ADHD (Attention Deficit Hyperactivity Disorder) in Children

ADHD is a chronic bio-behavioral disorder. Originally it is obvious in childhood and is characterized by hyperactivity, impulsivity, and inattention. People with ADHD are not always affected by all three behavioral categories. These symptoms can bring about difficulty in academic, emotional, and social functioning. ADHD is the most frequently studied and diagnosed psychiatric disorder in children, affecting about 3% to 5% of children worldwide and diagnosed in about 2% to 16% of school aged children.

Symptoms

  • Inattention-Can’t pay close attention to details or makes careless mistakes in schoolwork, work or other activities.Has trouble keeping attention on tasks or play.
  • Doesn\’t appear to listen when being told something.
  • Neither follows through on instructions nor completes chores, schoolwork, or jobs (not due to oppositional behavior or failure to understand).
  • Have trouble organizing activities and chores.
  • Dislikes or avoids tasks that involve sustained mental effort (homework, schoolwork).
  • Loses objects needed for activities (assignments, books, pencils, tools, toys).
  • Easily diverted by irrelevant stimuli. They often switch off to one activity to another.
  • Forgetful. Absent-Minded

Hyperactivity-Impulsivity

  • Wriggles in seat or fidgets.
  • Inappropriately leaves seat.
  • Improperly runs or climbs (in adolescence or adulthood, they may have hardly a subjective feeling of restlessness).
  • Has problem quietly playing or engaging in leisure activity.
  • Emerges driven or \”on the go\”.
  • Talks extremely.

Impulsivity

  • Replies questions before they have been completely asked.
  • Has problem waiting for things they want or waiting their turns in games
  • Disrupts or intrudes on others.
  • Initiates before age 7.

Symptoms must be present in at least 2 types of situations, such as school, work, and home.

The disorder brings trouble in school, social or occupational functioning.
It is more difficult for a child to perform well in school.

How is ADHD diagnosed?

The assessment of a child suspected of having ADHD engages a range of disciplines to give complete medical, developmental, educational, and psychosocial evaluations. Psychiatric assessment is the most important.

Interviewing parents and the child along with the child\’s teacher(s) is essential. Investigation concerning the family history for behavioral and social problems is crucial.

As direct person-to-person interaction is considered vital at the beginning of an investigation, follow-up studies may be guided by comparing standardized questionnaires (parental and teacher) completed before intervention and following to therapeutic trials of medication, behavioral therapy, or other approaches.

Both physicians and parents should be aware of that schools are federally authorized to perform an appropriate assessment if a child is suspected of having a disability that damages academic performance.

Causes of ADHD-has genetic origins that aren\’t yet evidently understood. No single cause has been acknowledged, but researchers are exploring a number of possible genetic and environmental associations. Studies have exposed that many kids with ADHD have a close relative who also has the disorder.

Although experts are uncertain whether this is the origin of the disorder, they have found that certain areas of the brain are about 5% to 10% smaller in size and activity in children with ADHD. Chemical changes in the brain also have been discovered.

Current research also determines that smoking during pregnancy leads to ADHD in a newborn. Other risk factors are such as premature delivery, very low birth weight, and injuries to the brain at birth.

A genetic inclination has been confirmed in (identical) twin and sibling studies. If one identical twin is diagnosed with ADHD, there is at 92% chance of diagnosis with the twin sibling. When comparing non-identical twin sibling subjects, the possibility drops to 33%.

A different theory is that the researchers assessed the level of glucose used by the areas of the brain that restrain impulses and control attention. In people with ADHD, the brain areas that control attention used less glucose, signifying that they were less active. It appears from this research that a lower level of activity in some parts of the brain may result in distraction and other ADHD symptoms.

One of the complications in examining ADHD is that it\’s frequently found in combination with other problems. These are described as 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 possess oppositional defiant disorder, which is characterized by stubbornness, outbursts of temper, and acts of defiance and rule breaking. Conduct disorder is alike but features more severe hostility and aggression. Kids who have conduct disorder are more prone to get in trouble with authority figures and, later, possibly with the law. Oppositional defiant disorder and conduct disorder are viewed normally with the hyperactive and combined subtypes of ADHD.

Mood Disorders-Approximately 18% of kids with ADHD, mostly the inattentive subcategory, also experience depression. They may go through inadequate, isolated, and frustrated by school failures and social problems, and have low self-respect.

Anxiety Disorders-Almost about 25% of kids with ADHD have Anxiety Disorders. Symptoms consist of excessive worry, fear, or panic, which can also lead to physical symptoms such as a racing heart, sweating, stomach pains, and diarrhea. ADHD is accompanied by other forms of anxiety like obsessive-compulsive disorder and Tourette syndrome, as well as motor or vocal tics (movements or sounds that are reiterated over and over). A child who has symptoms of these other conditions should be assessed by an expert.

Learning Disabilities-About half of all kids with ADHD also suffer from a particular learning disability. The most common learning problems are with reading (dyslexia) and handwriting. Though ADHD isn\’t classified as a learning disability, but both have the symptoms of difficulty in concentration as well as attention.

Treatment:ADHD can\’t be cured, but it can be effectively controlled. Firstly your child\’s doctor will make an individualized, long-term plan. And to do so he/ she needs support from you and other members of your family. The aim is to help a child with ADHD learn to organize his or her own behavior and to help families create an ambiance in which this is expected to happen. In most cases, ADHD is best treated with a combination of medication and behavior therapy.

Medications-Various distinct types of medications are available to treat ADHD:Stimulants are the well-known treatments — they\’ve been applied for more than 50 years in the treatment of ADHD. Some require some doses per day, each lasting about 4 hours; some last up to 12 hours. Potential side effects are such as decreased appetite, stomachache, irritability, and insomnia. There\’s at present no evidence of lasting side effects.

Non-Stimulants are recommended to treat ADHD but these have more side affects than stimulants.

Antidepressants are at times an alternative treatment; though, in 2004 the U.S. Food and Drug Administration (FDA) warned that these drugs may cause a rare increased risk of suicide in children and teens. If an antidepressant is recommended for your child, be definite about the risks, consult with your doctor.

Behavioral TherapyResearch has revealed that to restrain impulsive behavior and attention difficulties medications are more useful when they are combined with behavioral therapy. Various forms of behavioral intervention have been found- these comprise of individual or play therapy, long-term psychotherapy, psychoanalysis, sensory-integration training, and cognitive behavioral therapy.

Behavioral therapy attempts to modify behavior patterns by:

  • reorganizing a child\’s home and school environment
  • giving clear directions and commands
  • setting up a system of consistent rewards for appropriate behaviors and negative consequences for inappropriate ones

Here are some instances of behavioral strategies that may help a child with ADHD:

Create a routine. A schedule should be followed every day, from wake-up time to bedtime. Make a routine and post it in a prominent place, so your child can see what\’s expected throughout the day and when it\’s time for homework, play, and chores.

Get organized. Keep the right thing at right place. Put schoolbags, clothing, and toys in the same place every day so your child will be less likely to lose them and find out easily.

Avoid distractions. Turn off the TV, radio, and computer games, particularly when your child is doing homework.

Limit choices. Give them a choice between two things (this outfit, meal, toy, etc., or that one) so that your child isn\’t overwhelmed and over stimulated.

Change your interactions with your child. Instead of long-winded explanations and cajoling, use clear, brief directions to remind your child of responsibilities.

Use goals and rewards. Create a chart to list goals and track positive behaviors, then reward your child\’s attempts. Be sure the goals are realistic (think off small steps rather than overnight achievement).

Discipline effectively. Shouting or spanking make the thing spoilt. Use time-out or removal of privileges as consequences for inappropriate behavior. Younger kids may simply need to be distracted or ignored until they come with better behavior.

Help your child discover a talent. All kids want to experience success to feel good about them. You can find out the fields of interests of your child — whether its sports, art, or music — can boost social skills and self-esteem.

Several other alternative therapies are endorsed 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 established them to be effective, and most have not been studied carefully, if at all.

Parent TrainingParenting a child with ADHD is challenging. Kids with ADHD may not respond well to typical parenting practices. Also, because ADHD tends to run in families, parents may also have various problems with organization and consistency themselves and need active coaching to help learn these skills.

Experts advise parent education and support groups to help family members accept the diagnosis and to teach them how to help kids organize their environment, develop problem-solving skills, and cope with frustrations. Training can also educate parents to respond aptly to a child\’s most trying behaviors with calm disciplining methods. Individual or family counseling can also be useful.

Cooperation with teachers and school make your job easy. Communicate with teachers and school officials to monitor your child\’s progress. Initially you have to create a plan which you will share with the teachers for the classroom success.

Cooperation with teachers and school make your job easy. Communicate with teachers and school officials to monitor your child\’s progress. Initially you have to create a plan which you will share with the teachers for the classroom success.

Reduce seating distractions. The proper sitting arrangements can reduce the distractions of your child. The child should sit near the teacher instead near of the window.

Use a homework folder for parent-teacher communications. The teacher can take account of assignments and progress reports, and you can check to make sure all work is accomplished on time.

Break down assignments. Your instructions should be comprehensible and concise. Separate larger tasks into smaller, more convenient pieces.

Give positive feedback. Positive behaviors are required to deal with the people with ADHD. You should request the teacher to offer praise when your child stays seated, doesn\’t call out, or waits his or her turn instead of criticizing when he or she doesn\’t.

Teach good study skills. Underlining, note taking, and reading out loud will help the child with ADHD stay focused and preserve information.

Supervise. Ensure that your child goes and comes from school with the right books and materials. Sometimes kids are paired with a partner who can assist them to stay on right track.

Be sensitive to self-esteem issues. Request the teacher of your child’s school to give feedback to your child confidentially, and avoid asking your child to perform a task publicly that might be too difficult.

Involve the school counselor or psychologist. He or she can help to create and elaborate behavioral programs to deal with definite problems in the classroom.