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ADHD Symptoms: How Should I Know My Child Has ADHD?

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that can affect your child’s success at school, as well as their relationships with family members and friends.

Today, Sara Ritchie tells Flo how to recognize the disorder and what treatment options can help your child to live a better life. 

What is ADHD?

ADHD stands for attention deficit hyperactivity disorder and is a chronic disorder usually diagnosed in childhood that affects a multitude of daily living. Behavioral, emotional, social functioning, academic functioning can be pretty comprehensive in that way.

What is the difference between ADHD and ADD?

ADD, attention deficit disorder, is an outdated term. It used to be that they separated the diagnoses based on what symptoms you had. But nowadays, they call everything ADHD and then after that, they'll use a subtype classification. 

How common is ADHD?

It is one of the most common disorders of childhood and the prevalence of it in school-age children is about eight to eleven percent. So it's pretty high. And more common in boys than girls, as far as the diagnosis goes.
 

Symptoms

There are three different things that we look at: inattention, hyperactivity, impulsivity. 

Inattention signs would be the following:

  • The child can appear to be daydreaming or they have sort of a sluggish tempo to how they go about their daily activities. 
  • They don't pay close attention to details and they have a hard time maintaining their attention either at school, at home, or even in play. 
  • They lose objects easily or they're easily distracted by irrelevant things to what their focus on at the moment. 

We can't pinpoint exactly what causes the disorder to set off. But it's generally thought to be a combination of genetic factors and environmental factors, with genetic factors playing a more predominant role.

As far as hyperactivity and impulsivity, a lot of times in kids they go hand in hand. What will happen is you'll get reports from teachers or even notice that at home, a lot of fidgetiness or they have excessive fidgeting. They can't stay seated for very long. A lot of times they just look and act restless all the time. 

They have a hard time playing quietly

Excessive talking can be a sign too, blurting out answers really quickly, and interrupting other people frequently. Those are signs of hyperactivity and impulsivity.

What are the causes of this disorder?

We can't pinpoint exactly what causes the disorder to set off. But it's generally thought to be a combination of genetic factors and environmental factors, with genetic factors playing a more predominant role. A lot of times you'll get a history of a parent with ADHD, and that can clue you into the diagnosis as well.

How is ADHD diagnosed? 

It's a combination of a history and an interview with the parent and the patient. And included in that history, is how the functioning is at home, in school. 

Then there are some questionnaires that you can use or even some computer-based models that you can use to help diagnose it. 

But in general, for children, they have to have six symptoms of hyperactivity and/or impulsivity or they have to have six symptoms of inattention. And they have to be present in both home and another environment, usually at school.

Treatment

There are quite a number of approaches for ADHD. It depends on the age but most commonly we're talking about school-age children. 

The first-line therapy that we have is stimulant therapy. That is an oral medication that you would take but you can combine it also with different types of therapies. 

There are different kinds of cognitive-behavioral therapies, other nonstimulant medications, interventions you can do at school and at home to help with behavior.

Non-drug treatments for ADHD

The non-drug treatment has three categories. 

Child-focused treatment. The idea is that you're focusing on the patient. That would be things like behavior therapy, psychotherapy sessions that they have maybe once or twice a week, sometimes more depending on the patient. It helps the patient learn skills so that they can perform better. 

Because we have the symptoms of ADHD both home and school, the schools participate a lot in helping the child create an environment that's going to set them up for success.

Family therapies or trainings that help parents learn how their child thinks maybe differently from them and they can learn techniques to help foster more positive interactions with their child so that their child feels better supported in their diagnosis. 

School-based interventions. Because we have the symptoms of ADHD both home and school, the schools participate a lot in helping the child create an environment that's going to set them up for success. For example, the teachers have skills to help manage behavior in the classroom. They can have special resource room support. There are modifications that you can make to the classroom to accommodate the student a little better so that their inattentive symptoms are more addressed, like sitting at the front of the classroom, for example.

What are the most popular medications prescribed for ADHD?

There are two levels of medications: stimulant and non-stimulant. 

The stimulant medications are generally first-line therapy for kids older than the age of six. If the patient is younger than that, a lot of times we start with behavioral therapy first. But if you're older than six, first-line treatment will be medication. 

There are two main types of medication: methylphenidates and amphetamines. 

The methylphenidates that people probably know the best would be, for example, Ritalin or Concerta. And the amphetamine that people probably know is Adderall. 

Generally, we'll pick one of those classes to start. As far as non-stimulant therapy, we have a few drugs in that category. 

Sometimes you can try them by themselves or you can use them in conjunction with the stimulant to see if that helps with symptoms a little bit better. There are three of the most common ones - Strattera or atomoxetine, Guanfacine, and Clonidine. Those are all medications that are commonly used. 

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