ADHD: An Update on Diagnosis and Treatment for Kids
Diagnosing attention deficit hyperactivity disorder (ADHD) is sometimes controversial. But for children with the condition, treatment options are working.
Making the Diagnosis continued...
According to Stein, the health care professional who is evaluating the child
should do a thorough medical exam, being careful to rule out other problems
that might explain the behavior, such as hearing or vision problems. Then he or
she must take a history of symptoms from an established list from the
Diagnostic and Statistical Manual of Mental Disorders, published by the
American Psychiatric Association. (See also the "Signs of ADHD,"
After his testing, Jeremiah was diagnosed with the type of ADHD marked by
hyperactivity and impulsiveness. And his symptomatic behaviors -- impatience
and hitting other children -- are typical, says Adesman. "Cutting the
[teacher's] hair is more extreme," he says of Jeremiah's experience,
"although it is not uncommon for the child to cut his own hair."
Jeremiah's doctor recommended a combination of behavior modification therapy
and medication, a typical approach to treating ADHD.
Psychostimulants - or simply stimulants, such as Ritalin, Adderall, and
Concerta -- are most commonly prescribed. Experts believe they work by helping
the network of nerve cells in the brain communicate better with each other and
increase chemicals that "arouse" the parts of the brain that help
people pay attention and control impulses. The drugs don't cure the condition
but rather help control the symptoms that are causing problems.
More than 200 scientific studies have found the medications effective,
although the stimulants can cause reduced appetite, sleeping difficulties, and
tics, such as excessive blinking or facial grimacing.
The FDA recently approved Strattera, a nonstimulant drug that affects the
brain chemical norepinephrine and helps improve ADHD symptoms -- but without
the stimulant side effects. Strattera can cause abdominal pain, headache,
reduced appetite, dry mouth, and insomnia. This drug, along with the stimulants
already mentioned, is FDA-approved for children, Stein says.
Antidepressants are also sometimes prescribed because they can help decrease
impulsivity, hyperactivity, and aggression. Even though these drugs are not
specifically approved for ADHD, doctors sometimes prescribe them "off
More than 70% of children do well on the stimulants or Strattera, says
Stein. And of the 30% who don't -- those whose symptoms do not improve or who
have side effects such as nervousness or insomnia -- half of those will do well
on other medications such as antidepressants.