Attention deficit hyperactivity disorder

What is Attention Deficit (Hyperactivity) Disorder or (ADHD)?

Attention-deficit Hyperactivity Disorder is "a condition of the brain that makes it hard for children to control their behavior".  

All kids have problems with their behavior from time to time, but kids with ADHD have behavior problems that interfere with regular life and are continual. ADHD used to be called Attention Deficit Disorder or ADD. ADHD usually lasts your whole life. A lot of adults have ADHD.

Kids with Attention Deficit Hyperactivity Disorder (ADHD or AD/HD) can have different kinds of symptoms:

Inattention : These kids have trouble with paying attention, are disorganized or daydream too much.

Hyperactivity : These kids are always moving, can't sit down or talk too much.

Impulsivity : These kids act and talk without thinking, interrupt a lot or show poor judgment.

Combination : The above symptoms can occur in different combinations.

How common is ADHD?

Attention Deficit Hyperactivity Disorder is the most common behavior disorder in school aged kids. About 8-12% of kids have it.

What causes it?

The exact causes of ADHD are not yet known. Experts think that ADHD is caused by differences in the way messages are sent in the brain. ADHD seems to run in families, so it may be inherited.

How is ADHD diagnosed?

ADHD is usually only diagnosed in school aged kids (ages 6-12), because it is hard to diagnose in younger children.

The diagnostic process has many steps, and you, your child's school and other caregivers will all need to provide information about your child's behavior. To find out about diagnosis, read the American Academy of Pediatrics clinical practice guideline.

How is ADHD treated?

The best treatment for ADHD is usually medication, combined with behavior therapy (including training parents in behavior therapy) and setting things up for your child at home and at school to make it easier to pay attention.

Because ADHD is a chronic (on-going) condition, treatment must also be on going. Usually you will have a long term plan that includes goals for your child. When all the parts of the treatment plan are in place, and everyone (child, parents, teachers, doctors, caregivers, etc.) works together, treatment will be most effective.

What if I think my child might have ADHD?

If you think your child may have ADHD, you should have them checked by their primary care provider or a psychiatrist. Sometimes a sight or hearing problem, family stress, worry, a learning disability or communication problems can affect a child's attention and behavior. You should also get help from your school system.

What can the school system do for my child?

If your child is struggling in school, ask your school system in writing for an evaluation of your child. They are required to provide it, at no cost to you. The purpose of an evaluation is to find out why your child is not doing well in school.

A team of professionals will work with you to evaluate your child. If they do not find a problem, you can ask the school system to pay for an Independent Educational Evaluation (IEE). There are strict rules about this, so you may not get it.

You can also have your child tested again privately, and pay for it yourself. But check with your school district first to make sure they will accept the private test results.

By law, the school system must consider the results of the second evaluation when deciding if your child can get special services.

What about medication?

There is lots of news lately about medications and kids. Some people think medication is prescribed too much. Others see it working and think it is a great idea. Whatever your feelings, be sure you know the basic facts about ADHD medications. Stimulant medicines like Ritalin, Dexedrine and Adderall have been used for a long time and have a good track record. A newer medication that is not a stimulant, called Strattera, may show promise for some kids who haven't done well on the stimulants.

Medication Is more effective than behavioral alone

Multimodal treatment is better for ADHD associated with comorbidities (coexisting conditions). Coexisting conditions include anxiety, oppositional defiant disorder (ODD), conduct disorders, etc.

There are also other kinds of medicine that your child's doctor may try if the stimulants don't work. Sometimes, your child's doctor may need to try a few different medicines at a few different doses to find the one that works best for your child. You could think of the brain as a black box that we can't see inside. The doctor doesn't know how a medicine will affect the brain until he or she tries it. Nine out of ten kids improve on stimulant medication.

If your child's doctor prescribes a medication for your child, make sure you ask about the benefits and risks of taking the drug.

If your child is just starting medication, you can use this sheet to keep track of how they're doing and share it with your child's doctor at your next office visit.

Remember : if your child takes a medication and their behavior improves, it is really your child's own strengths coming out from behind the ADHD. Give the credit for improvement to the child, not to the drug.

What about alternative and complementary treatments?

You may feel desperate for a "silver bullet" that will cure your child's problem. Some of the alternative treatments may sound reasonable, and may even be developed by doctors or specialists.

But if they are not scientifically proven, you risk spending time, money and hope on false promises. On the other hand, you and your child's doctor might decide it's worth it to try a low risk alternative treatment.

Some alternative treatments, such as mega vitamins and special supplements, may actually be dangerous to your child. Use caution, and talk with your child's doctor if you are considering alternative and complementary treatments.

Your child's doctor needs to know all treatments being used, as some may interact with prescribed treatments.

What about girls with ADHD?

ADHD seems to be more easily recognized in boys than in girls. Girls with ADHD tend to draw less attention to themselves than boys do, and the "squeaky wheel gets the grease." Some experts believe that girls with ADHD may act very differently from the typical picture we have of the kid with ADHD.

It's possible that girls with primarily hyperactive type ADHD act like tomboys. They may be active, messy and disorganized. Girls who have trouble paying attention may act more like daydreamers, and may go unnoticed at school because they are so quiet.

Finally, girls with a combination of the two may be hyper talkative, rather than hyperactive, and also be silly and excitable.

When girls with ADHD fall through the cracks and go undiagnosed, they pay a high price. They may not do well in school and their self-esteem may suffer. They may come to think of themselves as not very bright, quitters or low achievers.

If you suspect your daughter may have ADHD, you should find a professional who has experience in diagnosing ADHD in girls, and have your daughter evaluated.

How can I help my child improve their behavior?

Don't try to change lots of behaviors at once. Target one to three behaviors at a time to work on.

Talk about the behavioral goals with your child.

You'll probably want to focus closely on target behaviors for tracking and feedback for an hour a day or for limited time periods on a regular routine.

Doing this all day long is too grueling for both you and your child.

Reward your child with privileges and special activities like a trip to the park or a family picnic for successfully meeting behavioral goals.

Keep a few rules and enforce them consistently. (Choose your "battles" carefully.)

Offer choices, but keep them simple.

How should I set up the house and our routine to help my child?

Keep a regular routine and provide lots of structure, so your child knows what to expect.

Post lists and reminders for the routines in key places around the house.

For example, you might keep a list of things to bring to school by the front door or in your child's backpack.

Keep your home organized. Store things as close as possible to where they are used, and have "a place for everything, and everything in its place."

How do I get my child's attention?

No more yelling a laundry list of instructions from the other room while you're doing something else. You already know that doesn't work anyway.

To get your child's attention, get down on the floor in front of them, and put your hands on their shoulders. When they make eye contact with you, say, "There you are." and then tell them what you need to say.

When you give directions, give them one at a time. Break down big jobs into several smaller jobs.

Repeat your directions, and make lots of good eye contact. Expect to have to repeat yourself over and over.

Try writing a checklist for multiple tasks and to break big jobs down into do-able chunks.

How can we cope with the challenges of raising a child with ADHD?

Teachers will change each year, but parents are always there. That's why you are your child's best and most important teacher.

Plan for one-on-one time with your child each day. Even just 10-15 minutes every day will go a long way in letting your child know they are special to you. Follow your child's lead during this special time. This will help both of you feel connected and loving toward each other.

Stay calm and in control of yourself. You can't force your child to behave the way you want them to, but you are in complete control of your own behavior.

Act the way you want your child to act. Be a good role model.

Get support. There are a lot of other parents out there going through the same thing as you, and you can help each other with ideas and just by listening.

What can teachers do to help kids with ADHD?

A teacher who understands ADHD and how to work with kids with ADHD will make a big difference in your child's school experience.

You may need to help your child's teacher learn more about how to work best with your child at school. Some basic tips for modifying the classroom include:

Seating the child near the teacher

Repeating instructions

Not putting time limits on test and quizzes

Helping the child organize

Boosting the child's self-esteem

Having consistent consequences for unacceptable behavior. (Reprint)

Attention deficit hyperactivity disorder

What is Attention Deficit (Hyperactivity) Disorder or (ADHD)? Attention-deficit Hyperactivity Disorder is a condition of the brain that makes it hard for children to control their behavior. All kids have problems with their behavior from time to time, but kids with ADHD have behavior problems that interfere with regular life and are continual. ADHD used to be called Attention Deficit Disorder or ADD. ADHD usually lasts your whole life. A lot of adults have ADHD. Kids with Attention Deficit Hyperactivity Disorder (ADHD or AD/HD) can have different kinds of symptoms: Inattention : These kids have trouble with paying attention, are disorganized or daydream too much. Hyperactivity : These kids are always moving, cant sit down or talk too much. Impulsivity : These kids act and talk without thinking, interrupt a lot or show poor judgment. Combination : The above symptoms can occur in different combinations. How common is ADHD? Attention Deficit Hyperactivity Disorder is the most common behavior disorder in school aged kids. About 8-12% of kids have it. What causes it? The exact causes of ADHD are not yet known. Experts think that ADHD is caused by differences in the way messages are sent in the brain. ADHD seems to run in families, so it may be inherited. How is ADHD diagnosed? ADHD is usually only diagnosed in school aged kids (ages 6-12), because it is hard to diagnose in younger children. The diagnostic process has many steps, and you, your childs school and other caregivers will all need to provide information about your childs behavior. To find out about diagnosis, read the American Academy of Pediatrics clinical practice guideline. How is ADHD treated? The best treatment for ADHD is usually medication, combined with behavior therapy (including training parents in behavior therapy) and setting things up for your child at home and at school to make it easier to pay attention. Because ADHD is a chronic (on-going) condition, treatment must also be on going. Usually you will have a long term plan that includes goals for your child. When all the parts of the treatment plan are in place, and everyone (child, parents, teachers, doctors, caregivers, etc.) works together, treatment will be most effective. What if I think my child might have ADHD? If you think your child may have ADHD, you should have them checked by their primary care provider or a psychiatrist. Sometimes a sight or hearing problem, family stress, worry, a learning disability or communication problems can affect a childs attention and behavior. You should also get help from your school system. What can the school system do for my child? If your child is struggling in school, ask your school system in writing for an evaluation of your child. They are required to provide it, at no cost to you. The purpose of an evaluation is to find out why your child is not doing well in school. A team of professionals will work with you to evaluate your child. If they do not find a problem, you can ask the school system to pay for an Independent Educational Evaluation (IEE). There are strict rules about this, so you may not get it. You can also have your child tested again privately, and pay for it yourself. But check with your school district first to make sure they will accept the private test results. By law, the school system must consider the results of the second evaluation when deciding if your child can get special services. What about medication? There is lots of news lately about medications and kids. Some people think medication is prescribed too much. Others see it working and think it is a great idea. Whatever your feelings, be sure you know the basic facts about ADHD medications. Stimulant medicines like Ritalin, Dexedrine and Adderall have been used for a long time and have a good track record. A newer medication that is not a stimulant, called Strattera, may show promise for some kids who havent done well on the stimulants. Medication Is more effective than behavioral alone Multimodal treatment is better for ADHD associated with comorbidities (coexisting conditions). Coexisting conditions include anxiety, oppositional defiant disorder (ODD), conduct disorders, etc. There are also other kinds of medicine that your childs doctor may try if the stimulants dont work. Sometimes, your childs doctor may need to try a few different medicines at a few different doses to find the one that works best for your child. You could think of the brain as a black box that we cant see inside. The doctor doesnt know how a medicine will affect the brain until he or she tries it. Nine out of ten kids improve on stimulant medication. If your childs doctor prescribes a medication for your child, make sure you ask about the benefits and risks of taking the drug. If your child is just starting medication, you can use this sheet to keep track of how theyre doing and share it with your childs doctor at your next office visit. Remember : if your child takes a medication and their behavior improves, it is really your childs own strengths coming out from behind the ADHD. Give the credit for improvement to the child, not to the drug. What about alternative and complementary treatments? You may feel desperate for a silver bullet that will cure your childs problem. Some of the alternative treatments may sound reasonable, and may even be developed by doctors or specialists. But if they are not scientifically proven, you risk spending time, money and hope on false promises. On the other hand, you and your childs doctor might decide its worth it to try a low risk alternative treatment. Some alternative treatments, such as mega vitamins and special supplements, may actually be dangerous to your child. Use caution, and talk with your childs doctor if you are considering alternative and complementary treatments. Your childs doctor needs to know all treatments being used, as some may interact with prescribed treatments. What about girls with ADHD? ADHD seems to be more easily recognized in boys than in girls. Girls with ADHD tend to draw less attention to themselves than boys do, and the squeaky wheel gets the grease. Some experts believe that girls with ADHD may act very differently from the typical picture we have of the kid with ADHD. Its possible that girls with primarily hyperactive type ADHD act like tomboys. They may be active, messy and disorganized. Girls who have trouble paying attention may act more like daydreamers, and may go unnoticed at school because they are so quiet. Finally, girls with a combination of the two may be hyper talkative, rather than hyperactive, and also be silly and excitable. When girls with ADHD fall through the cracks and go undiagnosed, they pay a high price. They may not do well in school and their self-esteem may suffer. They may come to think of themselves as not very bright, quitters or low achievers. If you suspect your daughter may have ADHD, you should find a professional who has experience in diagnosing ADHD in girls, and have your daughter evaluated. How can I help my child improve their behavior? Dont try to change lots of behaviors at once. Target one to three behaviors at a time to work on. Talk about the behavioral goals with your child. Youll probably want to focus closely on target behaviors for tracking and feedback for an hour a day or for limited time periods on a regular routine. Doing this all day long is too grueling for both you and your child. Reward your child with privileges and special activities like a trip to the park or a family picnic for successfully meeting behavioral goals. Keep a few rules and enforce them consistently. (Choose your battles carefully.) Offer choices, but keep them simple. How should I set up the house and our routine to help my child? Keep a regular routine and provide lots of structure, so your child knows what to expect. Post lists and reminders for the routines in key places around the house. For example, you might keep a list of things to bring to school by the front door or in your childs backpack. Keep your home organized. Store things as close as possible to where they are used, and have a place for everything, and everything in its place. How do I get my childs attention? No more yelling a laundry list of instructions from the other room while youre doing something else. You already know that doesnt work anyway. To get your childs attention, get down on the floor in front of them, and put your hands on their shoulders. When they make eye contact with you, say, There you are. and then tell them what you need to say. When you give directions, give them one at a time. Break down big jobs into several smaller jobs. Repeat your directions, and make lots of good eye contact. Expect to have to repeat yourself over and over. Try writing a checklist for multiple tasks and to break big jobs down into do-able chunks. How can we cope with the challenges of raising a child with ADHD? Teachers will change each year, but parents are always there. Thats why you are your childs best and most important teacher. Plan for one-on-one time with your child each day. Even just 10-15 minutes every day will go a long way in letting your child know they are special to you. Follow your childs lead during this special time. This will help both of you feel connected and loving toward each other. Stay calm and in control of yourself. You cant force your child to behave the way you want them to, but you are in complete control of your own behavior. Act the way you want your child to act. Be a good role model. Get support. There are a lot of other parents out there going through the same thing as you, and you can help each other with ideas and just by listening. What can teachers do to help kids with ADHD? A teacher who understands ADHD and how to work with kids with ADHD will make a big difference in your childs school experience. You may need to help your childs teacher learn more about how to work best with your child at school. Some basic tips for modifying the classroom include: Seating the child near the teacher Repeating instructions Not putting time limits on test and quizzes Helping the child organize Boosting the childs self-esteem Having consistent consequences for unacceptable behavior. (Reprint)