ADHD in Children

It is estimated that 6.4 million American children between the ages of 4 – 17 have been diagnosed with Attention Deficit Hyperactivity Disorder (ADHD), making it one of the most common childhood psychiatric disorders. ADHD is a neurodevelopmental disorder that typically begins in childhood, usually between ages 3 – 6 and can continue into adulthood. There are direct and indirect problems associated with ADHD. An example of a direct problem might be sitting still to learn in a classroom setting. An example of an indirect problem might be the accrual of social or cognitive deficits that attend this difficulty. Thus, ADHD is an important public health problem that impacts the health system, the education system, and the penal system as many impulsive, undertreated teens find themselves in legal trouble as opposed to under the supervision of a psychiatric treatment team.

Inattention, hyperactivity, and impulsivity are the hallmark behaviors of ADHD. There are three different subtypes – now in DSM V considered presentations because of the relative flexibility of the symptoms – of the disorder so in reality it probably reflects a number of discrete disorders of attention that we have collapsed under a single diagnostic paradigm. Some people mainly have problems staying focused. Others present more hyperactive and impulsive symptoms. The third and most common subtype is people who have problems with both. The third type was extensively studied in The Multimodal Treatment of Attention Deficit Hyperactivity Disorder Study which clarified the importance of treatment.

According to the American Academy of Child and Adolescent Psychiatry, children often show the following symptoms:

• Trouble paying attention
• Inattention to details and makes careless mistakes
• Easily distracted
• Loses school supplies, forgets to turn in homework
• Trouble finishing class work and homework
• Trouble listening
• Trouble following multiple adult commands
• Blurts out answers
• Impatience
• Fidgets or squirms
• Leaves seat and runs about or climbs excessively
• Seems “on the go”
• Talks too much and has difficulty playing quietly
• Interrupts or intrudes on others

Boys and girls tend to present symptoms differently. ADHD is often more noticeable in boys. They are more likely to act out, be impulsive, hyperactive and show physical aggression such as hitting. Girls’ symptoms are typically less obvious and are OFTEN overlooked by teachers and providers as the symptoms are more likely to be inattentive in nature which is less overtly problematic (i.e., the squeaky wheel phenomena). In addition, females tend to have co-morbid anxiety and mood disorders which may include low self-esteem, anxiety, daydreaming and verbal aggression such as teasing and name-calling.

If these symptoms are observed in your child, don’t panic. The symptoms may reflect an underlying ADHD or something else. To figure this out, you should ask your pediatrician for a referral to a child and adolescent psychiatrist who has the expertise to evaluate and make an accurate diagnosis. Treatment focuses on symptom reduction and usually consists of stimulant and non-stimulant based medication(s) with substantial evidence to support their role in improving attention and focus. Several empirically supported psychotherapies have demonstrated efficacy in helping children, teens, and adults with ADHD and both with respect to core ADHD symptoms as well as ancillary problems that may have accrued along the way. There are structured measures utilized by health care providers, many of which are available on the Internet. One screening tool is the SNAP scale.

It’s important to remember that ADHD is not the result of bad parenting and your child doesn’t lack intelligence – they are dealing with the challenges of the disorder. With the proper treatment your child can still live a happy and successful life. It’s crucial to learn how to support your child at home and don’t forget to take care of yourself. In order to support your child, you need to be mindful of your own well-being. Here are some helpful tips from the National Alliance on Mental Illness (NAMI). The American Academy of Child and Adolescent Psychiatry and Children and Adults with Attention Deficit/Hyperactivity Disorder (CHADD) publishes helpful information as well.