what is adhd?

ADHD (Attention Deficit Hyperactivity Disorder) is classified as a neurodevelopmental disorder that is characterized by problems paying attention, impulsive or inappropriate behavior, restlessness and excessive activity.

Children with ADHD may also exhibit reckless activities with little or no consideration of consequence. The Centers for Disease Control and Prevention (CDC) estimates that approximately 11% of children 4-17 years of age have been diagnosed with ADHD. It is also the most commonly diagnosed mental disorder. What causes ADHD is still unknown. But what we do know is that is diagnosed approximately 3 times more often in boys than girls.

 

 

Predominantly Inattentive Presentation:

Individuals with this type have difficulty finishing tasks and paying attention, getting organized following instructions or details in conversation. They're easily distracted and can forget details of everyday routines. This type is sometimes referred to as ADD (Attention Deficit Disorder).

Predominantly Hyperactive-Impulsive Presentation:

Individuals of this type often seem like they're driven by a high speed motor. They also struggle with impulse control. They may squirm, fidget or find it hard to sit in place. Children with this type may find it difficult to participate in quiet activities or follow directions. They might have issues taking turns during play. Talking out of turn or blurting out is common. 

Combined Presentation: 

This is the most common type of ADHD. Individuals of this type have symptoms of both hyperactive-impulsive and inattention types.

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DSM-5 Diagnostic Criteria For ADHD

Inattention:

17 and younger: Six or more of these symptoms must be present for at least 6 months, be inconsistent with the child's developmental level, and have a negative effect on their social and academic activities.  To be endorsed, the following must occur "often":

 

• Fails to pay close attention to details

• Has trouble sustaining attention

• Doesn't seem to listen when spoken to directly

• Fails to follow through on instructions and fails to finish schoolwork or chores

• Has trouble getting organized

• Avoids or dislikes doing things that require sustained focus

• Loses things frequently

• Easily distracted by other things

•  Forgets things

 

Hyperactivity and Impulsivity:

Six or more of these symptoms must be present for at least 6 months, be inconsistent with the child's developmental level, and have a negative effect on their social and academic activities.  To be endorsed, the following must occur "often":

 

• Fidgets with hands/feet or squirms in chair

• Frequently leaves chair when seating is expected

• Runs or climbs excessively

• Trouble playing/engaging in activities quietly

• Acts "on the go" and as if "driven by a motor"

• Talks excessively

• Blurts out answers before questions are completed

• Trouble waiting or taking turns

• Interrupts or intrudes on what others are doing

(Source: American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (DSM-5), Washington, D.C.: American Psychiatric Association)

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ADHD Treatment

Jake constantly loses things and can't ever remember where he left them. He starts tasks but never finishes them. He's easily distracted by sounds outside or by conversations in another room. In the beginning, I used to feel like he'd never get it together. 

Non-drug interventions for ADHD means making adjustments in the child's environment. Create an environment that is more structured and encourages routines.

Create a daily schedule: 

create an everyday routine for your child to follow. break down the day into playtime, homework and other low level chores to get them acquainted with consistency.  I went to the local office supply store and bought a "dry-erase" white board. I placed it in an area where he'd always see it.  Since his mother and I live in different homes, we work together by enforcing the same schedule when he's with her. 

Help them organize their everyday items:

Create a designated area for your child's clothes, backpack toys and snacks. I color coded certain areas using stickers and construction paper. Green is for toys. Yellow is for clothes and orange is school stuff.

 I noticed that he had a hard time with the toys so I placed green stickers under them too. when it's time to clean up, I remind him to look under the toys. We made a game out of it. This greatly reduced the risk of stepping on that random Lego block at 3 AM when I'm making that late night bathroom run.

When it comes to children with ADHD, sticking to routines and being consistent is key. Keep the rules concise and easy to follow. 

When you see that your child is following all of the rules, reward them. I keep a small drawer full of toys that I buy from the local dollar store. It's nothing expensive.

 

 ADHD Drug Treatment

Stimulant ADHD drugs include methylphenidate, dextroamphetamine and amphetamine stimulants. These ADD drugs are FDA approved for use in children. Research has shown that there is a deficiency of dopamine and norepinephrine in the brains of those who have ADHD. The stimulant agents in these medications increase the levels of norepinephrine and dopamine in the brain. Researchers believe that normal levels of these neurotransmitters in the brain promote increased attention and concentration.

Side effects of these medications may include loss of appetite, weight loss, sleep problems, or irritability; while long-acting medicines may have greater effects on appetite and sleep.

The U.S. Food and Drug Administration (FDA)  issues warnings about the risk of amphetamine abuse . The FDA is also aware of the possibility that all amphetamine and methylphenidate stimulants used for ADHD may increase the risk of heart and psychiatric problems.

Always consult your child's doctor or therapist before beginning any ADHD drug treatment intervention.

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