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ADHD I
OVERVIEW: Attention deficit hyperactivity disorder (ADHD), also called hyperactivity, is a behavior problem marked by a short attention span, low frustration tolerance, impulsivity, distractibility, and usually, hyperactivity. ADHD can result in poor school performance, difficulty in peer relationships, and parent/child conflict.
SIGNS AND SYMPTOMS: • Fidgets
• Difficulty remaining seated
• Easily distracted
• Can't wait turn
• Blurts out answers before question is complete
• Difficulty following instructions
• Difficulty sustaining attention
• Shifts from one uncompleted task to another
• Difficulty playing quietly
• Talks excessively
• Interrupts others
• Doesn't seem to be listening
• Loses things
• Engages in physically dangerous activities without considering consequences
CAUSES: Multiple factors
SCOPE: ADHD affects about 5% of school-aged children.
MOST OFTEN AFFECTED: • Onset before 7 years old
• Lasts into adolescence and adulthood
• 50% can be diagnosed by age 4
• May affect more than one family member
• Males affected 4-6 times more often than females
RISK FACTORS: • Poor prenatal health (preeclampsia, drug and alcohol use, smoking)
• Associated with, but not caused by, other conditions:
• Learning disabilities
• Tourette's syndrome
• Mood disorders
• Conduct disorder
DIAGNOSIS PHYSICAL EXAMINATION: • The Physician will obtain a history and perform a thorough physical examination of the patient.
• Other possible causes of the behavior will be investigated, such as learning disability or hearing/vision disorder.
TESTS AND PROCEDURES: • Laboratory testing rarely needed
• Lead level in the blood may be measured.
• Behavioral or psychological testing may be performed.
TREATMENT GENERAL MEASURES: • ADHD is managed in the outpatient setting.
• Doctor and parents must work closely with teachers and other school officials.
• Avoid unproved therapies.
• Reinforce good behavior with rewards and attention.
• Make eye contact with each request.
• Keep child on one task at a time.
• Administer time-out (brief) for problems.
• Stop behavior before it escalates.
• Find things the child is good at and emphasize these tasks.
• Some families benefit from anger training, social training, and family therapy.
• Keep realistic expectations during growth stages (newborn to adulthood).
• Discuss pros and cons of drug therapy with doctor.
• Parents may need help dealing with feelings (guilt, shame, anxiety, exhaustion, and blame).
• At school:
• Keep work sessions short.
• Make sure rules are clear.
• Consequences for unacceptable behavior must be immediate.
• Reinforce good behavior.
• Teachers should coordinate homework with parent (child may not bring home messages).
ACTIVITY: • Allow for increased activity in safe environment.
• Children with ADHD often respond well to water play/bathtubs.
DIET: • No dietary changes have been proven to help ADHD.
• Parents can experiment with nonharmful diets by eliminating sugar, dyes, additives.
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