Attention deficit/hyperactivity disorder (ADHD) is among the most common neurobehavioral disorders presenting for treatment in children and adolescents. ADHD is often chronic with prominent symptoms and impairment spanning into adulthood. ADHD is often associated with co-occurring disorders including disruptive, mood, anxiety, and substance abuse. The diagnosis of ADHD is clinically established by review of symptoms and impairment. The biological underpinning of the disorder is supported by genetic, neuroimaging, neurochemistry and neuropsychological data. Consideration of all aspects of an individual s life needs to be considered in the diagnosis and treatment of ADHD. 

Multimodal treatment includes educational, family, and individual support. Psychotherapy alone and in combination with medication is helpful for ADHD and comorbid problems. Pharmacotherapy including stimulants, noradrenergic agents, alpha agonists, and antidepressants plays a fundamental role in the long-term management of ADHD across the lifespan. 

The management of ADHD includes consideration of two major areas: non-pharmacological (educational remediation, individual and family psychotherapy) and pharmacotherapy. 

I personally support Psychotherapy. Specialized educational planning based on the child s difficulties is necessary in a majority of cases. Since learning disorders co-occur in one-third of ADHD youth, ADHD individuals should be screened and appropriate individualised educational plans developed. Educational adjustments should be considered in individuals with ADHD with difficulties in behavioral or academic performance. Increased structure, predictable routine, learning aids, resource room time, and checked homework are among typical educational considerations in these individuals. Similar modifications in the home environment should be undertaken to optimize the ability to complete homework. For youth, frequent parental communication with the school about the child s progress is essential. 

Symptoms in children and teenagers 

The symptoms of ADHD in children and teenagers are well defined, and they're usually noticeable before the age of six. They occur in more than one situation, such as at home and at school. The main signs of each behavioural problem are detailed below:

Inattentiveness: having a short attention span and being easily distracted making careless mistakes   for example, in schoolwork appearing forgetful or losing things being unable to stick at tasks that are tedious or time-consuming appearing to be unable to listen to or carry out instructions constantly changing activity or task having difficulty organising tasks 
Hyperactivity and impulsiveness: being unable to sit still, especially in calm or quiet surroundings constantly fidgeting being unable to concentrate on tasks excessive physical movement excessive talking being unable to wait their turn acting without thinking interrupting conversations little or no sense of danger 
These symptoms can cause significant problems in a child's life, such as underachievement at school, poor social interaction with other children and adults, and problems with discipline. 

Related conditions in children and teenagers 

Although not always the case, some children may also have signs of other problems or conditions alongside ADHD, such as: 

anxiety disorder   which causes your child to worry and be nervous much of the time; it may also cause physical symptoms, such as a rapid heartbeat, sweating and dizziness 
oppositional defiant disorder (ODD)   this is defined by negative and disruptive behaviour, particularly towards authority figures, such as parents and teachers 
conduct disorder   this often involves a tendency towards highly antisocial behaviour, such as stealing, fighting, vandalism and harming people or animals 
depression 
sleep problems   finding it difficult to get to sleep at night, and having irregular sleeping patterns 
autistic spectrum disorder (ASD)   this affects social interaction, communication, interests and behaviour 
epilepsy   a condition that affects the brain and causes repeated fits or seizures 
Tourette s syndrome   a condition of the nervous system, characterised by a combination of involuntary noises and movements called tics 
learning difficulties   such as dyslexia Symptoms in adults In adults, the symptoms of ADHD are more difficult to define. This is largely due to a lack of research into adults with ADHD. 
ADHD is a developmental disorder; it's believed that it can't develop in adults without it first appearing during childhood. But it's known that symptoms of ADHD often persist from childhood into a person's teenage years, and then adulthood. Any additional problems or conditions experienced by children with ADHD, such as depression or dyslexia, may also continue into adulthood. By the age of 25, an estimated 15% of people diagnosed with ADHD as children still have a full range of symptoms, and 65% still have some symptoms that affect their daily lives. The symptoms in children and teenagers, which are listed above, is sometimes also applied to adults with possible ADHD. But some specialists say that the way in which inattentiveness, hyperactivity and impulsiveness affect adults can be very different from the way they affect children. For example, hyperactivity tends to decrease in adults, while inattentiveness tends to get worse as the pressure of adult life increases. Adult symptoms of ADHD also tend to be far more subtle than childhood symptoms. 

Some specialists have suggested the following list of symptoms associated with ADHD in adults: 

carelessness and lack of attention to detail 
continually starting new tasks before finishing old ones 
poor organisational skills 
inability to focus or prioritise 
continually losing or misplacing things 
forgetfulness 
restlessness and edginess 
difficulty keeping quiet and speaking out of turn 
blurting out responses and often interrupting others 
mood swings, irritability and a quick temper 
inability to deal with stress 
extreme impatience 
taking risks in activities, often with little or no regard for personal safety or the safety of others   for example, driving dangerously 
Additional problems in adults with ADHD As with ADHD in children and teenagers, ADHD in adults can occur alongside several related problems or conditions. One of the most common conditions is depression. Other conditions that adults may have alongside ADHD include: 

personality disorders   conditions in which an individual differs significantly from an average person, in terms of how they think, perceive, feel or relate to others 
bipolar disorder   a condition that affects your moods, which can swing from one extreme to another 
obsessive-compulsive disorder (OCD)   a condition that causes obsessive thoughts and compulsive behaviour 
The behavioural problems associated with ADHD can also cause problems such as difficulties with relationships, social interaction, drugs and crime. Some adults with ADHD find it hard to find and stay in a job. If you notice any of the above in your child or yourself , it is worth making the effort and spending some time and money to have your child and or yourself assessed on a priority basis as ADHD causes neural changes in the brain. 

Attention Deficit Hyperactivity Disorder (ADHD) - A Guide!

For a child, the first visit to the dentist can be panicky. This is because they don't realize what's in store. Children get a better idea about dentists after getting some information about the visit. We, as grown ups, must be set up to answer the inquiries and instruct our children in the most ideal way. The following are some valuable tips on the best way to set up a child for the first dentist appointment.

1. Guardians regularly ask when they ought to take their child for the first ever dental visit. The best time to begin taking children for a dental checkup is either when their first tooth pops out, or right around their first birthday. Expert dentists are capable of instantly recognizing any potential issues with the development and advancement of the jaw and delicate palate. Children's teeth are more porous and defenseless to decay than grown-up's teeth; so early mediation is a basic to guarantee those small teeth staying sound. It is also recommended that guardians begin brushing their child's teeth when they start coming out, utilizing a delicate toothbrush and plain water. Brushing should be started as early as possible.

2. It's never too early to begin acquainting your kids with tooth brushing and knowledge of oral health. The best time to begin is before your kid's first dental visit. Youngsters love to find out about their bodies, and love to grin, touch, and investigate new things. There are many fun ways to impart oral health education to children. The more agreeable they are with their mouth and teeth, the less demanding your youngster's first dental visit will be.

3. Tooth brushing is an essential piece of our everyday self-care, and it is our habit. A child, after being introduced to a brush and a toothbrush will take a certain time period to make daily brushing a habit. Guardians and the kids can brush their teeth" together. It is essential to note that toothbrushes are apparatuses, not toys, and that infants and babies ought to be firmly directed.

4. Little children, are extremely insightful and touchy to the states of mind of people around them. Children regularly reflect our conduct. When we are casual and upbeat, children will probably be loose, as well. Children are additionally more casual when they are prepared for or taught something. Invest energy conversing with children about going to the dentist. You can also discuss what the dentist will do, emphatically.

5. Always choose the most trustworthy dentist who is friendly and knows how to handle a child on his first dentist visit.

A child's first dentist appointment is a special one, and you should prepare him accordingly.

Tips to Prepare Your Child For First Dental Visit

Coughing during the night can really wreak havoc for your sleep and cause inexplicable discomfort in the throat and chest region. Thankfully, you can manage it by soothing your tickling throat as well as sensitive airways before you go to bed at night. 

Drink herbal tea: A mugful of non-caffeinated tea mixed with a teaspoon of honey before going to bed can help you to a considerable extent. This is because any warm liquid has the power to break down the formation of mucus in the throat region and with a bit of honey, the herbal tea becomes even more powerful.
Try to sleep in an inclining position: Gravity is your greatest enemy while combating night-time cough. When you lie down flat on your back at night, all the mucus and dust particles, which you have swallowed all through the day, would accumulate in the throat area and aggravate it making more cough. But you can easily defy gravitational force by piling up some pillows and prop yourself on them while sleeping. You may also keep a wooden block of 4 inches height under your head, which would keep the acids in the stomach so that they don t come up to irritate your throat.
Make sure you use the steam cautiously: When your airways are dry, it can make you cough harder. Therefore, you may find relief if you take a warm shower or a bath before going to bed. But you have to be sure that you don t have asthma as steam can prove harmful for you.
Check the level of humidity: Humidifiers are known to soothe the problem of persistent coughing when the surrounding air is dry. But too much of moisture during the night can also make you cough. This is because dust mites, mold and other allergens thrive well in the damp air and they could conspire to make your cough even worse. So, pick up a cheap hygrometer from a hardware store and see that the humidity level stays within 40 to 50 percent.
Equip yourself at night: Keep all the things from drops to water to cough syrup or anything that soothes coughing at your bedside so that you can help yourself in case you wake up in the middle of the night and start coughing.
By following these few tips every day, you can manage the night time cough and have a good night s sleep without any interruptions.

Night Time Cough - 5 Tips to Manage it

Early childhood is a time when the brain develops rapidly and nutrition is an important part of healthy brain development. It is important for children to eat a variety of foods that can provide them with the proper intake of carbohydrate, protein, good fats, minerals, vitamins and antioxidants. There is a very strong mind-gut connection; therefore focusing on the food you choose to complete the nutritional needs of your child can make a great difference in their brain function.

Certain foods are better for our brains than others, these brain foods may help boost a child's brain growth and even improve the memory and cognitive development.

During infancy, the amino acids and fatty acids in breast milk are ideal for optimal brain development. The brain continues to grow throughout early childhood and children who do no consume a balanced diet are at risk of developing mental retardation and behavioral problem.

10 brain foods to feed the mind and body properly:

1. Whole grains: Brain needs a consistent supply of glucose, thus foods those are high in refined sugars and carbohydrates leads to rapid fluctuation in blood glucose levels and the brain doesn't get the steady fuel supply and energy for proper functioning, therefore to nourish the most active part of body include whole-grain breads, oatmeal, roasted grains in the diet of children for regular release of glucose in body. Oats are also rich in vitamin-B, Vitamin-E, potassium and zinc.

2. Eggs: The protein and nutrients in eggs help kids concentrate because the egg yolks are packed with choline which boosts memory. Eggs are also rich in protein, which provides energy to help the brain stay alert longer.

3. Fish: Fish is a good source of vitamin D and omega-3s, which protect the brain from declining mental skills and memory loss. Salmon, tuna, and sardines are all rich in Omega-3s. The more Omega-3s we can get to the brain, the better it will function and the better kids will be able to focus.

4. Seeds: Packed with protein, essential fatty acids, vitamins and minerals. Seeds may boost mood and keep your nervous system in check. For example sunflower seed butter as they are rich in folate, vitamin E and selenium and are safe for nut-free zones.try to include seeds directly to the meals.

5. Iron is important for brain development: Preschoolers and toddlers typically eat less iron-rich foods than they did in infancy. In addition, the iron that children get is usually non-Heme iron (from plant sources,) which has lower availability than heme iron (from animal source).sources beef, nuts and dark leafy vegetable (spinach) and tofu.

6. Milk and Yoghurt: Milk and yoghurt contains healthy fats and proteins those are important for brain health. The majority of the brain is made up of fat, so it is no wonder healthy fat is important to feed the developing brain. Protein is important as it can help brain cells send and receive information effectively. Yoghurt also contains good bacteria that will help boost your child's immune system as well as aid digestion, children need higher dose of vitamin D, which is present in dairy and its products.

7. Organic Foods and leafy vegetables: These organic foods are free from pesticides and insecticides and preservatives and do not cause neurodevelopment problems in children, which will impair proper brain functioning. Green leafy vegetables are loaded with vitamin A and K; these keep inflammation at bay .e.g. Spinach, kale, lettuce.

8. Walnuts: The high level of antioxidants, vitamin and minerals in walnuts improves the cognitive health of kids and improve their mental alertness also.

9. Colorful veggies: Vegetables with a rich, deep color such as tomatoes, sweet potatoes, pumpkin, carrots, and spinach are the best sources of antioxidants that support brain health and keep brain cells strong. These foods can be given from weaning age.

10. Berries: The color of the food tells the nutritional value of it. All the berries like strawberry, cherries, blueberries and blackberries have intense color are especially rich in vitamin C and high levels of antioxidants. Blueberries have high levels of Gallic acid, which boost memory by preventing degeneration of brain cells.

So, go ahead and try to include different food group to your Child's plate for a better performance.

Must Have Brain Foods for Your Kids!

Down Syndrome is a genetic disorder resulting from chromosomal aberration. Usually, a person is born with 23 pairs of chromosomes (46 chromosomes in total). In the case of a Down Syndrome, there is a total of 47 chromosomes (an extra complete or partial chromosome appearing in the 21st pair). This extra chromosome is the main wrecker in chief that triggers the behavioral and developmental alterations characteristic of Down Syndrome.

Depending on the distribution of the chromosome during cell division, Down Syndrome may be triggered by three conditions

Trisomy 21: One of the most common causes of Down Syndrome, Trisomy 21 is characterized by the presence of an extra chromosome in chromosome 21.
Translocation Down syndrome: As the name suggests, here a part of the chromosome 21 translocates itself to some other chromosome. There will be no trisomy on chromosome 21. However, there will be extra genetic material resulting from the chromosome containing the translocated portion of chromosome 21.
Mosaic Down Syndrome: This is a rare condition where some cells will have 46 chromosomes (23 pairs) while few others will have 47 chromosomes (trisomy 21).
Symptoms characteristic of Down Syndrome
Some of the symptoms synonymous to Down Syndrome include

The face appears flattened with a short mouth and a protruding tongue.
The ears, neck, arms, and legs are shorter than usual.
Children and adults with Down Syndrome usually have a short stature.
The muscles also lack proper tone.
Children with Down Syndrome are often found to have impaired cognitive ability. The condition also affects the memory, both short, as well as long-term.
Managing a child with Down Syndrome
No parent would ever want their child to suffer from Down Syndrome. Along with the medications and therapies, as a parent, you should also be prepared to manage the situation well.

The situation is by no means easy for you, but if you get weak or panic, things will only go from bad to worse. Thus, you need to be strong.
Be in constant touch with the attending physician to know the progress of your child.
If your child is still very young, get them enrolled in the special enhancement programs. These programs play a significant role in improving the language, motor movements, as well as developing the various self-help skills in the Down Syndrome children.
Connect with families dealing with identical situations. Discussing your problems with them or learning about theirs can help in better management.
Your concern for the child is understood but do not snatch their independence. Give them the freedom they deserve. They might make mistakes, but it will help build their confidence.
If the situation demands, get your child admitted to schools which are specially designed for such children.
Do not keep your child confined within the four walls of the home. Take them outside. Let them interact with people. Indulge in family outings and get-togethers.
The situation may be difficult but not impossible. Have faith and do what is in your hands.

Down Syndrome - How It Should Be Dealt With?

Cystic fibrosis is a genetic condition, which primarily affects the lungs and persistence of this condition might lead to severe breathing problems and loss of lung function. If you have inherited two copies of the defective gene from your parents, you are likely to suffer from this disease. Cystic Fibrosis causes a buildup of thick mucus in your lungs and affects other organs such as the kidneys, pancreas and the intestines in your body.

It isn't very uncommon as one out of fifty people in Asia is a carrier of this disease. The disease gets its name from the cysts formed in the pancreas of the sufferer. However, this disease can be detected by testing the quantity of salt present in your sweat. Prenatal testing for Fibrosis is another method to test if your newborn is likely to contract a lung infection.

Complications faced due to cystic fibrosis include:
1. Serious sinus infections
2. Serious damage in lungs due to inflammation and incessant infection
3. Malnutrition
4. Complication in breaking down protein
5. Respiratory tract contamination

If you observe one or more of the following symptoms, you might be suffering from Cystic Fibrosis:
1. Salty-tasting skin
2. Bowel obstruction caused due to meconium ileus (obstruction of the bowels)
3. Mucus amiss in your alveoli
4. Persistent coughing with phlegm discharge
5. Shortness of breath while engaging in a physical task
6. Stunted or measly growth despite healthy lifestyle habits
7. Infertility in males

If you're suffering from cystic fibrosis, there isn't any particular treatment which is recommended due to the varying degrees of it found in people. However, consultation with a medical practitioner and an individualised treatment plan can help you minimise the risks and lead a better life.

Some therapies you can opt for are:
a) Airway clearance: This therapy helps sift the thick layer of mucus around your organs. Some people have also chosen to use the inflatable vest which vibrates around your chest, thereby, thinning and loosening the layer of mucus.

b) Inhaled medicines: Another breakthrough in the field of respiratory medicine, this method requires the patient to sniff a liquid consisting of mist, which is inhaled with the aid of a nebuliser. This method is known to be beneficial for opening airways.

c) Pancreatic enzyme supplements: Along with multivitamins, these specially designed supplements are known to cater to your pancreas with the much-needed nutrients and they need to be consumed with every meal.

Cystic Fibrosis: All You Need to Know

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