Attention deficit hyperactivity disorder is one of the most common conditions that affect children today. At times children with this condition, exhibit uncontrolled behavior. Continual trouble controlling behavior that interferes with normal life could be a sign of a problem. Between 4 and 8 percent of children have ADHD, although it is three times more common in boys. Kids with ADHD often have trouble focusing or concentrating, and they might shout out answers without raising their hand, lose things, interrupt people, or fidget and move around a lot.

Though ADHD seems extremely common—even more so than in the past—it is also receiving more attention. Doctors are constantly studying this condition and developing new methods of treatment. The focus on this disorder allows for symptom recognition and early treatment.

• Types of ADHD
• How is ADHD diagnosed?
• What causes ADHD?
• How is ADHD treated?

Types of ADHD

There are three main types of ADHD

1. Inattentive: People with inattentive ADHD have a hard time paying attention for long periods of time. They often don't listen to instructions, can be disorganized and forgetful, and may have trouble being careful on homework. Kids will often avoid activities that require mental focus, and they may have trouble completing tasks and following directions. In a classroom, this child might seem simply uninterested and could be overlooked by a teacher.
   
2. Hyperactive-impulsive: People with hyperactive ADHD have trouble staying seated and often are often squirmy, constantly moving or fidgeting. They might talk a lot and interrupt people or blurt out answers. They are often constantly in motion, impatient and have trouble waiting in line. Their behavior seems disruptive and intrusive. These behaviors are often noticed in a classroom, as compared to the behaviors of other children.
   
3. Combination: People with combination ADHD have a combination of inattentive and hyperactive-impulsive. Combination ADHD is the most common type in both kids and adults.

Children with ADHD do not act out intentionally. They are not in control of their behavior.

Back to top

How is ADHD diagnosed?

ADHD symptoms can range from barely noticeable to very severe, and it is not always easy to tell if someone has ADHD or not. There is no clear test to prove a diagnosis, so ADHD should be diagnosed by a doctor or someone who specializes in mental health, along with a team of observers. The primary care doctor usually makes the original diagnosis and refers the child to specialists such as a neurologist, psychiatrist, or psychologist.

Usually, kids are diagnosed with the problem between ages 6 and 12, when the condition starts to affect schoolwork and studying. It is not usually diagnosed in preschool kids; it is normal for them to act inattentive and squirmy, so it's hard to tell what's normal and what's ADHD. Before a doctor decides that an older child has ADHD, however, he or she will make sure that the symptoms were present before age 7. The diagnosing doctor will compare the child’s behavior to that of other kids of the same age to see if these behaviors have a negative effect on many environments including school and home, other activities and relationships. The symptoms also must persist for a minimum of six months.

If a major stress or event has occurred in a child’s life, they may exhibit ADHD symptoms for a period of time, although they have not developed ADHD. A death in the family, illness, divorce or change in environment can negatively affect a child’s behavior.

ADHD does have a genetic component, meaning it runs in families. When diagnosing a child, a doctor will take a medical history. Parents often complete a questionnaire and will be asked questions regarding their child’s behavior and development in various environments. Other adults who interact with the child, as well as an educational specialist at the child’s school, may also be interviewed. This extensive collection of information is extremely valuable in making a diagnosis.

Quite often, ADHD co-exists with another condition. In fact, two-thirds of the diagnoses are made in conjunction with another disorder. In children diagnosed with hyperactive-impulsive ADHD, there are two common accompanying disorders: Approximately 35 percent of children with ADHD also have oppositional defiant disorder (ODD), in which the child refuses to follow authority and stubbornly reacts; or conduct disorder (CD), in which the child may encounter trouble following directional authority at school, and if left untreated, with the law later in life. Children with the inattentive type of this disorder may exhibit mood disorders such as depression or anxiety. These children’s difficult academic and social interactions can lead them to feel alone and lower their self-esteem. Twenty-five percent of children with ADHD exhibit symptoms of an anxiety disorder, such as obsessive-compulsive disorder, or Tourette syndrome. Learning disabilities accompany 50 percent of ADHD diagnoses, most commonly dyslexia and difficulty with handwriting or reading.
Back to top

What causes ADHD?

Most researchers believe ADHD is partially genetic, so it is common within families. It might also be related to drugs, smoking or alcohol use when the mother is pregnant, although this has not been confirmed. A premature birth, low-birth weight or brain injury when born may also lead to ADHD development.

Research has shown that children with ADHD have a 5 to 10 percent smaller size of some brain regions, as well as chemical differences in the brain. ADHD may also be connected to abnormal activity of two brain chemicals called dopamine and norepinephrine. These chemicals control concentration and activity.

Various studies, though not confirmed, show that young children who watch TV or other visual media have shorter attention spans and difficulty concentrating. The American Academy of Pediatrics recommends children under age 2 watch no TV or such media, and children over the age of two watch no more than one or two hours a day.
Back to top

How is ADHD treated?

There is no cure for ADHD, but it can be controlled. Treatment is generally considered if symptoms affect daily living or school work. People with ADHD may take certain medicines or get therapy or counseling.

Parents play a crucial role in identifying symptoms, and after diagnosis, creating an environment to help manage the behaviors. As with any disorder, education is key. Educate yourself about treatment options and discuss them with your child’s team of helpers. A successful treatment plan often includes both medication and behavioral therapy, provided by a psychiatrist and a psychologist.

Behavioral therapy helps a child recognize positive and undesirable or negative behaviors, along with a system of rewards and punishments. The therapist helps a child create a successful routine that they can follow every day, as well as organize tasks that need to be completed. Parents can help their child adhere to an organized schedule, and when offering a choice to a child, limit the complicity and give concise directions. It is important for parents to realize that behavior change is a gradual process taken one step at a time. Small improvements add up to successful change, and appropriate rewards and discipline can encourage a child. Organize a list of positive reinforcements, and follow through when the child makes improvements. Instead of overly harsh discipline, remove a privilege or wait to respond until the child exhibits improved behavior. Allow your child to feel confident. Help them find things they are good at to encourage their success.

The most common type of medication used to treat ADHD is stimulants. Taken orally, these pills usually last between four and 12 hours, and they have successfully been used in treatment for more than 50 years. There are no obvious long-term effects, but in the short-term, a child may feel nauseous, have trouble sleeping and eating properly, and they may seem irritable. Drugs called non-stimulants do not cause the effects of stimulants, and they have been used since 2003. Non-stimulants are usually taken once a day. As of 2004, the FDA warned the use of antidepressants may cause an increased risk of suicide or depression. Antidepressants can be a successful treatment option, however, so parents should discuss concerns with doctors. All medications are different and have various effects depending on the patient. Be persistent, and make sure your child is carefully monitored while taking medications.

Alternative treatment methods have not proved as successful as the combination of medication and behavioral therapy.

Dealing with ADHD is a difficult task, but with proper attention to symptoms and treatment, and consistent follow-up, parents can help their children who have this disorder succeed.
Back to top