Topic Reference

ADHD is the most common behavior disorder treated by pediatricians (Stein, 2009).  It is thought that    8-12% of children worldwide have one of the three types of this condition (Psychiatric Times, 2009). Characteristics that determine the type of ADHD fall into 3 categories of symptoms:  inattention, hyperactivity and impulsivity.  The most prominent symptoms will determine the exact diagnosis. The subtypes of this condition are

• ADHD, Combined Type (symptoms of both inattention and hyperactivity-impulsivity)
• ADHD, Predominantly Inattentive Type 
• ADHD, Predominantly Hyperactive-Impulsive Type

To be diagnosed with a type of ADHD, your child must have had symptoms for at least 6 months that cause problems in more than one setting such as school, play and/or home.  Problems must occur in a developmentally appropriate setting, task or activity where there are reasonable expectations for the child’s maturity level.  Information from parents, teachers and other caregivers help the physician determine whether or not a child has ADHD.  The following symptoms are the characteristics that a physician will look for when determining whether or not your child has ADHD (American Psychiatric Association, 2000).  These are problems that occur during interactions with others, while engaged in solitary tasks, or during activities with others. 

Symptoms of Inattention

• Not paying attention to the details of play, schoolwork or other tasks that could be reasonably expected to hold attention
• Making mistakes that appear careless in schoolwork or other developmentally appropriate activities
• Becoming distracted from tasks or play activities and/or leaving tasks and activities unfinished
• Appearing not to listen when directly spoken to
• Not following instructions that others of similar development do
• Being unusually and consistently disorganized in activities
• Losing things needed for tasks and activities such as schoolwork, school supplies or toys
• Being easily distracted in any interaction, activity or task
• Appearing forgetful.

Symptoms of hyperactivity and impulsivity   

• Frequent movement such as ‘fidgeting’ or ‘squirming’
• Not remaining seated in situations when this would be appropriate
• Running, climbing or otherwise moving excessively or appearing unusually restless
• Being frequently unable to engage quietly in appropriate activities
• Appearing unusually energetic or ‘on the go’
• Excessive talking, interrupting or ‘blurting out’
• Having difficulty waiting
• Frequently intruding upon others’ conversations, activities or play

Associated Problems for the Child and Family

Children with ADHD and their families are impacted daily by this condition.  Children with ADHD may experience sleep disturbances, anxiety and even depression that compound problems.  School performance is seriously affected by daily problems in the classroom and problems with assignments.  These difficulties can cause children to miss important educational milestones.   They then are at significant risk for future academic problems as they often fall farther and farther behind.  The inability to appropriately accept supervision and direction creates conflict and disruption in daily activities and home life, often causing the child to be viewed as intrusive, uncooperative, lazy or defiant.  As a result, these children are often ostracized by peers and considered problematic by teachers and other caregivers.  Consequently, children with untreated ADHD can have many negative beliefs about themselves such as believing themselves to be ‘bad’ or ‘stupid’.  A sense of failure, not being liked, low self-esteem, frustration and helplessness are typical for children with untreated ADHD.  Furthermore, family life is stressful as parents and siblings struggle to assist and supervise a child with this condition and such related problems. Many times siblings of a child with ADHD will feel neglected and resentful as that child will consume much of the parents’ time and attention.

Treatment

Treatment for ADHD can involve multiple approaches combined into one treatment plan for your child.  Medication is considered to be the primary treatment of choice.  Medication is vital in treating ADHD since symptoms are the result of a chemical imbalance in the brain.  Medications correct the brain’s inability to control attention, hyperactivity and impulsivity so that your child can function better in relationships, school, play and family life.  The benefits of medication are impressive and have been researched for many years. Furthermore, medication works quickly and positive effects are apparent almost immediately. 

In addition to the use of medication, your child may benefit from counseling that helps children with ADHD recover from the low self-esteem, anxiety, depression and lack of social skills that this untreated condition causes.  Educational interventions such as tutoring and remedial classes will help your child recover from academic problems and are especially effective with the use of medication.  Additionally, family therapy can help the parents and siblings of a child whose untreated ADHD was particularly stressful and disruptive in family life.  Some children with ADHD are also helped by adding attention to good nutrition, relaxation techniques and exercise to the primary treatment plan prescribed by your physician. To find a service provider in your area who specializes in ADHD, visit our Directory.

References

American Psychiatric Association.  (2000).  Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, D.C.: American Psychiatric Association.

Psychiatric Times.  (2009, February 5).  New Research Examines Genetics Behind ADHD. Psychiatric Times. Vol.26, No.2 .

Stein, Horowitz, Strofer-Isser,  et al.  (2009, January).  Attention Deficit/Hyperactivity Disorder: How Much Responsibility Are Peditricians Taking? PEDIATRICS, Vol. 123, No.1 , pp. 248-255.

An ADHD diagnosis will often vary from one health care provider to the next, leaving parents confused and frustrated.  However, the children are the ones who truly suffer.  Many will be stuck with an inaccurate label that will dramatically alter the way the world interacts with them as well as prescribed unnecessary medication that may in fact do more harm than good.  Others, will not recieve a definitive diagnosis and thus, the help they need.  Parents are starting to shift their focus from searching out the definitive ADHD diagnosis and towards seeking treatment.