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Could your child have ADHD?

July 9, 1999
Web posted at: 11:35 AM EDT (1535 GMT)

In this story:

Only a professional can diagnose ADHD

What is it like to have ADHD?

Theories behind the cause

Diagnosing ADHD: Looking at the big picture

Treatment: Controlling the symptoms and making lifestyle changes

Why is ADHD so controversial?


By Michael Regalado, M.D.

There are a number of conditions that can mimic ADHD. Some of them are:
  • learning disorders
  • anxiety disorders (e.g., separation anxiety)
  • mood disorders (e.g., depression)
  • ear infections, with intermittent hearing problems
  • sleep disorders
  • pervasive developmental disorder
  • medication side effects
  • (WebMD) -- A 7-year-old boy's teacher pleads with his parents to have him evaluated by a doctor for ADHD. "He can't sit still, can't complete an assignment, is always up and about disrupting other children's work," she tells them. In addition, he is falling behind the other children in the class. His parents are concerned but wonder if their son is simply "being a kid."

    Only a professional can diagnose ADHD

    Though many kids are labeled as "hyperactive," only a pediatrician or another trained professional can diagnose attention-deficit hyperactivity disorder (ADHD). Typically, symptoms of ADHD develop before the age of 7, but the disorder can go undiagnosed into adulthood and can have devastating effects, including poor self-esteem, school failure and loss of friendships. But with the right treatment and early intervention, a child can learn to cope with the condition and keep pace with his peers.

    What is it like to have ADHD?

    ADHD is one of the most common psychiatric conditions among children, affecting 3 percent to 5 percent of all school-age kids. Children with ADHD generally have a poor attention span and/or high levels of activity and impulsivity. They seem to live in a high-speed world of shifting thoughts, sights and sounds, which they can't filter out as unimportant to the task at hand, whether it's learning in a classroom, following directions from a parent or following the conversation of a friend.

    Theories behind the cause

    Our understanding of ADHD has changed over the years. At one time, it was thought to be due to subtle, undetectable brain damage. Instead, more recent studies suggest that individuals with ADHD show differences in the areas of the brain responsible for controlling attention span, planning and motor activity. Theories that food allergies, excess sugar and other popular dietary scapegoats cause ADHD lack scientific validation, but more studies are needed. There certainly are genetic factors at work: ADHD tends to run in families. However, the bottom line is that the cause of ADHD is still unknown.

    Diagnosing ADHD: Looking at the big picture

    Because there is no single test for ADHD, a diagnosis must be made considering a number of factors. Pediatricians often do the initial diagnostic assessment. If a case of ADHD appears severe, the child will be referred to a specialist, such as a psychologist, neurologist or psychiatrist. The pediatrician or specialist collects information about behavior, learning difficulties and other information from the child, parents and teachers and pulls it all together for a complete picture, which is then compared against a set of ADHD criteria. Experts must be sure to rule out other behavioral conditions (see "When it's not ADHD"). Tests of intelligence and school achievement may also be administered to evaluate the possibility of learning disorders.

    Treatment: Controlling the symptoms and making lifestyle changes

    There is no cure for ADHD. However, there are medications that can help control symptoms. The most commonly prescribed medications for ADHD are stimulants, which help increase a child's attention span. These include Ritalin (methylphenidate), Adderall (mixed salts of a single-entity amphetamine product), Dexedrine (dextroamphetamine) and Cylert (pemoline). Other types of medications may be used, depending upon each child's needs: According to the American Academy of Pediatrics, nearly half of all children with ADHD also suffer from conditions such as depression and anxiety disorders.

    Because medications do not help a child with learning or social situations, behavioral interventions -- helping the child learn social skills, helping parents with discipline (see "What parents can do") -- are also used in the treatment of ADHD. In children whose ADHD is extreme, family therapy may also be recommended.

    Why is ADHD so controversial?

    ADHD has been, and remains, a controversial condition. Most debatable is the use of stimulant medication and its side effects, such as decreased appetite, weight loss and temporary slowing of growth. Although parents worry that the use of stimulants may lead to later drug abuse, this is actually more myth than reality. And new evidence from the Multimodality Treatment of ADHD study, sponsored by the National Institutes of Health, suggests that stimulants do remain beneficial over the long term. Some experts have questioned the validity of the disorder itself, as there is no diagnostic test. As a result, the approach to the management of ADHD by the health-care profession has not been standardized in any way.

    Despites the obstacles facing a child with ADHD, there are proven ways to maximize a child's effectiveness in school and other social settings. The most important thing is that all the adults in a child's life -- parents, teachers, doctors -- work together to address problems and help the child to help himself.

    Copyright 1999 by WebMD, Inc. All rights reserved.

    Attention-Deficit Hyperactivity Disorder

    Understanding the Child With ADHD
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