What is ADHD?
Attention-deficit/hyperactivity disorder (ADHD) is one of the most common mental disorders affecting children. ADHD is a brain condition that is often first identified in school-aged children when it causes disruption in the classroom or problems with schoolwork. An estimated 3 to 7 percent of school-aged children have symptoms of ADHD. ADHD can affect adults too. While some children seem to outgrow the disorder, or learn to compensate for the symptoms, others do not. Attention-deficit/hyperactivity disorder (ADHD) has been called attention-deficit disorder (ADD) and hyperactivity. But ADHD is the preferred term because it includes the two main aspects of the condition: inattention and hyperactive-impulsive behavior.
Symptoms and Diagnosis
Many ADHD symptoms, such as high activity levels, difficulty remaining still for long periods and limited attention spans, are common to young children in general. The difference in children with ADHD is that their hyperactivity and inattention are noticeably greater than expected for their age and interfere with functioning at home, at school, or with friends. A child with ADHD may squirm and fidget, daydream a lot, have difficulty following instructions, appear to not listen when being spoken to, not be able to stay seated, talk too much/interrupt, or be easily distracted. Diagnosing ADHD can be challenging because the symptoms differ from child to child: for some children hyperactivity is significant, others struggle more with paying attention. For the majority, the symptoms cause problems. There is no lab test for ADHD. Diagnosis involves gathering information from parents, teachers, and others, often filling out checklists, and a medical evaluation (including vision and hearing screening) to rule out other medical problems
Causes of ADHD
Scientists have not yet identified the specific causes of ADHD.There is evidence that genetics contribute to ADHD. For example, 3 out of 4 children with ADHD have a relative with the disorder. Other factors that may contribute to the development of ADHD include being born prematurely; brain injury; and the mother smoking, using alcohol, or having extreme stress during pregnancy.
ADHD and Adults
Adult ADHD symptoms may include:
- Trouble focusing or concentrating
- Difficulty completing tasks
- Low frustration tolerance
- Frequent mood swings
- Hot temper
- Trouble coping with stress
- Unstable relationships
Many adults with ADHD aren't aware they have it — they just know that everyday tasks can be a challenge. Adults with ADHD may find it difficult to focus and prioritize, leading to missed deadlines and forgotten meetings or social plans. The inability to control impulses can range from impatience waiting in line or driving in traffic to mood swings and outbursts of anger.
All adults with ADHD had ADHD as children, even if it was never diagnosed. Some people with ADHD have fewer symptoms as they age, while others continue to have significant symptoms as adults.
ADHD and the School-Aged Child
Teachers and school staff can provide parents and doctors with information to help evaluate behavior and learning problems and can assist with behavioral training. However, school staff cannot diagnose ADHD, make decisions about treatment, or require that a student take medication to attend school. Only parents and guardians can make those decisions with the child’s physician. Students whose ADHD impairs their learning may qualify for special education services through their school. Children with ADHD can benefit from study skills instruction, changes to the classroom setup, alternative teaching techniques, and a modified curriculum.
Children who have ADHD tend to benefit from structure, established routines, and clear expectations. It may be helpful to maintain routines, make sure instructions are understood – use simple words/demonstrate, focus on your child when talking to him/her, maintain communication with the child’s teacher, model calm behavior, and focus on effort and reward good behavior. Consequences of Untreated ADHD If left untreated, children with ADHD are at greater risk for potentially serious consequences, including school failure and dropout, behavioral and discipline problems, social difficulties, family problems, alcohol and drug abuse, and depression. Similar problems can persist into adulthood, including relationship and employment problems
Consequences of Untreated ADHD
If left untreated, children with ADHD are at greater risk for potentially serious consequences, including school failure and dropout, behavioral and discipline problems, social difficulties, family problems, alcohol and drug abuse, and depression. Similar problems can persist into adulthood, including relationship and employment problems.
Behavioral therapy and medication can improve the symptoms of ADHD. Studies have found that a combination of behavioral therapy and medication works best for most patients.
Behavioral therapy focuses on managing the symptoms of ADHD. Therapy usually consists of teaching parents and teachers how to provide positive feedback for desired behaviors and consequences for negative ones. Although behavioral therapy requires careful coordination, it can help children learn how to control their behavior.
There are two main types of medication for ADHD: stimulants and non-stimulants. Stimulant medications are highly effective treatments that have been safely used for decades.They include methylphenidate (which is sold under brand names Ritalin, Concerta, Metadate, and Focalin) and amphetamines (sold as Dexedrine,Vyvanse, and Adderall). As with all medicines, children taking these drugs must be carefully monitored by their parents and doctors. Atomoxetine (Strattera) and guanfacine (Intuniv) are nonstimulants that have also been shown to be effective in the treatment of ADHD symptoms.These medications are alternatives for those who do not respond well to stimulants or if a non-stimulant is preferred. Some children experience dramatic relief of symptoms with medication and this relief continues with ongoing treatment. Other children may experience only partial relief or the medication may seem to stop working. A change in medication or adjustment in dose may improve the response. Other children and families may benefit from additional therapy specific to problem behaviors.