ADHD

What is Attention Deficit-Hyperactivity Disorder?

Attention deficit-hyperactivity disorder (ADHD) is a neurobehavioral disorder that affects 3-5 percent of all American children. It interferes with a person's ability to stay on a task and to exercise age-appropriate inhibition (cognitive alone or both cognitive and behavioral). Some of the warning signs of ADHD include failure to listen to instructions, inability to organize oneself and school work, fidgeting with hands and feet, talking too much, leaving projects, chores and homework unfinished, and having trouble paying attention to and responding to details. ADHD is usually diagnosed in childhood, although the condition can continue into the adult years.

How common is ADHD?
• ADHD is very common. On average, it affects 5% of school-aged children around the world, or about one in every 20 children. This means that in many countries, there may be one or two children with ADHD in every classroom.

How do we diagnose ADHD?
A child's teacher may be the first person to suspect that a child has ADHD, especially if he is hyperactive and often disrupts class. However, parents may notice signs of ADHD before the child begins school, such as problems with social skills and disruptive behaviour. Alternatively, parents may realize that their child is having problems if she does poorly at school. If you or your child’s teacher suspects your child might have ADHD, your child should be assessed by a doctor.
A doctor will consider ADHD when they see a child who:
• is failing at school
• disrupts class
• cannot sit still or is hyperactive
• acts without thinking
• does not pay attention or does not seem to listen
• cannot concentrate
• daydreams
• has problems with friendships and other social relationships
• has low self-esteem

What happens if you do not diagnose or treat the ADHD?
• School failure
• Depression and anxiety
• Problems with relationships
• Substance abuse
• Delinquency
• Risk for accidental injuries
• Job failure

Children with ADHD are at higher risk for:
• Epilepsy
• Other behaviral problems
• Tics
• Autistic spectrum disorder

Is there any treatment?

The usual course of treatment may include medications, which are stimulants that decrease impulsivity and hyperactivity and increase attention. Most experts agree that treatment for ADHD should address multiple aspects of the individual's functioning and should not be limited to the use of medications alone. Treatment should include structured classroom management, parent education (to address discipline and limit-setting), and tutoring and/or behavioral therapy for the child.
What is the prognosis?

Children with the disorder seldom outgrow it; however, some may find adaptive ways to accommodate the ADHD as they mature.

Dr R K Jain
MBBS, DCH, MRCPCH, CCT - British Board Certification (Oxford), FRCPCH (UK)
Fellowship, Paediatric Neurology, GOSH, London.

Sr Consultant, Paediatric Neurologist, Fortis Hospital, Gurgaon.