ADHD in Children
Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurobiological disorder characterized by developmentally inappropriate impulsivity, inattention, and in some cases, hyperactivity. All of us have occasional difficulty sitting still, paying attention, or controlling impulsive behavior. For some children and adults, however, the problem is so pervasive and persistent that it interferes with their daily lives at home, at school, at work, and in social settings.
Between 3 to 7 percent of school children are affected by ADHD in the U.S. In the pediatric age group, ADHD is much more common in boys than in girls.
Studies show that patients with ADHD have demonstrable low levels of catecholamine in their brains, and the actual brain volume in certain areas of the brain may also be smaller. Scientists have also isolated certain genes which are specifically associated with ADHD. Essentially, ADHD occurs due to low levels of certain chemicals in the brain.
How to diagnose ADHD?
To make the diagnosis, several of the ADHD symptoms must be present before the age of 12 years, and symptoms must be present in more than one setting. Diagnosis is made mostly by getting history from the parents, caregivers, teachers and other adults who work with the child. Your doctor will ask the parent/caregiver and the teacher to fill out one of several different rating scales. Some of the commonly used rating scales are the Connor’s, Vanderbilt, and Child Behavior Checklist. Then, the doctor will do a very detailed interview with you and the child.
What are the symptoms of ADHD?
ADHD has three sub types, and symptoms will vary accordingly:
- ADHD inattentive type
- ADHD hyperactive/impulsive type
- ADHD combined type
The symptoms of the inattentive type of ADHD include:
- Makes careless mistakes/poor attention to detail
- Difficulty sustaining attention in tasks/play
- Does not seem to listen when spoken to directly
- Difficulty following instructions
- Difficulty organizing tasks/activities
- Avoids tasks requiring sustained mental effort
- Loses items necessary for tasks/activities
- Easily distracted by extraneous stimuli
- Often forgetful in daily activities
The symptoms of the hyperactive/impulsive type include:
- Leaves seat
- Runs or climbs excessively (or restlessness)
- Difficulty engaging in leisure activities quietly
- “On the go” or “driven by a motor”
- Talks excessively
- Blurts out answers before question is completed
- Difficulty waiting turn
- Interrupts or intrudes on others
What are the treatment options for ADHD?
The Gold standard of treatment is stimulant medication, though there are several other classes of medications also that can be used. Other things that could be used in conjunction are: cognitive behavioral therapy, parent management training, social skills training and educational support at school in the form of a 504 plan and/or an Individualized Education Plan (IEP.)
Will my child ever “grow out of it”?
As the child matures, the hyperactivity and impulsivity decrease, but the inattention is more likely to be a lifelong issue.
We often use the “Rule of Thirds” to break down the potential outcomes of ADHD cases:
- 1/3 -> complete resolution
- 1/3 -> continued inattention, some impulsivity
- 1/3 -> early Oppositional Defiant Disorder/Conduct Disorder, poor academic achievement, substance abuse, antisocial adults
How Preferred Medical Group Can Help
Erica Chapman, Mother of Eriel Chapman
Many behaviors can be a sign of possible learning problems. Of course, one indicator is poor grades in school. But often, children with learning problems also have trouble learning to take care of themselves at home or in the community independently (e.g., young children may show delays in learning to walk or talk, older children may have trouble learning to keep up their daily hygiene on their own). Other children have very strong abilities in some areas but struggle in one particular area. Sometimes children act out when they have learning problems. They might try to avoid going to school or begin to have physical ailments, such as stomachaches or headaches.
If you suspect your child may have learning problems, talk to your child’s teacher or doctor about your concerns. Learning problems can be diagnosed by completing a psychological evaluation that includes an IQ or developmental test to assess your child’s overall intellectual abilities, an assessment of adaptive behavior skills (i.e., independent daily living skills), and, depending on your child’s age, possibly an achievement test to assess specific academic skills. A comprehensive evaluation is necessary to rule out other problems that may be affecting your child’s grades, such as depression, anxiety, or ADHD. Treatment for learning problems usually includes special instruction or accommodations at school to help your child learn.