Attention Deficit Hyperactivity Disorder
Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most common health concerns among school-aged children.
ADHD can occur in both genders as well as in all ethnic and racial populations. Although it is diagnosed as much as nine times more often in males than in females, many researchers believe that it occurs equally in girls, but because females display more inattentive symptoms and fewer behavioral symptoms, they may never be diagnosed or may be diagnosed much later than males.
How do I know when to seek help for ADHD?
There are two basic clusters of symptoms that characterize ADHD: cognitive symptoms are seen in inattention; behavioral symptoms are seen in hyperactivity and impulsivity. If your child displays many of the symptoms below or if your child's teacher is concerned about similar patterns of behavior being present in the classroom, you should speak to a professional and consider the possibility of having your child evaluated for ADHD.
Signs of inattention. Your child -
- does not pay close attention to details or makes careless mistakes in school work
- is easily distracted from tasks or play
- is often forgetful or does not appear to listen when spoken to
- does not follow instructions, or fails to complete school work or chores
- has trouble organizing tasks and personal belongings
- avoids or dislikes activities requiring concentration, such as schoolwork
Signs of hyperactivity and impulsivity. Your child -
- has difficulty sitting still, often fidgets and squirms
- often talks out of turn or excessively in the classroom
- displays high levels of energy and activity, often engaging in risky behaviors
- interrupts frequently or intrudes into conversations or games
- acts or speaks impulsively
- displays immaturity in a variety of social situations
ADHD can affect families by straining sibling relationships; causing a child to underachieve in school, which may lead to failure and truancy; diminishing parental bonding and family cohesiveness; and creating marital stress, tension, and potential divorce.
Since ADHD causes repercussions in so many aspects of a child's life and affects the entire family, several professionals may be involved in accurately assessing the disorder and developing an effective treatment plan. A skilled family therapist may be the best professional to coordinate the overall plan and provide ongoing therapy to family members. Additional professionals may include a special education person from the child's school who would coordinate the school's accommodation plan for the student; a pediatric specialist or child psychiatrist who would assess the need for medication; an educational specialist who would assist in providing academic and tutorial resources; and a psychometrist who would provide psychoeducational testing to determine the severity of the symptoms and the level of cognitive impairment (and who could also address the presence of learning disabilities, which are common among children with ADHD).
How do I distinguish between normal and problem behaviors?
Reports in the media of greatly increased rates of diagnosis of ADHD and the frequent prescribing of stimulants for children may lead parents to wonder if ADHD is being diagnosed properly. Are these diagnosed children simply exhibiting normal childhood behaviors? Aren't many children extremely active, impulsive, or inattentive?
Each child's range of behaviors must be evaluated according to their age and developmental maturity. For example, behaviors which may be normal in a 5-year-old might be viewed as problematic in a 10-year-old. The symptoms that support a diagnosis of ADHD are usually present in early childhood, though the inattentive symptoms may not be recognized until much later in a child's life. Patterns of forgetfulness, disorganization, and overactive behaviors which would determine a diagnosis of ADHD occur more frequently and persistently, and create more problems in a variety of settings than behavior that is typical in a particular age group. Further information on exactly what ADHD is and how it differs from typical childhood behavior can be found in the resources listed at the end of this flyer.
How do I know that the diagnosis of ADHD for my child is correct?
A diagnosis of ADHD requires several steps and may take two or three visits to a qualified health professional. Information to support the diagnosis is collected from parents, teachers, health care professionals, and an interview with the child. The clinician who is assessing your child will also consider other possible causes of problem behaviors. Select a professional who specializes in working with ADHD and share your concerns. If you still question the diagnosis, get a second opinion from another qualified professional.
Does my child have to be treated with medication?
In treating ADHD, medication may be used to reduce hyperactivity and impulsivity, and to improve a person's ability to concentrate and focus on activities and tasks. The effectiveness of the medication can help a child perform better in school, as well as in family and social situations. The first-line medications prescribed are the stimulants, which include Ritalin, Dexedrine, and Adderall. These have the most direct effect on moderating the ADHD symptoms and may be effective in up to 75% of ADHD children and adolescents. If these medications cause unacceptable side effects or are found to be ineffective, antidepressants may be prescribed, but often with somewhat less effectiveness. Improvement with the medication may be dramatic. However, medication does not cure the disorder; it controls the symptoms temporarily. Experts advise that medication is most effective when combined with therapy in order to improve self esteem, social skills, family relations, and academic performance. The use of medication without supportive therapy is less effective.
Family therapists are well qualified to suggest the type of assessment and treatment which might be needed to help. Children who are successfully treated for the disorder live happier, more secure lives, and are better able to succeed in their educational and career goals. Adults who are successfully treated for the disorder are able to improve their marital relationships, parenting skills, social interactions, and career direction and success.