Have you been concerned about your child’s ability to focus or sit still? They may have attention deficit hyperactivity disorder. ADHD is a developmental disorder characterized by either poor focus, frequent movement or fidgeting, and/or impulsive behavior. These symptoms can interfere with academic performance, peer relations, and the ability to complete activities of daily living.
Diagnosis
Patients can have ADHD that is predominantly inattentive, predominantly hyperactive/impulsive, or a combination of both. Inattentive ADHD may cause trouble with focus, distractibility, inability to complete tasks, and forgetfulness. Hyperactive ADHD may cause trouble staying seated, frequent fidgeting, talking out of turn, and acting as if driven by a motor. Doctors evaluating patients with these symptoms will use several other criteria to diagnose ADHD.
- Symptoms must be present for at least 6 months
- Symptoms must be present prior to age 12
- Symptoms must be present in more than one setting
- Symptoms must interfere with the ability to function in academic and/or social settings
- Symptoms can not be due to another mental health condition
Treatment
Evidence based treatment for ADHD involves a combination of behavior therapy, medication, and lifestyle changes. This can include school supports like preferential seating, tutoring, or extra time for tests and assignments. You can read more about individualized education plans and school supports here. It’s best to have an evaluation with the school simultaneously with your evaluation by the pediatrician in order to provide optimal treatment options.
Recommended lifestyle changes may include increased physical activity. In fact, children perform better on academic tasks following phys ed or active playtime. Other lifestyle changes include improved nutrition, improved sleep, and decreased screen time.
Behavior therapy is important for helping patients learn skills to manage their ADHD. This might also include training parents on how to best help their child.
First line medications for ADHD are called stimulants. These medications increase the chemicals dopamine and norepinephrine in the brain. These chemicals help the brain stay focused. Strattera is a medication that also improves these chemicals in the brain but is not a stimulant.
Other therapies are also available. Non-stimulant medications called guanfacine or clonidine can be given in addition to stimulants to help patients who have extreme hyperactivity or emotional dysregulation. Additionally, there is a video game called EndeavorRx that is FDA approved to help patients with ADHD.
Other considerations
ADHD occurs frequently in patients who have other conditions. Most commonly anxiety, depression, learning disorders, and oppositional defiant disorder. Sometimes it’s hard to tell whether symptoms of a mental health disorder are causing the symptoms of ADHD or vice versa. This is why testing at the school to look for learning disorders is so important. Furthermore, your pediatrician may recommend cognitive behavior therapy for a mental health concern prior to treating symptoms of ADHD. However, some patients may need to be treated for both simultaneously.