Brain, Nervous System and Mental Conditions
Attention Deficit Hyperactivity Disorder
What is ADHD?
It is common for children to have problems with attention, learning or behavior.
If your child or teen has problems with family, friends or school due to trouble with attention, learning or behavior that lasts longer than six months, they may have attention deficit hyperactivity disorder (ADHD) or a related disorder such as oppositional defiant disorder (ODD).
ADHD is the most common mental health problem of childhood. It affects up to 10% of the population and is more common in boys than in girls.
What are the symptoms of ADHD?
The signs and symptoms of ADHD in children and adolescents include age-inappropriate:
- Hyperactivity ("on the go" or restless)
- Impulsivity (butts into conversations, acts without thinking)
- Inattention (off-task, distractible, trouble completing schoolwork)
To be diagnosed with ADHD, your child's ADHD symptoms must:
- Be present for at least six months and before the age of 12
- Cause problems at home or at school, or with peers
How common is ADHD?
ADHD is a very common problem. Children and adolescents with this condition display a wide range of problems, from mild to serious. They often have other psychiatric, medical and learning problems.
What causes ADHD?
ADHD is a neurodevelopmental disorder, which means there is impairment of the growth and development of the brain or central nervous system. The circuits related to motivation, attention, organization and reward are affected.
There is a strong genetic component (passed from parent to child). 25% of the time there is another close family member with the disorder. There are some factors in the environment that can make ADHD worse, such as exposure to tobacco smoke during pregnancy, toxins such as lead and poor nutrition.
What is the impact of ADHD?
Although symptoms often lessen and change over time, about two-thirds of children with ADHD continue to have the disorder during their adolescent years. Though they may no longer meet the full diagnostic criteria, many teens and young adults continue to have problems with learning, attention or behavior.
If it is untreated, teens with ADHD have a higher chance of school failure and dropout, low self-esteem, demoralization, substance or alcohol abuse and delinquency (breaking the law).
How is ADHD diagnosed?
A healthcare provider may diagnose ADHD after gathering information about your child from many sources (such as parents and teachers). They will also consider other disorders that can look similar to or co-occur with ADHD, identify your child's strengths and weaknesses and develop a treatment plan. There is no single "test" for ADHD.
Since most children with ADHD have other problems, including learning or behavioral problems, it is important that these issues be evaluated and addressed as well.
Rating scales can be used to screen for ADHD symptoms and other disorders. Often, the same or similar rating scales will also be used during treatment to see how well it is working.
How is ADHD treated?
Behavior modification therapy and medicine are the treatments that work best for youth with ADHD.
Behavior modification therapy
In behavior modification therapy, you and your child's teachers are taught how to work with your child on:
- Increasing positive interactions and using rewards to encourage good behaviors
- Making clear rules and consistently enforcing them
- Increasing structure at home and school
- Giving clear and appropriate commands
- Using time out from positive reinforcement to discourage bad behaviors
- Using a daily home-to-school and school-to-home note to motivate the child at school and communicate between school and home
In most cases, stimulant medicines will be tried first to treat ADHD. Two types of stimulant medicines are used to treat ADHD symptoms:
- Methylphenidate products (such as Ritalin, Concerta and Daytrana)
- Amphetamine products (such as Adderall and Vyvanse)
These medicines come in many different forms and are approved by the U.S. Food and Drug Administration (FDA) for treating ADHD. Some have effects that last almost 12 hours, while others last for a much shorter time. There are also two types of nonstimulant medicines that are approved by the FDA for treatment of ADHD that act differently on the body and have different side effects.
Is ADHD treatment helpful?
ADHD can be effectively treated in most cases, and improvement happens most quickly with the combination of medicines and behavior therapy.
ADHD symptoms change as children grow. Both behavioral and medicine treatments need to be monitored, and may need some changes over time. Many students with ADHD now attend college, and there are many examples of successful adults with the condition.
What should I do if I think my child has ADHD?
If you're concerned about your child's learning, behavior or attention, talk to your pediatrician.
If your child if 5 years old or younger, it's a good idea to have their hearing and vision checked.
How can I help my child succeed at school?
Your child may be eligible to receive a 504 plan or Individual Educational Achievement Plan so they can receive accommodations and support to reduce the impact of ADHD on school achievement.