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What is ADHD?
ADHD, also called attention-deficit disorder, is a behavior disorder, usually first diagnosed in childhood, that is characterized by inattention, impulsivity, and, in some cases, hyperactivity. These symptoms usually occur together; however, one may occur without the other(s).
The symptoms of hyperactivity, when present, are almost always apparent by the age of 7 and may be present in very young preschoolers. Inattention or attention-deficit may not be evident until a child faces the expectations of elementary school.
What are the different types of ADHD?
Three major types of ADHD include the following:
ADHD, combined type. This, the most common type of ADHD, is characterized by impulsive and hyperactive behaviors as well as inattention and distractibility.
ADHD, impulsive/hyperactive type. This, the least common type of ADHD, is characterized by impulsive and hyperactive behaviors without inattention and distractibility.
ADHD, inattentive and distractible type. This type of ADHD is characterized predominately by inattention and distractibility without hyperactivity.
What causes attention-deficit/hyperactivity disorder?
ADHD is one of the most researched areas in child and adolescent mental health. However, the precise cause of the disorder is still unknown. Available evidence suggests that ADHD is genetic. It is a brain-based biological disorder. Low levels of dopamine (a brain chemical), which is a neurotransmitter (a type of brain chemical), are found in children with ADHD. Brain imaging studies using PET scanners (positron emission tomography; a form of brain imaging that makes it possible to observe the human brain at work) show that brain metabolism in children with ADHD is lower in the areas of the brain that control attention, social judgment, and movement.
Who is affected by attention-deficit/hyperactivity disorder?
Estimates suggest that about 4% to 12% of children have ADHD. Boys are 2 to 3 times more likely to have ADHD of the hyperactive or combined type than girls.
Many parents of children with ADHD experienced symptoms of ADHD when they were younger. ADHD is commonly found in brothers and sisters within the same family. Most families seek help when their child's symptoms begin to interfere with learning and adjustment to the expectations of school and age-appropriate activities.
What are the symptoms of attention-deficit/hyperactivity disorder?
The following are the most common symptoms of ADHD. However, each child may experience symptoms differently. The 3 categories of symptoms of ADHD include the following:
Short attention span for age (difficulty sustaining attention)
Difficulty listening to others
Difficulty attending to details
Poor organizational skills for age
Poor study skills for age
Often interrupts others
Has difficulty waiting for his or her turn in school and/or social games
Tends to blurt out answers instead of waiting to be called upon
Takes frequent risks, and often without thinking before acting
Seems to be in constant motion; runs or climbs, at times with no apparent goal except motion
Has difficulty remaining in his/her seat even when it is expected
Fidgets with hands or squirms when in his or her seat; fidgeting excessively
Has difficulty engaging in quiet activities
Loses or forgets things repeatedly and often
Inability to stay on task; shifts from one task to another without bringing any to completion
The symptoms of ADHD may resemble other medical conditions or behavior problems. Keep in mind that many of these symptoms may occur in children and teens who do not have ADHD. A key element in diagnosis is that the symptoms must significantly impair adaptive functioning in both home and school environments. Always consult your child's doctor for a diagnosis.
How is attention-deficit/hyperactivity disorder diagnosed?
ADHD is the most commonly diagnosed behavior disorder of childhood. A pediatrician, child psychiatrist, or a qualified mental health professional usually identifies ADHD in children. A detailed history of the child's behavior from parents and teachers, observations of the child's behavior, and psychoeducational testing contribute to making the diagnosis of ADHD. Because ADHD is a group of symptoms, diagnosis depends on evaluating results from several different sources, including physical, neurological, and psychological testing. Certain tests may be used to rule out other conditions, and some may be used to test intelligence and certain skill sets. Consult your child's doctor for more information.
Treatment for attention-deficit/hyperactivity disorder
Specific treatment for attention-deficit/hyperactivity disorder will be determined by your child's doctor based on:
Your child's age, overall health, and medical history
Extent of your child's symptoms
Your child's tolerance for specific medications or therapies
Expectations for the course of the condition
Your opinion or preference
Major components of treatment for children with ADHD include parental support and education in behavioral training, appropriate school placement, and medication. Treatment with a psychostimulant is highly effective in most children with ADHD.
Treatment may include:
Psychostimulant medications. These medications are used for their ability to balance chemicals in the brain that prohibit the child from maintaining attention and controlling impulses. They help "stimulate" or help the brain to focus and may be used to reduce the major characteristics of ADHD.
Medications that are commonly used to treat ADHD include the following:
Methylphenidate (Ritalin, Metadate, Concerta, Methylin)
Dextroamphetamine (Dexedrine, Dextrostat)
A mixture of amphetamine salts (Adderall)
Atomoxetine (Strattera). A nonstimulant SNRI (selective serotonin norepinephrine reuptake inhibitor) medication with benefits for related mood symptoms.
Psychostimulants have been used to treat childhood behavior disorders since the 1930s and have been widely studied. Traditional immediate release stimulants take effect in the body quickly, work for 1 to 4 hours, and then are eliminated from the body. Many long-acting stimulant medications are also available, lasting 8 to 9 hours, and requiring 1 daily dosing. Doses of stimulant medications need to be timed to match the child's school schedule to help the child pay attention for a longer period of time and improve classroom performance. The common side effects of stimulants may include, but are not limited to, the following:
Rebound activation (when the effect of the stimulant wears off, hyperactive and impulsive behaviors may increase for a short period of time)
Most side effects of stimulant use are mild, decrease with regular use, and respond to dose changes. Always discuss potential side effects with your child's doctor.
Antidepressant medications may also be administered for children and adolescents with ADHD to help improve attention while decreasing aggression, anxiety, and/or depression.
Psychosocial treatments. Parenting children with ADHD may be difficult and can present challenges that create stress within the family. Classes in behavior management skills for parents can help reduce stress for all family members. Training in behavior management skills for parents usually occurs in a group setting which encourages parent-to-parent support. Behavior management skills may include the following:
Contingent attention (responding to the child with positive attention when desired behaviors occur; withholding attention when undesired behaviors occur)
Teachers may also be taught behavior management skills to use in the classroom setting. Training for teachers usually includes use of daily behavior reports that communicate in-school behaviors to parents.
Behavior management techniques tend to improve targeted behaviors (such as completing school work or keeping the child's hands to himself or herself), but are not usually helpful in reducing overall inattention, hyperactivity, or impulsivity.
Prevention of attention-deficit/hyperactivity disorder
Preventive measures to reduce the incidence of ADHD in children are not known at this time. However, early detection and intervention can reduce the severity of symptoms, decrease the interference of behavioral symptoms on school functioning, enhance the child's normal growth and development, and improve the quality of life experienced by children or adolescents with ADHD.
How I can grow my 1 year old baby health. He is too weak. He drink only packed milk and do not eat any food usually vomit if forced to eat. He do not drink water as well. What and how I should fead him so that he should be stronger with bady and brains. height is also my concern. He two times suffered from pneumonia and admitted to hospital. He usually suffered from any disease.
My baby is 7 month (premature). Now he is now 52 days old. Recently we had giving him vaccine for 6 weeks. Now he is getting continously fever. After giving him medicine he will be fine for 1hrs. Then again fever will come. So, please suggest what should we need to be do for his fever? or we need to go for doctor? vaccine had given on 08.06. 2015.
Hi doctor. My 2 year daughter has habit of thumbsucking. Somebody suggested femite. Are these medicines safe? any safer alternative. Thanks.
My child is a 4 year old. But he have a problem, that he is suffer fever frequently between 24-30 days continued. What shall I do at first ? But I had consulted with a doctor and prescribe some medicine, but not works properly. What shall I do, at first for my child ?
Hello Dr. My baby is 15 days old. I had c section because of which I started breastfeeding the baby 7 days before. Wen I feed him it takes me 2 hours but then too he is hungry. And then I hav to give him lactogen. What should I do so that he should be full because I don't want to give him top feed please suggest.
My Son is of two years of told. Still he cries and fights with my wife for breast feeding. How to make him to leave it?
Hi, I want to ask about my 7 years old boy. He is having worms in his stomach. But there is no stomach ache. At night while sleeping his teeth make different sound. Like rubbing one another. We have given albendazole 2 months before, can we give it again now or anything else?
Hai last Saturday I putted sixth week vaccination to my kid. After that he not taking milk properly. Now he doesn't have fever. Kindly advice wat to do to take the milk properly.
I have 3 month baby, he doesn't sleep properly at night. I am preparing for competitive xams and for that I have to study at night but the baby doesn't allows me to concentrate fully even for 2-3 hrs. Is there any way I can make him sleep strongly for 2-3 hours so I can study by that time.
Hello Dr. mera baby one and half month ka hai aaj wo subah se sota hi jaa rha hai even rat me bhi puri rat soya tha wo feed be kam kar rha hai kya reason ho skta hai plzz rply urgent.
Hi, My daughter is grinding her teeth during sleep. She also sleeps with her eyes half closed. The problem is only increasing and more noticeable now. She has also started taking fingers in her mouth. Is this behaviour normal? What could be the reason? Please suggest a remedy. Thanks, Nawaz.
Hello, my baby is of 13 days old and he was fine these days but from last 2 to 3 days he is having a bleeding at the penis end not much but a small drop. Is it normal or what? If not what precautions I should to take to make sure he is safe. Please help me.
Hi i have been facing problem while coughing rite side of my back pains heavily. i hv checked my blood my esr is 24 serum c reactive protein is 0.61
We welcome our bundle of joy with old, washed, sun dried clothes as they are almost sterile. New clothes are probably handled by many and may be infected. The breast feeding is started with the help of young unmarried girl. This educates the girl about this AMRIT SAVEN. Mother is given ajwayan water which helps to lactate. On the sixth day bua does the ceremony of chatti by giving bath and putting on new clothes to baby. By sixth day the umbilical cord falls and there after the baby should be given a bath. On the occasion of chatti mother is given all kind of foods and after that she is supposed to have everything including all fruits, vegetables and dal, then ladoos or panjiri rich in ghee, dry fruits. These help mother for extra calories and minerals especially calcium and iron required postpartum. In this ceremony Bua plays an important role and rewarded with lots of gifts by bhabhi for the hard work she has been doing and will do after that, till 45 days. During these crucial 45 days outsiders are not allowed to get in mother?s room as people coming from outside may infect the child . The child is never left alone, a knife or a match boxes is kept besides baby, it is a primitive method to save the baby from animals and strangers. The God (baby and mother) has come and the duo should be prayed (taken care) and not do pooja or attend functions