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Understanding ADHD: A Primer for Parents

 

When a child just cannot seem to hold still, many parents wonder if attention deficit hyperactivity disorder, or ADHD, may be the cause. Sometimes, it is — and sometimes, kids just get fidgety.

Knowing the difference isn’t always easy, but it can be critical for a child’s long-term success in academics, making friends and living out his or her dreams.

ADHD is one of the most commonly diagnosed disorders among children, and the rate with which it’s been diagnosed has increased in recent years, leading some parents to be skeptical about the disorder. Current estimates are that between 8 to 10 percent of children age 4 to 17 have ADHD. Boys tend to develop the disorder at twice to four-times the rate of girls.

It’s important to understand that ADHD is a disorder, not a disease. It’s an impairment in the functioning of the brain itself — a “disorder” in how signals that control impulse and focus are relayed through the brain. While it’s unclear why some children develop ADHD and others do not, recent research suggests that the disorder often runs in families. Other risk factors include exposure to lead when young (often through pipes or paint) and children born with low birth weight. Brain injuries also can lead to the disorder. Emerging research has suggested that children born to mothers who smoked or used alcohol or drugs during pregnancy may also be at increased risk as well.

Undiagnosed, ADHD leads to more than rambunctious behavior: ADHD is clinically tied to instances of depression, significant behavior issues, substance abuse, and dropping out of school. Long-term, children with untreated ADHD also tend to demonstrate poor workplace performance and an increased risk of accidents. Through treatment, however, children tend to develop better long-term relationships — with parents, siblings, educators and others — as well as better academic performance and fewer behavior-related issues.

Treatment does not necessarily have to include medicines, either — though the medications available today tend to work very well when used as prescribed. If the disorder is diagnosed early enough — when the child is preschool age, for instance — behavioral treatments are preferred, and medicinal therapy may be added if necessary as the child grows older.

The medications most commonly used to treat ADHD are stimulants, and are administered and monitored under close medical supervision. While stimulant medications such as Ritalin or Adderall are used most commonly, non-stimulant alternatives are also available. The medications work by improving, or stimulating, communication between several regions of the brain to improve concentration and self-control. The medications do not “cure” ADHD, but when paired with effective behavioral treatments, they are very good at helping children work better with others, follow rules and motivate themselves to be successful. Generally, a medical provider will start a child out on a low dose of the medication and gradually increase the dose until the patient achieves the desired level of focus.

Rather than being dismayed by a diagnosis of ADHD, many parents feel a sense of relief. Finally, they know why their child behaves differently from other children or struggles in school. Knowing that the behavior is often beyond the child’s control also helps parents in terms of patience. The pediatrician and his or her patient care team work not only with the child, but with parents in understanding the diagnosis and the types of behavior modification that can help the child be successful at home and at school. With this help, the great majority of ADHD patients can grow up to be successful and happy adults.

ADHD can be difficult to diagnose because the symptoms may at times be true of any child. Unfortunately, no blood tests or other diagnostic studies are available to diagnose ADHD. The diagnosis is most often made by taking the patient’s history, family history, and administering questionnaires for parents and others (usually teachers) to obtain further insight into the child’s problems. In cases of ADHD, the symptoms tend to be pronounced and long-term, usually occurring in multiple settings (i.e., at home, school, playground, place of worship, etc.) and persist for at least six months:

  • Hyperactivity – the inability to sit still, play quietly or be calm
  • Impulsivity – inability to wait one’s turn, often causing disruptions at home or in class
  • Inattention – forgetfulness, being easily distracted, losing things, poor attention to detail, messy and disorganized desk at school or bedroom at home

Don’t be afraid to speak with your pediatrician if your child demonstrates the symptoms of ADHD; help for you and your child is available.

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