Children with attention-deficit hyperactivity disorder (ADHD) find it unusually difficult to concentrate on tasks, to pay attention, to sit still and to control impulsive behavior. Our guide to ADHD offers information on symptoms, diagnosis and treatment options for ADHD.
ADHD: What Is It?
Attention-deficit hyperactivity disorder, or ADHD, is a persistent pattern of inattention and/or hyperactivity and impulsivity that exceeds the typical range for a child’s age and interferes significantly with his functioning. ADHD makes it unusually difficult for kids to concentrate on tasks, to pay attention, to sit still, and to control impulsive behavior. While some children exhibit mostly inattentive behaviors and others predominantly hyperactive and impulsive, the majority of those with ADHD have a combination of both.
ADHD: What to Look For
ADHD behaviors usually become apparent when a child is between 3 and 6 years of age. Hyperactive or impulsive behaviors, which are often noticed first, include fidgeting, an inability to sit still, excess energy, verbal outbursts, extreme impatience, talking incessantly, and interrupting others. The inattentive behaviors often become noticeable only when a child enters school. He might be easily distracted, have difficulty following instructions, be unusually forgetful, struggle with organizing tasks, avoid things that involve mental exertion, and appear oblivious to what’s going on around him.
Boys are diagnosed with ADHD much more frequently than girls, at a rate of about 2 to 1, though girls experience the disorder differently.
ADHD: Risk Factors
Children with a first-degree biological relative who has ADHD are more likely to develop the disorder.
Because symptoms of ADHD can also reflect other disorders, such as anxiety or depression or trauma, a professional diagnosing your child must carefully rule out other possible reasons for a child’s behavior.
A child should be diagnosed with ADHD only if he exhibits a variety of inattentive or impulsive behaviors, at a level that is abnormal for children his age, over an extended period and in multiple settings—at home and at school, for instance. The behavior must be interfering significantly with schoolwork or social interaction. A trained clinician will make the diagnosis only after a thorough examination of the child and collecting information from several people who have observed your child, including parents, teachers, and other adults. To qualify for the diagnosis, symptoms must have been present before the age of 12.
Treatment for ADHD is usually a combination of behavioral therapy and medication.
Psychotherapeutic: A variety of behavioral and psychotherapeutic methods have proven successful in managing the symptoms of ADHD. Parent-child interaction therapy, which focuses on teaching parents how to cultivate desired behaviors while minimizing the impulsive or inattentive ones, is often used effectively. Parent training is another that uses the family to address the symptoms, while cognitive behavioral therapy teaches a child to control his behaviors by understanding how his thoughts and feelings influence them. Close consultation with your child’s teachers can help him succeed despite his disorder. Tools such as a daily report card that targets desired behaviors can be effective. Social skills training may help him behave more appropriately with other children, and family therapy can help parents and siblings manage the stress created by the ADHD child’s needs and behavior.
Pharmacological: The most common medications prescribed for ADHD are psychostimulants. The two most widely used are known, generically, as methylphenidate and dextroamphetamine, which go by brand names like Ritalin and Adderall. What these drugs stimulate is the brain’s production of certain neurotransmitters that seem to activate the brain’s centers of attention and impulse control. They serve to focus the attention and curb the impulsivity and hyperactivity of kids with ADHD. Stimulant medications can have significant side effects, such as headaches, loss of appetite, and trouble sleeping. Some children are prescribed other, non-stimulant drugs approved for treatment of ADHD if the side effects of stimulants are troublesome or excessive.
Many children will outgrow their diagnosis by the time they reach young adulthood, as symptoms wane or disappear. Others continue to have symptoms that are seriously impairing as adults. Inattentive and impulsive symptoms are more likely to persist into adulthood than motor hyperactivity.
ADHD: Risk For Other Disorders
Children with ADHD are often diagnosed with oppositional defiant disorder, anxiety or depressive disorders. Tourette’s syndrome, which can cause tics and spontaneous and inappropriate utterances, also appears in conjunction with ADHD. Any course of treatment for a child with ADHD will be more effective if all of the co-occurring conditions are addressed.