Attention deficit hyperactivity disorder (ADHD) is a condition that robs children of their ability to focus and pay attention. Kids with ADHD are fidgety and easily distracted. This makes it difficult to stay "on task," whether it's listening to a teacher or finishing a chore. The National Institute of Mental Health estimates 3% to 5% of kids have ADHD, but some experts believe that figure could be as high as 10%.
ADHD Symptoms: Inattention
The main symptom of ADHD is the inability to pay attention. Kids may have trouble listening to a speaker, following directions, finishing tasks, or keeping track of personal items. They may daydream often and make careless mistakes. Children with ADHD tend to avoid activities that require sustained concentration or that might be boring.
ADHD Symptoms: Hyperactivity
Another component of ADHD is the inability to sit still. Children may run and climb on things constantly, even when indoors. When they are seated, they tend to squirm, fidget, or bounce. Some kids with ADHD talk excessively and find it difficult to play quietly.
ADHD Symptoms: Impulsiveness
A third symptom is impulsiveness -- cutting in line, interrupting others, or blurting out answers before the teacher finishes a question. This aspect of ADHD makes it difficult for children to wait their turn or think before they act.
ADHD's Impact on Daily Life
Without treatment, ADHD can affect a child's development socially and academically. The inability to focus often leads to poor performance in school. Kids who interrupt or cut in line may have trouble making and keeping friends. These setbacks can lead to low self-esteem and risky behaviors. ADHD also increases the risk of childhood depression and anxiety disorders.
Causes of ADHD
Children with ADHD have less activity in areas of the brain that control attention. They may also have imbalances in brain chemicals called neurotransmitters. It's unclear what causes these irregularities, but ADHD runs in families, so many experts believe genetics play a role.
There are no lab tests to detect ADHD. Instead, doctors rely on the patient's response to questions, the family's description of behavior problems, and a school assessment. With ADHD, a child must display some combination of inattention, hyperactivity, and impulsivity for at least six months to a degree that is maladaptive and inconsistent with his or her age. Onset of the symptoms needs to have appeared no later than age 7.
Types of ADHD
There are three forms of ADHD. Combined type is the most common and applies to children who display inattention, hyperactivity, and impulsiveness. In the hyperactive/impulsive type, children are fidgety and can't control their impulses. Kids with the inattentive type, formerly called attention deficit disorder, have trouble focusing. But they are not overly active and usually don't disrupt the classroom.
Medications for ADHD
Stimulant medications can help increase a child's attention span while controlling hyperactivity and impulsive behavior. Studies suggest these drugs work in 70% to 80% of patients, although they may have some troubling side effects. Non-stimulant medications are also options for some children.
Counseling for ADHD
Counseling can help a child with ADHD learn to handle frustrations and build self-esteem. It can also provide parents with supportive strategies. A specific type of therapy, called social skills training, can help kids improve at taking turns and sharing. Studies show that long-term treatment with a combination of drugs and behavioral therapy is more effective than medication alone.
Special Education for ADHD
Most children with ADHD are educated in standard classrooms, but some do better in a more structured environment. Special education is a type of schooling that is tailored to meet the specific needs of children with learning disabilities or behavioral disorders. Not all children with ADHD qualify for special education.
The Role of Routine
Parents can give kids more structure at home by laying out clear routines. Posting a daily schedule will remind your child of what he or she is supposed to be doing at any given time. This can help a child with ADHD stay on task. The schedule should include specific times for waking up, eating, playing, homework, chores, activities, and bedtime.
The jury is still out on whether diet may improve ADHD symptoms. While studies on ADHD diets have produced mixed results, some health experts believe foods that are good for the brain could reduce symptoms of ADHD. High-protein foods, including eggs, meat, beans, and nuts, may improve concentration. It might also be helpful to replace simple carbs, like candy and white bread, with complex carbs, like pears and whole-grain bread. Talk to your pediatrician before making any dramatic changes to your child's diet.
ADHD and Junk Food
While many kids bounce off the walls after eating junk food, there is no evidence that sugar is a cause of ADHD. The role of food additives is less certain. Some parents believe preservatives and food colorings worsen the symptoms of ADHD, and the American Academy of Pediatrics says it's reasonable to avoid these substances.
ADHD and Television
The link between television and ADHD is unclear, but the American Academy of Pediatrics suggests limiting young children's exposure. The group discourages TV viewing for kids under 2 and recommends no more than two hours a day for older kids. To help your child develop attention skills, encourage activities like games, blocks, puzzles, and reading.
There is no surefire way to prevent ADHD in children, but there are steps you can take to reduce the risk. You can increase your chance of your child not having ADHD by staying healthy during pregnancy. Start by avoiding alcohol, drugs, and tobacco during pregnancy. Children whose mothers smoked during pregnancy are twice as likely to develop ADHD.
Outlook for Children With ADHD
With treatment, a large majority of children with ADHD improve. They should continue to undergo regular follow-up since many kids grow out of the disorder as they get older. But more than half of patients continue experiencing symptoms once they reach adulthood.
American Academy of Pediatrics news brief
Centers for Disease Control and Prevention
Feingold Association of the United States
McCann, D. Lancet, Nov. 3, 2007.
National Institute of Mental Health
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