ADHD

What is ADHD?

Attention-deficit hyperactivity disorder (ADHD) is the name of a group of behaviors found in many children and adults. People who have ADHD have trouble paying attention in school, at home or at work. They may be much more active and/or impulsive than what is usual for their age. These behaviors contribute to significant problems in relationships, learning and behavior. For this reason, children who have ADHD are sometimes seen as being "difficult" or as having behavior problems.

ADHD is more common in boys than in girls. You may be more familiar with the term attention deficit disorder (ADD). This disorder was renamed in 1994 by the American Psychiatric Association (APA).


What are the symptoms of ADHD? 

The four key features of ADHD are as follows:
  • Impulsiveness - “acting without thinking”
  • Inattentiveness - “can’t concentrate”
  • Unsustained attention - “can’t stay on task”
  • Distractibility - “all over the place”

 The child with ADHD who is inattentive will have 6 or more of the following symptoms:
  • Has difficulty following instructions
  • Has difficulty keeping attention on work or play activities at school and at home
  • Loses things needed for activities at school and at home
  • Appears not to listen
  • Doesn't pay close attention to details
  • Seems disorganized
  • Has trouble with tasks that require planning ahead
  • Forgets things
  • Is easily distracted
               
The child with ADHD who is hyperactive/impulsive will have at least 6 of the following symptoms:

  • Fidgety
  • Runs or climbs inappropriately
  • Can't play quietly
  • Blurts out answers
  • Interrupts people
  • Can't stay in seat
  • Talks too much
  • Is always on the go
  • Has trouble waiting his or her turn

Children who have ADHD have symptoms for at least 6 months.


What causes ADHD? 

 

Children who have ADHD do not make enough chemicals in key areas in the brain that are responsible for organizing thought. Without enough of these chemicals, the organizing centers of the brain don't work well. This causes the symptoms in children who have ADHD. Research shows that ADHD is more common in children who have close relatives with the disorder. Recent research also links smoking and other substance abuse during pregnancy to ADHD. Exposure to environmental toxins, such as lead, can also be a factor. 

 

Things that don't cause ADHD:         


  • Bad parenting (though a disorganized home life and school environment can make symptoms worse)
  • Too much sugar
  • Too little sugar
  • Aspartame (one brand name: NutraSweet)
  • Food allergies or other allergies
  • Lack of vitamins
  • Fluorescent lights
  • Too much TV
  • Video games

 

What should I do if I think my child has ADHD?       


Talk with your child's doctor. A diagnosis of ADHD can be made only by getting information about your child's behavior from several people who know your child. Your doctor will ask you questions and may want to get information from your child's teachers or anyone else who is familiar with your child's behavior. Your doctor may have forms or checklists that you and your child's teacher can fill out. This will help you and your doctor compare your child's behavior with other children's behavior.

There are 3 primary situations which justify medicat treatment of properly diagnosed ADHD:
  • The major one is difficulty learning.
  • A second is classroom disruption which cannot be corrected by non-medical means
  • A third situation is household disruption which cannot be corrected by non-medical means
The psychological and social consequences of untreated ADHD have been well-documented, and may be progressive and extreme:

Psychological consequences:

  • Feelings of inadequacy and lack of accomplishment
  • Lack of confidence/insecurity/poor self-esteem
  • Feelings of depression, frustration and anger
  • Antisocial behavior
  • Recklessness leading to dangerous risk-taking

Social consequences:

  • Being “labeled” as a “problem child” in school and in the community
  • Unfair perception as lazy, unmotivated or troublesome
  • Discipline problems at home, in school, and in the community
  • Poor peer relationships
  • Alcohol and drug abuse

The diagnosis and treatment of ADHD does NOT require hyperactivity (or even overactiveness).  Non-hyperactive ADD is prevalent, exhibits the key features of ADHD, and is just as disruptive to learning, and just as likely to affect self-esteem and personal safety. Recognizing a hyperactive child is not difficult, but recognizing non-hyperactive ADD may be very subtle - this is the reason why any evaluation of school problems should be comprehensive.  Simply determining that a child isn’t “hyper” DOES NOT rule out ADHD.


What medicines are used to treat ADHD?       

Your doctor may recommend trying medicine to see if it helps control your child's hyperactive behavior. A trial of medicine alone cannot be the basis for diagnosing ADHD. However, it can be an important part of evaluating your child if ADHD is suspected.

It might be hard for your doctor to tell if your child has ADHD. Many children who have ADHD aren't hyperactive in the doctor's office. For this reason, your doctor may want your child to see someone who specializes in helping children who have behavior problems, such as a psychologist.    


Medication for ADHD does NOT cause depression or “zombie-like” personality.
Most of the commonly utilized medications are stimulants, which increase the attentiveness and concentration activity of the brain - this is NOT a tranquilizing effect. 


Some of the medicines for ADHD are methylphenidate, dextroamphetamine, atomoxetine, and a drug that combines dextroamphetamine and amphetamine. These medicines improve attention and concentration, and decrease impulsive and overactive behaviors. Other medicines can also be used to treat ADHD. Talk with your doctor about what treatments he or she recommends.

It is important to understand that medication DOES NOT cure ADHD.

During the time it’s in effect, medication helps the child PAY ATTENTION BETTER which, in turn, lessens distractibility and improves concentration, thus enhancing learning.  As each dose of medication is metabolized and is no longer effective, the ADHD is no longer controlled, and the symptoms may return.

All we can expect the medication to do is to help learning and to help calm hyperactivity.  The medicine doesn’t replace the need for parental supervision and discipline.  The medicine doesn’t replace the need for the child to develop good study skills.  The medicine doesn’t replace the need for an ongoing classroom strategy to help the child stay on task.  The medicine doesn’t guarantee good grades or good behavior.
 

Sometimes uninformed people think you should be able just to “fix” ADHD with medicine.  This causes some parents to have unrealistic expectations for the prescribed treatment, leading to inappropriate claims of “medication failure.” 

The changes in an ADHD child’s behavior during the medication adjustment period(s) may be interpreted by misguided or uninformed individuals, including professionals, as causing some sort of “negative” personality effects.  Children whom have developed psychiatric problems while on ADHD medication have been shown to have preexisting psychiatric symptoms. 

The personality changes in an untreated ADHD child (caused by poor self esteem, poor self-image, frustration and anger) are real, and should not be overlooked.


What else can I do to help my child?       


A team effort, with parents, teachers and doctors working together, is the best way to help your child. Children who have ADHD may be difficult to parent. They may have trouble understanding directions, and their constant state of activity can be challenging for adults. Children who have ADHD also tend to need more structure and clearer expectations. You may need to change your home life a bit to help your child. Here are some things you can do to help:

  • Make a schedule. Set specific times for waking up, eating, playing, doing homework, doing chores, watching TV or playing video games, and going to bed. Post the schedule where your child will always see it. Explain any changes to the routine in advance.
  • Make simple house rules. It's important to explain what will happen when the rules are obeyed and when they are broken. Write down the rules and the results of not following them.
  • Make sure your directions are understood. Get your child's attention and look directly into his or her eyes. Then tell your child in a clear, calm voice specifically what you want. Keep directions simple and short. Ask your child to repeat the directions back to you.
  • Reward good behavior. Congratulate your child when he or she completes each step of a task.
  • Make sure your child is supervised all the time. Because they are impulsive, children who have ADHD may need more adult supervision than other children their age.
  • Watch your child around his or her friends. It's sometimes hard for children who have ADHD to learn social skills. Reward good play behaviors.
  • Set a homework routine. Pick a regular place for doing homework, away from distractions such as other people, TV and video games. Break homework time into small parts and have breaks.
  • Focus on effort, not grades. Reward your child when he or she tries to finish school work, not just for good grades. You can give extra rewards for earning better grades.
  • Talk with your child's teachers. Find out how your child is doing at school--in class, at playtime, at lunchtime. Ask for daily or weekly progress notes from the teacher.

Some children benefit from counseling or from structured therapy. Families may benefit from talking with a specialist in managing ADHD-related behavior and learning problems.


MYTHS and FACTS ABOUT ADHD   

 

Myth #1:  ADHD isn’t a real medical disorder. 

FACT:  ADHD has been recognized as a legitimate diagnosis by major medical, psychological, and educational organizations, including the National Institutes of Health and the U.S. Department of Education. The American Psychiatric Society recognizes ADHD as a medical disorder in its Diagnostic and Statistical Manual of Mental Disorders—the official mental health “bible” used by psychologists and psychiatrists. ADHD is biologically based. Research shows that it’s a result of an imbalance of chemical messengers, or neurotransmitters, within the brain. Its primary symptoms are inattention, impulsiveness, and, sometimes, hyperactivity. People with ADHD typically have a great deal of difficulty with aspects of daily life, including time management and organizational skills.

 

Myth#2:  Children who are given special accommodations because of their ADHD are getting an unfair advantage.  

FACT:  The federal Individuals with Disabilities Education Act (IDEA) requires that public schools address the special needs of all children with disabilities, including children with ADHD. Special accommodations, such as extra time on tests, simply level the playing field so that kids with ADHD can learn as successfully as their non-ADHD classmates.


Myth #3:  Children with ADHD eventually outgrow their condition. 

FACT:  More than 70% of the individuals who have ADHD in childhood continue to have it in adolescence.  Symptoms of ADHD often get better as children grow older and learn to adjust.  hyperactivity usually stops in the late teenage years.  Up to 50 percent will continue to have it in adulthood. Although it’s been estimated that 6 percent of the adult population has ADHD, the majority of those adults remain undiagnosed, and only one in four of them seek treatment. Yet, without help, adults with ADHD are highly vulnerable to depression, anxiety, and substance abuse. They often experience career difficulties, legal and financial problems, and troubled personal relationships. Children who have loving, supportive parents who work together with school staff, mental health workers and their doctor have the best chance of becoming well-adjusted adults.


Myth #4: ADHD affects only boys.  

FACT:  Girls are just as likely to have ADHD as are boys, and gender makes no difference in the symptoms caused by the disorder. But because this myth persists, boys are more likely to be diagnosed than girls.


Myth #5: ADHD is the result of bad parenting. 

FACT:  When a child with ADHD blurts things out or gets out of his seat in class, it’s not because he hasn’t been taught that these behaviors are wrong. It’s because he cannot control his impulses. The problem is rooted in brain chemistry, not discipline. In fact, overly strict parenting— which may involve punishing a child for things he can’t control— can actually make ADHD symptoms worse. Professional interventions, such as drug therapy, psychotherapy, and behavior modiļ¬cation therapy, are usually required.

 

Myth #6: Children who take ADHD medication are more likely to abuse drugs when they become teenagers.

FACT: Actually, it’s just the opposite. Having untreated ADHD increases the risk that an individual will abuse drugs or alcohol. Appropriate treatment reduces this risk. The medications used to treat ADHD have been proven safe and effective over more than 50 years of use. These drugs don’t cure ADHD, but they are highly effective at easing symptoms of the disorder. The drugs do not turn kids into addicts or zombies.

 

Myth #7: People who have ADHD are stupid or lazy—they never amount to anything.  

FACT:  Many well-known, high-achieving individuals have ADHD, including top executives such as David Neeleman, founder of JetBlue Airways, and Paul Orfalea, founder of Kinko’s. Other well-known, high achieving people with ADHD include Terry Bradshaw (quarterback, Super Bowl winner and NFL commentator), Howie Mandel (comedian and host of “Deal or No Deal”), James Carville (prominent political consultant and commentator), and Michael Phelps (swimmer and holder of 14 career Olympic gold medals, the most by any Olympian ever).



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