Attention Deficit Hyperactivity Disorder (ADHD)

What is Attention Deficit Hyperactivity Disorder (ADHD)?

ADHD is a behavioral disorder that affects nearly 8% to 10% of school-age children. Though not understood why, boys are three times as likely to be diagnosed with ADHD as girls.

Although Attention Deficit Hyperactivity Disorder is frequently diagnosed, sometimes the normal range of factors like distractibility, impulsivity, and struggling to concentrate are mistaken for ADHD. Children develop and mature at various rates and have different levels of energy, temperaments, and personalities. It is important to remember that in order for a child to be diagnosed with ADHD, the displayed behavior must be outside of what can be considered the normal range.

Symptoms of ADHD

Symptoms of ADHD typically appear early in life, frequently between the ages of 3 and 6 years old. Because the symptoms can vary from person to person, and the degree of symptomatology can be different with every person, ADHD can be difficult to diagnose. It is quite normal for all children to be inattentive, hyperactive, or impulsive from time to time; however, for children with ADHD, these behaviors are more severe and occur more often.

The characteristics of the hyperactivity component of the disorder include but are not limited to:

• talking non-stop
• having difficulty sitting still during school, dinner, or other activities
• difficulty managing quiet tasks or activities
• fidgety, squirmy, and/or dashing around
• playing or touching anything and everything within sight
• inability to focus
• forgetfulness
• moving from one activity to another frequently
• become easily confused and have difficulty processing information

Characteristics of impulsivity can include:

• impatience
• blurting out inappropriate comments
• acting without regard for consequences
• showing emotions without restraint
• interruption of conversations or the activities of others
• have difficulty waiting for things they want or desire

What causes ADHD?

To date, the medical community has been unable to determine the cause of Attention Deficit Hyperactivity Disorder. There are a number of scholarly and medical studies that suggest genes play a significant role in the condition. In addition to the genetics as a possible contributor, factors such as the environment, nutrition, the social environment as well as how brain injuries are all being considered as potential contributors to this condition. Moreover, preschool children who have been inadvertently exposed to high levels of head, which is often found in outdated plumbing fixtures and paint in old buildings, may have a higher risk of developing ADHD. Some experts associate refined sugar with the symptomatology of ADHD, or exacerbate the symptoms of the condition; while still other research has shown a potential causal link between early childhood brain injury and Attention Deficit Hyperactivity Disorder.

Diagnosis of ADHD

To be diagnosed with the disorder, a child must have symptoms for 6 or more months and to a degree that is greater than other children of the same age.

There is no singular test that can diagnose a child as having Attention Deficit Hyperactivity Disorder. Rather, a licensed health professional will need to be involved in the process of gathering pertinent information about the child, his or her environment, behavioral patterns, and even diet.

The American Academy of Pediatrics (AAP) has issued guidelines to bring more clarity to this issue.

• Children should have at least 6 impulsivity/hyperactivity symptoms and a least 6 attention symptoms, with some symptomatology prior to the age of 7.
• The symptoms must not be caused by any other problem, seen in more than one setting like home and school, and be present for no less than 6 months.

The child should have an evaluation by a doctor if ADHD is suspected. Evaluation may include:

• Parent and teacher questionnaires (for example, Connors, Burks)
• Psychological evaluation of the child and family, including psychological and intelligence testing
• Complete examination of the child including psychosocial, nutritional mental and physical

Treatment of ADHD

As previously advised, there is no determinant cause of Attention Deficit Hyperactivity Disorder; however, the medical and clinical communities have developed a number of treatments that can serve to relieve many of the symptoms associated with the disorder. There is, however, no cure for ADHD. The American Academy of Pediatrics has guidelines for treating ADHD that include setting  specific goals, initiating behavior as well as medication therapy, and follow up to determine if the goals have been met.

It’s important to note that there is no one size fits all approach to symptomatology, diagnosis, or treatment when it comes to Attention Deficit Hyperactivity Disorder. What may be successful with one child may not be as successful with another. Any child who may exhibit behaviors that can be associated with ADHD should be individually evaluated by a seasoned professional, with input from parents, school teachers, and others who have a vested interest in the child’s well being.

ADHD can be a frustrating circumstance. Because there is no cure for this condition, alternative remedies including herbs, chiropractic manipulation, and various supplements have become increasingly popular. However, there is minimal evidence for many of the alternative remedies marketed to parents.

How to Prevent and Manage ADHD

Both prior to and after a child is diagnosed with ADHD, stress for the child and family can be high. Families can experience a variety of emotions and feelings including frustration, anger and blame. Having the child and family participate in talk therapy can help everyone deal with these feelings, overcome them, and move forward.

A reward and consequence system designed to guide the child’s behavior is most helpful with a child diagnosed with ADHD. Parents must learn to manage and handle any disruptive behaviors. There are Support groups that can be helpful in bringing parents and families together that are dealing with the same or similar issues.

Other tips to help your child with ADHD include:

• Keep lines of communication open with the child’s teacher.
• Keep the child’s schedule as consistent as possible making sure to have regularly scheduled times for meals, homework, and playtime. If changes need to be made to the schedule, make them as early as possible to avoid last minute changes. Limit distractions.
• Provide the child a diet that is balanced with enough basic nutrients and plenty of fiber.
• Ensure the child receives enough rest nightly.
• Reward and praise good behavior.
• Rules for the child need to be consistent and clear.

References:

DSM-IV-TR workgroup. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC: American Psychiatric Association.

Wilens TE, Biederman J, Spencer TJ. Attention deficit/hyperactivity disorder across the lifespan. Annual Review of Medicine, 2002; 53:113-131.