ADHD is more than child's play

Children occasionally daydream, squirm in their seats, or leap before they look. Children with attention-deficit/hyperactivity disorder (ADHD) behave this way so frequently and severely that it can cause serious problems. It can be tempting to call these children bad or spacey. Yet their problems are symptoms of a real—and treatable—brain disorder.

Is it really ADHD?

Between four and 12 percent of school-age children have ADHD, according to Children and Adults with Attention-Deficit/Hyperactivity Disorder. A child may have one or more of these symptoms:

  • Inattention: Trouble paying attention, excessive daydreaming, being easily distracted, losing things frequently

  • Hyperactivity: Trouble sitting still, squirming and fidgeting, talking too much, being constantly in motion

  • Impulsivity: Trouble waiting for a turn, acting without thinking, blurting out rude comments, interrupting others

All children act this way now and then. But for those with ADHD, such behaviors are unusually apparent. They also occur in more than one setting, such as at home, in school, and on the playground. The symptoms usually start before age 7, although ADHD may not be diagnosed until later. In addition, the symptoms last for more than six months

Behavior barriers

If left untreated, ADHD can wreak havoc on a child’s life. Children who are inattentive seem unable to focus on anything for long. Schoolwork is often hard for them, and the results are usually incomplete or sloppy.

“These children have trouble following directions,” says Heidi Feldman, M.D., Ph.D., a Pittsburgh pediatrician. “It’s not that they don’t listen or don’t understand," Dr. Feldman says. "But as soon as they start one task, they get distracted and move on to something else. Before long, they’ve forgotten what the original task was.”

It's difficult for children with ADHD to settle down in school long enough to learn. Instead, they may roam the room, touch everything in sight, or noisily tap a pencil. Teachers often consider them discipline problems. Classmates may not like it if a child impulsively hits them or lashes out when upset, grabs away toys, or fails to take turns. At home, the nonstop activity and unpredictable behavior can wear down parents. Plus, impulsivity can create dangerous situations. Says Dr. Feldman, “These are children who dash into traffic when their ball bounces into the street.”

Pathways to success

The first step in helping your child is to get a diagnosis. Depression, anxiety disorders, and learning disabilities can cause symptoms similar to those of ADHD. In addition, some children have both ADHD and another disorder.

An accurate diagnosis requires a thorough evaluation by a doctor or counselor. This could include a pediatrician, developmental pediatrician, school or clinical psychologist, nurse practitioner, clinical social worker, psychiatrist, or neurologist. Keep in mind that there is no single test for ADHD. Instead, the doctor will review information from you, your child’s teachers and other caregivers. A medical exam can help rule out other possible causes for the symptoms.

Once a diagnosis of ADHD has been made, treatment can begin. A typical treatment plan has several elements:

  • Medications: Stimulants are the most widely used class of drugs for treating ADHD. Up to 80 percent of children with ADHD who take stimulants show improvement. A nonstimulant drug called atomoxetine also has been approved for ADHD treatment. Like all drugs, these medications sometimes cause side effects, such as depression or suicidal thoughts. Your doctor can help you weigh the risks against the benefits.

  • Therapy and training: There are different types of therapy that may help your child. Psychotherapy helps children learn new ways of handling their feelings and coping with ADHD. Behavior therapy focuses on changing thought patterns and actions to produce changes in behavior, such as helping a child organize tasks or rewarding actions, such as controlling anger. Parenting-skills training teaches parents techniques for managing their child’s behavior by using reward systems or timeouts. These specific skills and techniques practiced by adults can help improve the child’s behavior over time.

  • School supports: Most students with ADHD can succeed in a regular classroom with minor adjustments. Others may require some special services. Each student’s needs are different, so team up with teachers and school staff to find the best learning strategies for your child.

With treatment and support, most children with ADHD can achieve their full potential. Remember, you didn’t cause your child’s ADHD. Biology and genetics are the main causes, although parenting and behavior management are important during treatment. Together with your child’s doctor, you can be part of the solution.

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