Attention deficit hyperactivity disorder

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at March 9, 2016
StartDiseasesAttention deficit hyperactivity disorder

Attention deficit hyperactive disorder, or ADHD, is one of the most commonly diagnosed disorders in children. It’s usually diagnosed between the ages of 6 and 12, and even though it’s common in children, it can last through adolescence and adulthood.

ADHD can cause those affected to act without thinking about consequences, to lose their focus, to have problems sustaining focus, and it can cause hyperactivity.

Contents

Definition & Facts

ADHD is a common condition that begins during childhood and can continue through adolescence and adulthood. There are three common forms of ADHD that are classified by varying levels of inattention, hyperactivity, and impulsivity.

ADHD can make it difficult for children and adolescents to do well in school, to keep friends, to behave in the home environment, or act appropriately within their community. ADHD is treatable using varying methods that a doctor or specialist can assist with.

Symptoms & Complaints

There are three basic types of ADHD including hyperactive-impulsive, inattentive, and a combination of both. The symptoms are different for each type.

Some symptoms may first appear to be normal behaviors for a child. With ADHD the behaviors are much more pronounced and they occur more often. Children with ADHD typically have at least six symptoms that begin before they are 12 years of age. These behaviors may include:

  • Easily distracted and forgetful
  • Can’t attend to one activity too long before switching to the next
  • Daydreaming often
  • Constantly fidgeting or moving
  • Talking nonstop and interrupting others
  • Touching everything they see
  • Losing their belongings often
  • Issues with directions/instructions
  • Having troubles completing tasks such as homework or chores
  • Running around a lot
  • Trouble controlling their emotions
  • Making inappropriate comments
  • Very impatient

Causes

Diagnoses of ADHD are on the rise. It is not clear what the biological origins of ADHD are at this time. There is not a single identifier, but researchers are investigating a number of possible genetic factors and environmental factors.

ADHD tends to be prevalent within families. Researchers are finding that much of the risk of having ADHD is genetic. For instance, if someone in a family has been diagnosed with ADHD, there is a 25%-35% chance that another person in the family will also have it.

Environment can also play a factor. Some of the non-genetic factors that could increase a child’s risk for developing ADHD include:

There are other causes of ADHD that are still debated within the medical field including watching too much television and eating a diet high in sugar. These proposed causes are not proven.

Diagnosis & Tests

There is no test that can determine whether or not an individual has ADHD. A diagnosis can only come from a complete evaluation. Primary care doctors, including pediatricians and family practitioners, can complete evaluations and treat kids with ADHD using guidelines from the American Academy of Pediatrics or the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM).

Sometimes the primary care doctor will refer patients to specialists like psychiatrists, psychologists, or neurologists who can help if there is doubt about the diagnosis or if there are additional concerns. First, your child's doctor may conduct a physical examination and learn about their medical history including questions about any concerns and symptoms.

A hearing test and eye examination may be done to rule out other medical and emotional conditions. The parent will be asked questions concerning their child’s development and behaviors at home, school, and with their peers.

For a diagnosis the doctor will also need information from outside of the home sources, including from schools and caregivers. The doctor will consider the child's behavior compared with that of other children in the same age group. They may document these behaviors using standardized rating scales. Here are the criteria the doctor is looking for:

  • A child displays hyperactive-impulsive behavior, inattentive behaviors, or a combination of both before the age of 12
  • These behaviors are worse than their peers within the same age group
  • The behaviors take place over a time period over 6 months
  • The behaviors negatively affect a minimum of two areas of a child’s life such as home, school, friendships, or childcare setting.

Treatment & Therapy

There is no cure for ADHD, but children with ADHD can receive treatment that will greatly improve their daily life. There are several medications that can help. The most common types are called stimulants. These medications help children focus, learn, and stay calm. The downside to medications is that they can cause side effects like sleep problems or stomach aches. A child may need to try several medications before finding which one works best.

Monitoring the child while they are on medication is very important. This is both the responsibility of the doctor and the parent who may want to ask for feedback from caregivers as well. Medication does not have to be a permanent decision, but it isn’t safe to get off and on medications repeatedly. If the medication is not working well, contact the primary care doctor to discuss other options.

There are many forms of therapy that can help. Behavioral therapy is a sound choice because it teaches children to control their behavior so they can perform at school and control their behaviors at home. Medication and therapy can also be used in conjunction. Many children get the best results from using both treatments.

Prevention & Prophylaxis

There is no guaranteed way to prevent ADHD. There are some measures people can take including:

  • During pregnancy: Do not smoke or use drugs or alcohol; maintain a healthy diet, and attend all doctor’s appointments
  • For children with and without ADHD: Feed them a healthy diet from infancy on; set structured routines and schedules to follow; implement behavior management; spend quality time with your child each day; compliment good behaviors