or mood problems are often missed. For information, evaluation, or treatment contact Chrysalis Health.
