Does Your Child Have ADHD? Recognizing Signs, Finding Treatment Options
ADHD: Could My Child Be at Risk?
ADHD medications such as stimulants, coupled with behavioral therapy, can be very effective in the control of ADHD. Early identification of ADHD is advised. Follow the slide show to learn about ADHD causes, diagnosis, treatments and myths surrounding this condition.
All Kids Seem Hyperactive: How Can You Tell the Difference?
Over time, adolescents and teens with ADHD may become less hyperactive, but may still suffer from distraction, poor organization, and low impulse control. These behaviors, especially in adolescents and young adults, can be risky. Young adults with uncontrolled ADHD may be at a greater risk for alcohol and drug abuse, driving violations and accidents, dropping out of school, or job loss.
Signs and Symptoms of ADHD
- Difficulty with paying attention
- Can't follow instructions
- Interrupts or talks excessively
- Can be disorganized or careless
- Has trouble playing quietly in a group
- Restless or jittery
- Has trouble focusing on a task at school or home
- Difficulty forming or keeping friendships
What Causes ADHD - Is It a Genetic Disorder?
Some factors have been identified that may contribute to the development of ADHD, these include: low birth weight; fetal exposure to cigarette smoke, alcohol, herbicides, or pesticides; and exposure to toxic lead paint after birth. Additional research is needed to define the exact role of these environmental factors.
ADHD Myth: ADHD is Largely Over-Diagnosed
Indeed, as more has been learned about ADHD and how to recognize it, greater rates of diagnosis may have taken place. In addition, legal mandates in the school to increase special services for children may have led some to believe that there are now excessive numbers of children with this diagnosis, when in fact these children are now recognized when previously they may have been ignored. More adults are now being diagnosed, too, probably due to greater ADHD awareness.
How Do I Get My Child Tested for ADHD?
Most cases of ADHD are diagnosed at age 7 or 8, but symptoms may begin sooner. It is estimated that boys with ADHD outnumber girls two-to-one, but some experts feel that girls may not be diagnosed as often due to less disruptive behaviors.
Consequences of Untreated ADHD
- Increased risk for school failure in both high school and college
- Behavioral problems
- Social problems with peers and family
- Elevated risk due to accidents, alcohol or drug abuse
- Increased chances of depression or anxiety
- Obstacles at work possibly leading to job loss
Psychosocial Treatments: Always a First Line Therapy
Included in the education should be information about symptoms and course of ADHD, medical treatments and expected side effects, and local resources for the family and child. Communication should be initiated at the school. Parent-training to learn how to effectively manage ADHD behaviors, and child-focused treatment that fosters social, academic and problem-solving skills are important for success.
Drug Treatment Options for ADHD: Where to Begin?
The stimulants, such as methylphenidate, are often the first choice of drug treatment in ADHD. Stimulants are effective in up to 80 percent of patients, and they have been used for the treatment of ADHD for many decades. Stimulants act quickly in children to curb hyperactivity, impulsiveness and improve attention. They may be used in conjunction with patient counseling.
What Are the Choices in Stimulant Medications?
Stimulants are available in many versions of regular-release and sustained-release formulations to allow dosing that can be specific for a child's needs, such as around school and homework times; long-acting forms taken once-a-day are usually preferred.
Generic versions are available for many of these products, and can render cost-savings in your overall healthcare plan.
ADHD Myth: Bad Parenting Causes ADHD in Children
However, parenting style may worsen a child's ADHD symptoms. Parenting behaviors such as being overly critical, demanding, or negative may increase the risk for oppositional defiant disorder and conduct disorders that can accompany ADHD in up to 50 percent of children. Open communication with teachers and healthcare providers, as well as coaching or therapy for parents can be helpful.
My Child Takes a Stimulant But Has Trouble Falling Asleep at Night
However, mild side effects, such as difficulty sleeping, reduced appetite and weight loss, headaches and stomach upset can occur and should be reported to your child's doctor if they interfere with the daily routine.
Could My Child Become Addicted to Stimulant Medications?
In addition, adults with ADHD may be less likely to be involved in drug-related criminal activity, but the lowered risk of substance abuse may not last into adulthood.
Nonstimulants: Atomoxetine (Strattera)
Strattera is in a class of medications called norepinephrine reuptake inhibitors. Atomoxetine, unlike stimulants, may take several weeks for the full effect to be seen, but also has a low abuse potential. Atomoxetine might be an option for teens or college students when there is a concern about stimulant abuse or diversion; if there is an accompanying tic disorder, or if significant anxiety is present.
Alpha-2 Agonists: An Added Option
For these children, a class of medications called alpha-2 agonists can be used alone or added to stimulants or atomoxetine (Strattera). Alpha-2 agonists include generic clonidine (Catapres), guanfacine (Tenex), as well as the extended-release versions of clonidine (Kapvay) and guanfacine (Intuniv). Alpha-2 agonists may cause low blood pressure, slow heart rate, and drowsiness as side effects, but may be useful in children with trouble sleeping, aggression, or stimulant-induced tics.
Other Treatments: Bupropion and Tricyclic Antidepressants
Although not proven, there are also concerns that there may be a rare risk of suicidal thinking in children, adolescents, and young adults using nonstimulants or antidepressants for ADHD. It is important to monitor your child for changes in mood or signs of depression or suicide.
ADHD Myth: All Children Will Eventually Outgrow ADHD
Many adults with ADHD remain undiagnosed and are not able to address their illness; in fact, only 25 percent of adults with ADHD symptoms even seek treatment. Untreated ADHD can leave adults at risk for depression, anxiety, or alcohol and drug abuse. In addition, problems may arise within the workplace, with personal relationships, or with financial or legal issues.
My Child Can't Swallow Pills - Are There Other Options?
- Skin patches (Daytrana, Catapres)
- Liquids (Methylin Solution, ProCentra, Quillavant XR, Dyanavel XR)
- Chewable pills (Methylin Chewables, Quillichew ER)
- Capsule contents that can be sprinkled on applesauce, but don't chew the beads (Metadate CD, Ritalin LA, Focalin XR, Adderall XR)
- Capsule contents that may be sprinkled in water and taken immediately (Vyvanse)
ADHD Myth: People with ADHD are Lazy
Organizing information in their brains takes extra steps. Adequately completing a task in a timely fashion, and staying focused while doing it is not as easy for people with ADHD. Some experts suggest that a part of the brain in those with ADHD works harder but less efficiently than those without ADHD.
Options also need to be created for people with ADHD to work "differently", not "harder", so that they can focus; for example, external tools such as alarms, creating lists, and developing written charts for decision-making.
Special Considerations: Potential Abuse of Stimulants by Others
To safeguard medications, children and teenager's ADHD medications should be monitored, and caregivers or school personnel should safeguard and administer. At home, keep medications locked in a childproof container and deliver stimulant medication first-hand to the school nurse.
Finished: Does Your Child Have ADHD? Recognizing Signs, Finding Treatment Options
- National Institute of Mental Health. Attention Deficit Hyperactivity Disorder (ADHD). Last updated March 2016. Accessed April 17, 2016 at http://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtml
- American Academy of Child and Adolescent Psychiatry and American Psychiatric Association. ADHD. Parents Medication Guide. Accessed April 17, 2016 at . http://www.parentsmedguide.org/ParentGuide_English.pdf