In September, you get calls from your child's teacher about the terrible thing he said to a classmate. In October, you receive multiple emails about him getting up from his seat in the middle of class. After Thanksgiving dinner, he's standing on the couch and jumping into a pool of cousins huddled on the floor. In December he gets detention for talking in class after numerous warnings. A new year brings new problems: he can't keep his hands to himself, he doesn't let you finish a sentence, and Cs, Ds and "unsatisfactory" notations populate his report card. According to experts at Early Intervention Support, kids do have shorter attention spans than adults. But you begin to wonder if your child has a bigger problem than just being a kid. Attention deficit/hyperactivity disorder is one of the most common mental disorders in children and adolescents, according to the National Institute of Mental Health.
Types
Difficulty staying focused and paying attention, difficulty controlling behaviors and hyperactive behaviors characterize ADHD. According to the "Diagnostic Statistical Manual of Mental Disorders," three subtypes of ADHD exist: predominantly hyperactive-impulsive symptoms, predominantly inattentive symptoms and a combination of hyperactive-impulsive and inattentive symptoms. Hallmark signs of inattention include being easily distracted, difficulty tending to details, forgetting things, frequently switching activities, difficulty organizing or completing a task, daydreaming, moving slowly and not listening when spoken to. Hyperactive and impulsive symptoms include excessive talking, fidgeting and squirming, difficulty staying seated, impatience, frequently touching things or people, blurting out inappropriate comments, difficulty waiting turns, interrupting and excessive emotionality. Six months of six or more of these symptoms in one category, to a degree that is in excess of same-age peers, warrants a diagnosis of ADHD.
Significance
ADHD is not just for kids. Although it begins in early childhood before the age of seven, it can be missed. According to the National Institute of Mental Health, 4.1 percent of adults ages 18 to 44 have an ADHD diagnosis in a given year. Michael Bloomquist, Director of the Attention and Behavior Problems Clinic at the University of Minnesota, notes that children with problems in self-control are more likely to be rejected by peers, have school adjustment problems and may eventually develop more serious delinquent behavior or emotional problems. Adults with this disorder often have trouble sustaining jobs and relationships, organizing daily tasks, being on-time and productive, keeping appointments and may leave a reckless trail of accidents behind them.
Theories/Speculation
No single cause exists for ADHD. The National Institute of Mental Health suggests the combination of genetic and environmental factors as causes. Recent studies demonstrate that those with ADHD with a certain version of a gene have thinner tissue in the area of the brain associated with attention. Environmental factors such as cigarette and alcohol use during pregnancy, and lead exposure in childhood correlate with ADHD. Some children who have experienced a traumatic brain injury show similar symptoms as those with ADHD. Research supports that food additives, such as artificial colors and food preservatives, may lead to hyperactivity. Though there is no single cause, further research will lead to a better understanding of the factors contributing to ADHD, thus reducing its incidence in the future.
Solutions
No cure exists for ADHD. The good news is that ADHD can be well-managed. The National Institute of Mental Health outlines medications, psychotherapy, education and training, or a combination of these, as effective treatments for ADHD. Stimulant and other medications in the form of short and long-acting liquids, patches, pills and capsules may help reduce impulsivity and hyperactivity, and improve attention associated with ADHD. Common side effects of these stimulant medications include reduced appetite, irritability, anxiety, sleep problems and occasionally headaches and stomachaches. Work with your doctor to minimize these effects. Social skills training and behavioral therapies help those with ADHD learn how to interact with others in a socially appropriate manner, and how to monitor and change behaviors. Psychotherapy may also involve parents, so they can help structure and organize their child's day, correct unwanted behaviors and reinforce desired ones.
Considerations
ADHD symptoms mimic disciplinary and behavior problems. The National Institute of Mental Health indicates that without a proper diagnosis, you or your child may be wrongly targeted for willful and stubborn behavior. Many problems may mimic ADHD symptoms. These include undetected seizures, hearing and vision problems, learning disabilities, anxiety and depression, medical problems affecting thinking and behavior, and difficulty coping with severe environmental stressors such as a death or trauma that affect mood or concentration. Be sure to acquire thorough physical and psychiatric evaluations to ensure a proper diagnosis to guide treatment.
Warning
In 2007, the FDA mandated warnings on medications used for ADHD, outlining the risk of developing cardiovascular and psychiatric problems when taking these medications. According to the National Institute of Mental Health, this warning transpired after a study revealed that those who ingested these medications and had pre-existing cardiac problems had a slightly higher risk of cardiovascular problems while taking the medication. It also noted that those taking these medications had a one in 1,000 risk of experiencing psychiatric symptoms such as hearing voices, being extremely suspicious or developing excessive physical activity, or mania. Children and adolescents taking the non-stimulant atomoxetine for ADHD also carry an increased risk of developing sudden suicidal thoughts. Frequently monitor your child's cardiovascular health and behavior, and report any changes or suicidal thoughts to your doctor immediately.
References
- EarlyInterventionSupport.com: Attention Span
- NIMH: Attention Deficit Hyperactivity Disorder
- "Quick Reference Guide to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition"; American Psychiatric Association; 2000
- "Skills Training for Children With Behavior Problems"; Michael Bloomquist, Ph.D..; 2006
