Dr. Stephen Miller is a general pediatrician for The Vancouver Clinic in Vancouver, Washington. He graduated from the St. Louis School of Medicine in 1992. He then went on the perform his residency at Phoenix Children's Hospital.
DR. STEPHEN MILLER: Hi. My name is Dr. Stephen Miller, I'm a pediatrician here with the Vancouver Clinic in Vancouver, Washington, and I like to take a few minutes to talk about ADHD, otherwise known as Attention Deficit Hyperactivity Disorder. ADHD is caused by the constellation of symptoms related to inattention, which is that tends to be easily distracted, forgetful, or lose things frequently. Also ADHD relates to problems with hyperactivity, having trouble staying in the seat or talking excessively, and finally impulsivity, which is the inability to wait for ones on turn and acting without thinking to the consequences of those actions. ADHD is thought to affect between 6% and 9% of the general population which in a classroom 25 would imply that perhaps one or two students would meet the criteria for ADHD. Many people are impulsive or have problems with forgetfulness and we do not tend to look at ADHD as a disorder unless it goes on for many, many months or years, and causes quite a bit of impairment in their school or personal performance. There is no one single cause for ADHD, it oftentimes runs in families, and some environmental factors can cause ADHD such as severe malnutrition, lead exposure, or perhaps an illness or injury that affects the developing brain. ADHD is no thought to be due to refined sugar in the diet or food additives. ADHD is evaluated very carefully, taking input from multiple settings such as teachers and counselors and daycare providers and parents, and it's done with all attempts made to exclude any medical condition that might mimic symptoms of ADHD. These medical conditions can be obstructive sleep apnea that causes difficulty sleeping at night, or depression or anxiety or perhaps a learning disability. With therapy for ADHD is really aimed toward an improvement in that, first in school performance, job performance, or self-esteem. Not really is the therapy directed at a cure. The therapy is best done by developing a team approach, again using the parents, teachers, school professionals, and maybe different doctors, and the goal of the therapy is to try to help that child maximize school performance and self-esteem, and also their interpersonal relationships. The therapy can involve behavior treatment; this can involve counseling or reading books written by professionals so a child realizes that when he makes good decisions, good consequences comes from it typically and vice versa. Also, therapy is addressed at trying to help those co-existing factors such as the learning disability or any depression. And some children who have ADHD can do well in medicine. Actually, the medication does tend to help children and adults function better in school, be more attentive and make fewer mistakes, which in turn helps in self-esteem. As far as the outcome for ADHD, there's good news and bad news. The bad news is that many symptoms of impulsivity or inattention don't necessarily get better with age, but people do tend to develop more coping skills as they get older and learn to realize that good decisions tend to lead in possible outcomes. In summary, many adults have ADHD, and some of them take medication. They typically, hopefully, have learned to manage it well and they end up leading successful careers and having happy families even if they have to pay attention to those symptoms.
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