What Is Attention Deficit Hyperactivity Disorder (ADHD)?
ADHD is a disorder characterized by three behaviors:
You may see one or more of these behaviors. It is not necessary to have all three to have ADHD: e.g. one does not have to be hyperactive.
ADHD is related, to but different than, learning disabilities (LD). Some people only have learning disabilities. Some have ADHD only. Some have both. A number of professionals believe that as many as 50%-80% of those with ADHD will have LD. There is an overlap. It is important to remember each disorder requires different treatment.
What Are These Three Behaviors?
Hyperactivity: The child exhibits an unusual degree of activity. Most are fidgety; something is always in motion - fingers, pencil, feet. They squirm in their seat, or cannot remain seated, etc.
Distractibility: The child has difficulty blocking out unnecessary input from the environment.
Means paying attention to all sounds, not just appropriate ones, e.g. voices in halls, ringing of telephone.
Means paying attention to all things seen rather than the appropriate items, e.g. clouds, rug, pictures.
Impulsivity: The child does not think before acting or talking and does not consider the impact of his/her actions on others. Thus, they do not learn from experience. This child may be accident prone because of impulsive behavior combined with poor judgment.
Who Makes The Diagnosis?
Parents, teachers, and professionals may find evidence suggesting ADHD. However a physician usually confirms the diagnosis.
How Is The Diagnosis Made?
ADHD is the least common reason for hyperactivity, distractibility or impulsivity. The most common causes for these behaviors are anxiety or depression.
The history of the problem is the best indication. If the behaviors have been chronic, that is, present almost since birth, and pervasive, present all day, every day, it is probably ADHD.
Check list and rating scales can be of assistance. However, the history of the behavior combined with clinical observations remain the best procedure for establishing the diagnosis of ADHD.
What Causes ADHD?
The final answer is not known. Current research strongly suggests that ADHD is due to a deficiency in a specific neurotransmitter in the lower area of the brain. Research should lead to a
greater understanding of this disorder in coming years.
How Long Does It Last?
Current information suggests about 50% of children with ADHD will no longer have ADHD by puberty. The remainder will continue into adolescence and possibly into adulthood.
How Is ADHD Treated?
Behavioral approaches can be attempted to help the child concentrate on sitting still, staying on task or thinking before acting. Most of these are effective for short periods of time.
Several nutritional approaches have been proposed. The Feingold Diet appears to work at best for 1-2% of children with ADHD. Too much refined sugar can increase hyperactivity in some children.
The generally accepted treatment in this country is the use of medications.
Treatment With Medication:
Each medication has its own characteristics, effects and possible side effects. Thus, the physician should review these issues with the parents before beginning any medication. The goal is to decrease or stop the behavior without side effects.
Medications have been used since 1937 and are considered to be safe and effective. These medications do not "drug" or "alter the mind" of the child. Rather, research suggests that each medication increases the amount of the chemical that is deficient in the brain, allowing the brain to function normally; therefore, the behaviors are diminished. Thus, the child becomes less active, less distractible and more able to think before acting.
The current approach is to use one of three groups of medications. The physician will generally begin with Group One progressing to the others if no improvement is seen or side effects occur.
Since ADHD can interfere with classroom work, peer interactions and family life, it is recommended that the child be on medication throughout each day, not just during school hours.
Group One medications are:
- Ritalin (methylpenidate)
- Dexedrine (dextroamphetamine)
- Cylert (pemoline)
Group Two medications are
- Tofranil (imipramine)
- Noripane (desipramine)
Group Three medications are:
- Mellaril (thioridazine)
- Tegretol (carbamazepine)
Clonidine may be used with Group One or Two medications to increase their effectiveness.
Remember The Total Child:
Many children with ADHD also have learning disabilities. Treating the ADHD will not treat the learning disabilities. Each must be treated if the child is to make sufficient progress.