Attention Deficit with Hyperactivity Disorder
ADHD is a common behavioural disorder that affects an estimated 8% to 10% of school-age children. Boys are about three times more likely than girls to be diagnosed with it, though it's not yet understood why.
Kids with ADHD act without thinking, are hyperactive, and have trouble focusing. They may understand what's expected of them but have trouble following through because they can't sit still, pay attention, or attend to details.
Of course, all kids (especially younger ones) act this way at times, particularly when they're anxious or excited. But the difference with ADHD is that symptoms are present over a longer period of time and occur in different settings. They impair a child's ability to function socially, academically, and at home.
The good news is that with proper treatment, kids with ADHD can learn to successfully live with and manage their symptoms.
Symptoms
ADHD is broken down into three subtypes, each with its own pattern of behaviours:
1. an inattentive type, with signs that include:
· inability to pay attention to details or a tendency to make careless errors in schoolwork or other activities
· difficulty with sustained attention in tasks or play activities
· apparent listening problems
· difficulty following instructions
· problems with organization
· avoidance or dislike of tasks that require mental effort
· tendency to lose things like toys, notebooks, or homework
· distractibility
· forgetfulness in daily activities
2. a hyperactive-impulsive type, with signs that include:
· fidgeting or squirming
· difficulty remaining seated
· excessive running or climbing
· difficulty playing quietly
· always seeming to be "on the go"
· excessive talking
· blurting out answers before hearing the full question
· difficulty waiting for a turn or in line
· problems with interrupting or intruding
3. a combined type, which involves a combination of the other two types and is the most common
Although it can be challenging to raise kids with ADHD, it's important to remember they aren't "bad," "acting out," or being difficult on purpose. And they have difficulty controlling their behaviour without medication or behavioural therapy.
Diagnosis
Because there's no test that can determine the presence of ADHD, a diagnosis depends on a complete evaluation. Many children and adolescents diagnosed with ADHD are evaluated and treated by primary care doctors including pediatricians and family practitioners, but your child may also be referred to one of several different specialists (psychiatrists, psychologists, neurologists) especially when the diagnosis is in doubt, or if there are other concerns, such as Tourette syndrome, a learning disability, anxiety etc.
To be considered for a diagnosis of ADHD:
· a child must display behaviours from one of the three subtypes before age 7
· these behaviours must be more severe than in other kids the same age
· the behaviours must last for at least 6 months
· the behaviours must occur in and negatively affect at least two areas of a child's life (such as school, home, day-care settings, or friendships)
The behaviours must also not only be linked to stress at home. Kids who have experienced a divorce, a move, an illness, a change in school, or other significant life event may suddenly begin to act out or become forgetful. To avoid a misdiagnosis, it's important to consider whether these factors played a role in the onset of symptoms.
Causes of ADHD
ADHD is not caused by poor parenting, too much sugar, or vaccines.
ADHD has biological origins that aren't yet clearly understood. No single cause has been identified, but researchers are exploring a number of possible genetic and environmental links. Studies have shown that many kids with ADHD have a close relative who also has the disorder.
Although experts are unsure whether this is a cause of the disorder, they have found that certain areas of the brain are about 5% to 10% smaller in size and activity in kids with ADHD. Chemical changes in the brain also have been found.
Recent research also links smoking during pregnancy to later ADHD in a child. Other risk factors may include premature delivery, very low birth weight, and injuries to the brain at birth.
Some studies have even suggested a link between excessive early television watching and future attention problems. Parents should follow the American Academy of Pediatrics' (AAP) guidelines, which say that children under 2 years old should not have any "screen time" (TV, videotapes, computers etc) and that kids 2 years and older should be limited to 1 to 2 hours per day, or less, of quality television programming.
Related Problems
One of the difficulties in diagnosing ADHD is that it's often found in conjunction with other problems. These are called coexisting conditions, and about two thirds of kids with ADHD have one. The most common coexisting conditions are:
Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD)
At least 35% of kids with ADHD also have oppositional defiant disorder, which is characterized by stubbornness, outbursts of temper, and acts of defiance and rule breaking. Conduct disorder is similar but features more severe hostility and aggression. Kids who have conduct disorder are more likely to get in trouble with authority figures and, later, possibly with the law. Oppositional defiant disorder and conduct disorder are seen most commonly with the hyperactive and combined subtypes of ADHD.
Mood Disorders
About 18% of kids with ADHD, particularly the inattentive subtype, also experience depression. They may feel inadequate, isolated, frustrated by school failures and social problems, and have low self-esteem.
Anxiety Disorders
Anxiety disorders affect about 25% of kids with ADHD. Symptoms include excessive worry, fear, or panic, which can also lead to physical symptoms such as a racing heart, sweating, stomach pains, and diarrhea. Other forms of anxiety that can accompany ADHD are obsessive-compulsive disorder and Tourette syndrome, as well as motor or vocal tics (movements or sounds that are repeated over and over). A child who has symptoms of these other conditions should be evaluated by a specialist.
Learning Disabilities
About half of all kids with ADHD also have a specific learning disability. The most common learning problems are with reading (dyslexia) and handwriting. Although ADHD isn't categorized as a learning disability, its interference with concentration and attention can make it even more difficult for a child to perform well in school.
If your child has ADHD and a coexisting condition, the doctor will carefully consider that when developing a treatment plan. Some treatments are better than others at addressing specific combinations of symptoms.
Treating ADHD
ADHD can't be cured, but it can be successfully managed. Your child's doctor will work with you to develop an individualized, long-term plan. The goal is to help a child learn to control his or her own behaviour and to help families create an atmosphere in which this is most likely to happen.
In most cases, ADHD is best treated with a combination of medication and behaviour therapy. Any good treatment plan will require close follow-up and monitoring, and your doctor may make adjustments along the way. Because it's important for parents to actively participate in their child's treatment plan, parent education is also considered an important part of ADHD management.
Medications
Several different types of medications may be used to treat ADHD:
Medications can affect kids differently, and a child may respond well to one but not another. When determining the correct treatment, the doctor might try various medications in various doses, especially if your child is being treated for ADHD along with another disorder.
Behavioural Therapy
Research has shown that medications used to help curb impulsive behaviour and attention difficulties are more effective when combined with behavioural therapy.
Behavioural therapy attempts to change behaviour patterns by:
· reorganizing a child's home and school environment
· giving clear directions and commands
· setting up a system of consistent rewards for appropriate behaviours and negative consequences for inappropriate ones
Alternative Treatments
Currently, the only ADHD therapies that have been proven effective in scientific studies are medications and behavioural therapy. But your doctor may recommend additional treatments and interventions depending on your child's symptoms and needs. Some kids with ADHD, for example, may also need special educational interventions such as tutoring, occupational therapy, etc. Every child's needs are different.
A number of other alternative therapies are promoted and tried by parents including: megavitamins, body treatments, diet manipulation, allergy treatment, chiropractic treatment, attention training, visual training, and traditional one-on-one "talking" psychotherapy. However, scientific research has not found them to be effective, and most have not been studied carefully, if at all.
Parents should always be wary of any therapy that promises an ADHD "cure." If you're interested in trying something new, speak with your consultant first.
At ABCD…
We are bestowing the Attention Training, Behaviour Modification, Computer aided Instruction, Remedial Education and Clinical Teaching, Occupational Therapy etc to the children with ADHD to overcome his difficulties.
