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What is ADHD?

Attention deficit/hyperactivity disorder (ADHD) is one of the most common neurobehavioral disorders of childhood. It can profoundly affect children’s academic achievement, well-being, and social interactions. ADHD occurs in approximately 7% to 8% of children and youth.

Symptoms of ADHD begin in childhood, and most children with ADHD will continue to have symptoms and impairment through adolescence and into adulthood. Learning and language problems are common comorbid conditions with ADHD.

When to suspect ADHD

Symptoms:

  • Short attention span
  • Hyperactivity which may be physical, verbal and or emotional
  • Impulsivity, fidgeting or restlessness
  • Disorganization and difficulty prioritizing tasks
  • Poor time management
  • Frequent mood swings
  • Forgetfulness
  • Distractibility
  • Inability to control anger or frustration

There are three types of ADHD:

  1. Inattentive type
  2. Hyperactive or impulsive type
  3. Combined type

ADHD symptoms rarely disappear with age. Roughly 2 out of 3 children with ADHD become adults with ADHD. In the US, many adults get an ADHD diagnosis after one of their children is diagnosed to have ADHD. Unmanaged ADHD symptoms can cause difficulty keeping a job, conflicts with relationships, and substance abuse.

Preschool aged children:

ADHD cannot be reliably diagnosed in children younger than 4 years of age.

Older children:

Children typically present with ADHD symptoms during early school years. Children with the primarily inattentive type may not present until academic requirements increase (e.g. by the fourth grade).  They may also present with an associated learning disorder.

Adolescents:

New onset of ADHD symptoms is less common beyond 12 years of age but may occur because of increased academic demands or if subtle symptoms go unrecognized at an earlier age.

Why do you need to seek help?

ADHD is a neurodevelopmental disorder which begins in childhood and oftentimes persist into adulthood (79%). Identification and treatment of ADHD makes the individual more productive and make use of their full potential in everyday life. It makes them less distractible and more able to complete tasks without being reminded. Treatment makes them less prone to get into accidents, less likely to use drugs, and more likely to have a stable job and relationship.

Comorbid conditions:

  • Substance abuse
  • Anxiety
  • Depression
  • Learning disabilities

Available treatments:

The goal of ADHD treatment is to improve symptoms, optimize functional performance, and remove behavioral obstacles.

Children with ADHD may qualify for accommodations at school under section 504 of the rehabilitation act or under the individuals with disabilities education act.

1. Behavioral therapies:

Working with the parents, classroom management, peer interventions, and a combination of these interventions.

Treatment often involves 7 to 12 weekly sessions. It has demonstrated improved child behavior and parent satisfaction.

2. Pharmacologic treatment:

    • Stimulant – the most used medications in this category are methylphenidate, amphetamine salt and variants of amphetamine salts.
    • Non stimulant – the most used medications are atomoxetine and guanfacine.

Monitoring:

Providers follow up is recommended one month after initiating treatment. Monthly visits may be required until medication dosing and timing are optimized.  Follow up is recommended at least every three months during the first year.