Summary for HealthiNation's Attention Deficit Hyperactivity Disorder (ADHD)

Hosted by Dr. Preeti Parikh, Pediatrics

What Is ADHD?

ADHD is a disorder of the brain. It first appears during childhood, and continues throughout adulthood, affecting almost every part of life. ADHD is divided into two major patterns of behavior: inattention and hyperactive-impulsive behavior. It may even be a combination of the two. Inattention means it's hard for your child to focus on a set of tasks for a sustained period of time. Hyperactivity means your child may often feel restless and can't easily settle down. Impulsive behavior means trouble controlling urges and impulses.

Causes of ADHD

Experts aren't entirely sure about what causes ADHD, but there are some common factors that maybe play a role.

• Genetics. If a close relative has ADHD, a child has an increased chance of having it as well.
• Brain Chemistry. Studies have shown there may be a link between ADHD behavior and the amount of neuron transmitters in the brain. These are chemicals that help brain cells communicate with each other. Even the size of the brain can be related to ADHD.
• Environmental Factors. Children who are exposed to environmental toxins like lead, which can be found in paint, may be at in increased risk of developing ADHD.
• Behavior During Pregnancy. Smoking, drinking and drug use during pregnancy can affect a fetus' development in the womb and may increase the chances of having a child with ADHD.

Effects of ADHD

ADHD can lead to problems with self esteem, relationships, school work and stress. It is not only tough on kids who have it, but others around them can be affected as well. ADHD impulses can lead to dangerous behavior due to poor judgment, like running across the road without looking or being reckless on a bicycle.

Signs & Symptoms of ADHD

ADHD can be hard to spot, and there's no one test to diagnose it. It's recommended that parents watch for at least six symptoms to be present for at least six months. It's also important that your child show these symptoms in two settings—both home and school, so you should get input from your child's teachers, babysitters, or anyone who spends time with your child. Symptoms generally appear before a child is seven years old. They include:

• A failure to pay close attention to details, schoolwork or other activities
• Trouble paying attention during routine tasks or play
• Inability to listen when spoken to directly
• Difficulty following instructions or following through with school work or chores
• Trouble organizing tasks or activities
• Avoids or dislikes activities that require a lot of mental effort for a long period of time
• Loses things needed for certain tasks like pencils, books or toys
• Easily distracted or generally forgetful about daily activities

To spot hyperactivity specifically, look for these signs:

• Fidgeting with hands or feet or squirming in a seat
• Getting out of a seat when its expected that he or she remain seated
• Running or climbing at inappropriate times
• Difficulty playing or enjoying activities quietly
• Always seem "on the go"
• Talking excessively

Impulsivity symptoms include:

• Blurting out answers before questions are finished
• Difficulty waiting for one's turn
• Interrupting or intruding in on others, like butting into conversation or games

If feel your child has had at least six of these symptoms for six months or longer, consult a doctor. He or she will ask about your child's behavior at home and will give you forms to bring to your child's school.

Treating ADHD

There is no single treatment for children with ADHD, but the best course of action is believed to be a combination of therapy, medication, and a strong support system at home and at school.

Therapeutic Approaches

Behavioral Therapy. This uses a reward system to reinforce positive actions. On the flipside it uses a punishment system, like a' time-out,' to discourage negative actions.

Psychotherapy. Your child will meet with a psychologist or psychiatrist. Both can conduct therapy sessions, but only a psychiatrist can prescribe medications. During these sessions, your child will talk about what is happening in his or her life, and how he/she feels in different situations.

Family Therapy. This can be done to teach parents, brothers and sisters to understand what ADHD is and how to live with a family member who has it.

Medications

In some children, medications may be an appropriate form of treatment, especially if the disorder is severe. Work with your doctor to discuss the benefits and risks of each medication.

Stimulants. These are usually the first drug of choice, and have a long safety history. It's believed they help regulate natural chemicals called neurotransmitters in the brain. These are strong medicines, and need to be given in the correct dose and for the correct length of time. The controversy surrounding these drugs involves addiction. This is a valid concern since these medications are similar to amphetamines or "speed," but there have been no reports of addiction in the children who received the proper dosage.

Side effects to watch for include:

• Loss of appetite and weight
• Nervousness
• Sleep problems
• In rare cases, growth and heart problems have been reported

NRIs, or Norepinephrine Reuptake Inhibitors. These drugs are usually prescribed to people who are at a higher risk of developing side effects from stimulants. This drug though comes with its own side effects; including possible liver problems. The FDA has also warned doctors to watch for signs of suicidal thinking in both children and adolescents taking drugs in this class of medication.

Antidepressants. These have shown some promise in helping manage ADHD. Since many children with ADHD also suffer from depression, this treatment can be very effective.

The best course of treatment is the combination of both therapy and medication at the same time. Think of this as a partnership between you, your child's teacher and your child's doctor. Together you can ensure a bright future for a child with ADHD.

HealthiNation offers health information for educational purposes only; this information is not meant as medical advice. Always consult your doctor about your specific health condition.