Monday, April 19, 2010

Attention-Deficit/Hyperactivity Disorder (ADHD) in Children

Childhood ADHD -- attention-deficit/hyperactivity disorder -- is diagnosed after a child has shown six or more specific symptoms of inactivity and/or hyperactivity on a regular basis for more than six months in more than two settings. There is no single test for ADHD.

A doctor can diagnose ADHD with the help of standard guidelines. The diagnosis of ADHD involves the gathering of information from several sources, including school, caregivers, and parents. The doctor will consider how a child's behavior compares with that of other children the same age.

ADHD in Children

Symptoms of Childhood ADHD

Children with ADHD show signs of inattention, hyperactivity, and/or impulsivity in specific ways. These children:
• Are in constant motion.
• Squirm and fidget.
• Do not seem to listen.
• Have difficulty playing quietly.
• Often talk excessively.
• Interrupt or intrude on others.
• Are easily distracted.
• Do not finish tasks.

Some behaviors can appear to be ADHD-related, but are not. Some causes of ADHD-like behavior are:
• A sudden life change (such as divorce, a death in the family, or moving).
• Undetected seizures.
• Medical disorders affecting brain function.
• Anxiety.
• Depression.

How Is ADHD Diagnosed?

Your child's primary care doctor can determine whether your child has ADHD using standard guidelines developed by the American Academy of Pediatrics. These diagnosis guidelines are for children 6 to 12 years of age.

Know that it is very difficult to diagnose ADHD in children younger than 5 years of age. That's because many preschool children have some ADHD symptoms in various situations. In addition, children change very rapidly during the preschool years. It is also difficult to diagnose ADHD once a child becomes a teenager.

The process of diagnosing ADHD requires several steps and involves gathering a lot of information from multiple sources. You, your child, your child's school, and other caregivers should be involved in assessing your child's behavior.

A physician can conduct a medical history to help put a child's behavior in context. They will ask what symptoms a child is showing, how long the symptoms have occurred, and how the behavior affects a child and his/her family.

Types of ADHD in Children
Doctors may classify symptoms as the following types of ADHD:
• Combined Type (Inattentive/Hyperactive/Impulsive). Children with this type of ADHD show all three symptoms. This is the most common form of ADHD.
• Hyperactive/Impulsive Type. Children show both hyperactive and impulsive behavior, but are able to pay attention.
• Inattentive Type. Formerly known as attention deficit disorder (ADD), these children are not overly active. They do not disrupt the classroom or other activities, so their symptoms might not be noticed.

ADHD Treatment Overview
Education of the child and family is an essential component of any treatment plan, which may encompass special education programs, psychological intervention, and drug treatment. Be sure to discuss all options with your child's health care provider to find the best treatment for him or her.
Studies show that long-term treatment with a combination of medications andbehavioral therapy is far superior to just medication treatment, or no specific treatments in managing hyperactivity, impulsivity, inattention, and symptoms of anxiety and depression. Those kids treated with both ADHD drugs and therapy also had better social skills.

Drugs for Childhood ADHD
A class of drugs called psychostimulants or stimulants for short is a highly effective treatment for childhood ADHD. These medicines, including Ritalin, Concerta, and Adderall XR, help children to focus their thoughts and ignore distractions. Stimulant medications are effective in 70% to 80% of patients.
Another treatment used to treat ADHD in kids is the nonstimulant medication, Strattera. More studies will need to be done to contrast Strattera with the medications already available, but the evidence to date indicates that over 70% of children with ADHD given Strattera have significant improvement in their symptoms.
ADHD medicines are available in short-acting (immediate-release), intermediate-acting, and long-acting forms. It may take some time for a physician to find the best medication, dosage, and schedule for an individual with ADHD. ADHD drugs sometimes have side effects, but these tend to happen early in treatment. Usually, side effects are mild and short-lived.

Behavioral Treatments for Children With ADHD
Behavioral treatment for children with ADHD involves adjusting the environment to promote more successful social interactions. Such adjustments include creating more structure, encouraging routines, and clearly stating expectations of the child with ADHD.

Other forms of ADHD treatment that may benefit the child include:
• Social skills training. This can help a child with ADHD learn behaviors that will help them develop and maintain social relationships.
• Support groups and parenting skills training. Education and support for the parents can be an integral part of treating ADHD in children.

What Treatment Is Best for My Child?
For children with ADHD, no single treatment is the answer for every child. A child may have undesirable side effects to a medication, making a particular treatment unacceptable. If a child with ADHD also has anxiety or depression, a treatment combining medication and behavioral therapy might be best. Each child's needs and personal history must be carefully considered. It is important to work with a physician to find the best solution for your child.

The ADHD Coach?
Coaching is a relatively new field in the treatment of ADHD in children. ADHD coaches are meant to help children achieve better results in different areas of their lives.

Posted by Lim Sin Loong, T3

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