Definition:
Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood disorders and can continue through adolescence and adulthood.. Children with ADHD have impaired functioning in multiple settings, including home, school, and in relationships with peers. If untreated, the disorder can have long-term adverse effects into adolescence and adulthood.
Symptoms include difficulty staying focused and paying attention, difficulty controlling behavior, and hyperactivity (over-activity).
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ADHD has three subtypes:
1.Predominantly hyperactive-impulsive ……
*Most symptoms (six or more) are in the hyperactivity-impulsivity categories.
*Fewer than six symptoms of inattention are present, although inattention may still be present to some degree.
2.Predominantly inattentive …………………
*The majority of symptoms (six or more) are in the inattention category and fewer than six symptoms of hyperactivity-impulsivity are present, although hyperactivity-impulsivity may still be present to some degree.
*Children with this subtype are less likely to act out or have difficulties getting along with other children. They may sit quietly, but they are not paying attention to what they are doing. Therefore, the child may be overlooked, and parents and teachers may not notice that he or she has ADHD.
3.Combined hyperactive-impulsive and inattentive. .
*Six or more symptoms of inattention and six or more symptoms of hyperactivity-impulsivity are present.
*Most children have the combined type of ADHD
Treatments can relieve many of the disorder’s symptoms, but there is no cure. With treatment, most people with ADHD can be successful in school and lead productive lives. Researchers are developing more effective treatments and interventions, and using new tools such as brain imaging, to better understand ADHD and to find more effective ways to treat and prevent it.
Signs & Symptoms
Symptoms of ADHD will appear over the course of many months, and include:
Impulsiveness: a child who acts quickly without thinking first.
Hyperactivity: a child who can’t sit still, walks, runs, or climbs around when others are seated, talks when others are talking.
Inattention: a child who daydreams or seems to be in another world, is sidetracked by what is going on around him or her.
Inattention, hyperactivity, and impulsivity are the key behaviors of ADHD. It is normal for all children to be inattentive, hyperactive, or impulsive sometimes, but for children with ADHD, these behaviors are more severe and occur more often. To be diagnosed with the disorder, a child must have symptoms for 6 or more months and to a degree that is greater than other children of the same age.
Children who have symptoms of inattention may:
*Be easily distracted, miss details, forget things, and frequently switch from one activity to another
*Have difficulty focusing on one thing
*Become bored with a task after only a few minutes, unless they are doing something enjoyable
*Have difficulty focusing attention on organizing and completing a task or learning something new
*Have trouble completing or turning in homework assignments, often losing things (e.g., pencils, toys, assignments) needed to complete tasks or activities
*Not seem to listen when spoken to
*Daydream, become easily confused, and move slowly
*Have difficulty processing information as quickly and accurately as others
*Struggle to follow instructions.
Children who have symptoms of hyperactivity may:
*Fidget and squirm in their seats
*Talk nonstop
*Dash around, touching or playing with anything and everything in sight
*Have trouble sitting still during dinner, school, and story time
*Be constantly in motion
*Have difficulty doing quiet tasks or activities.
Children who have symptoms of impulsivity may:
*Be very impatient
*Blurt out inappropriate comments, show their emotions without restraint, and act without regard for consequences
*Have difficulty waiting for things they want or waiting their turns in games
*Often interrupt conversations or others’ activities.
ADHD Can Be Mistaken for Other Problems too.
Parents and teachers can miss the fact that children with symptoms of inattention have the disorder because they are often quiet and less likely to act out. They may sit quietly, seeming to work, but they are often not paying attention to what they are doing. They may get along well with other children, compared with those with the other subtypes, who tend to have social problems. But children with the inattentive kind of ADHD are not the only ones whose disorders can be missed. For example, adults may think that children with the hyperactive and impulsive subtypes just have emotional or disciplinary problems.
Diagnosis:
If ADHD is suspected, the diagnosis should be made by a professional with training in ADHD. This includes child psychiatrists, psychologists, developmental/behavioral pediatricians, behavioral neurologists, and clinical social workers. After ruling out other possible reasons for the child’s behavior, the specialist checks the child’s school and medical records and talks to teachers and parents who have filled out a behavior rating scale for the child. A diagnosis is made only after all this information has been considered.
Children mature at different rates and have different personalities, temperaments, and energy levels. Most children get distracted, act impulsively, and struggle to concentrate at one time or another. Sometimes, these normal factors may be mistaken for ADHD. ADHD symptoms usually appear early in life, often between the ages of 3 and 6, and because symptoms vary from person to person, the disorder can be hard to diagnose. Parents may first notice that their child loses interest in things sooner than other children, or seems constantly “out of control.” Often, teachers notice the symptoms first, when a child has trouble following rules, or frequently “spaces out” in the classroom or on the playground.
No single test can diagnose a child as having ADHD. Instead, a licensed health professional needs to gather information about the child, and his or her behavior and environment. A family may want to first talk with the child’s pediatrician. Some pediatricians can assess the child themselves, but many will refer the family to a mental health specialist with experience in childhood mental disorders such as ADHD. The pediatrician or mental health specialist will first try to rule out other possibilities for the symptoms. For example, certain situations, events, or health conditions may cause temporary behaviors in a child that seem like ADHD.
Between them, the referring pediatrician and specialist will determine if a child:
*Is experiencing undetected seizures that could be associated with other medical conditions
*Has a middle ear infection that is causing hearing problems
*Has any undetected hearing or vision problems
*Has any medical problems that affect thinking and behavior
*Has any learning disabilities
*Has anxiety or depression, or other psychiatric problems that might cause ADHD-like symptoms
*Has been affected by a significant and sudden change, such as the death of a family member, a divorce, or parent’s job loss.
A specialist will also check school and medical records for clues, to see if the child’s home or school settings appear unusually stressful or disrupted, and gather information from the child’s parents and teachers. Coaches, babysitters, and other adults who know the child well also may be consulted.
The specialist also will ask:
*Are the behaviors excessive and long-term, and do they affect all aspects of the child’s life?
*Do they happen more often in this child compared with the child’s peers?
*Are the behaviors a continuous problem or a response to a temporary situation?
*Do the behaviors occur in several settings or only in one place, such as the playground, classroom, or home?
The specialist pays close attention to the child’s behavior during different situations. Some situations are highly structured, some have less structure. Others would require the child to keep paying attention. Most children with ADHD are better able to control their behaviors in situations where they are getting individual attention and when they are free to focus on enjoyable activities. These types of situations are less important in the assessment. A child also may be evaluated to see how he or she acts in social situations, and may be given tests of intellectual ability and academic achievement to see if he or she has a learning disability.
Finally, if after gathering all this information the child meets the criteria for ADHD, he or she will be diagnosed with the disorder.
Treatment
Effective treatments for ADHD are available, and include behavioral therapy and medications.
Currently available treatments focus on reducing the symptoms of ADHD and improving functioning. Treatments include medication, various types of psychotherapy, education or training, or a combination of treatments.
Getting Help: Locate Services
Locate mental health services in your area, affordable healthcare, NIMH clinical trials, and listings of professionals and organizations.
Click to see for more locational services
You may also clic to see:->
*Child and Adolescent Mental Health:
*Treatment of Children with Mental Disorders
*Information about medications
*Attention Deficit Hyperactivity Disorder Information and Organizations from NLM’s MedlinePlus (en Español) :
*Listen to a NIH podcast about a study on ADHD medications by the National Institute on Environmental and Health Sciences:
*Chiropractic Care for ADD/ADHD
*ADD & Toxins
Resources:
http://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtm
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