Attention Deficit and Hyperactivity

Attention deficit hyperactivity disorder (ADHD) is a condition that interferes with a person's ability to focus attention. Three to 5 percent of all American children have the condition. It is three to five times more common in boys than in girls. One-half to two-thirds of children with ADHD will continue to have problems with ADHD symptoms and behaviors as adults.

Causes

The exact cause of ADHD is unknown. Popular theories that sugar, food dyes or other food additives contribute to hyperactivity or that the condition is caused by minute levels of brain damage have not been proved. A genetic cause that influences the chemical messengers in the brain called neurotransmitters is suspected.

Symptoms

Symptoms and their severity vary from person to person. ADHD is usually diagnosed in childhood. Some people are diagnosed as adults, however, because the symptoms were not recognized when they were children.

ADHD is sorted into three general types, based on symptoms:  

• Attentional form, in which the majority of symptoms relate to not paying attention

• Hyperactive form, in which the majority of symptoms relate to physical restlessness or poor control of impulses

• Combined form, in which combination of attentional and hyperactive symptoms occurs

To be diagnosed with one of the forms of ADHD, a person must have had symptoms for at least six months and the symptoms must be severe enough to interfere with at least two of these situations: work, home, school or relationships. People with ADHD may have problems graduating from school or keeping jobs, or may have marital or legal problems. The symptoms must not be because of any other health, learning, emotional, hearing or visual problem. 

An adult or child with the attentional form of ADHD has at least six of the following symptoms:

• Often fails to give close attention to details or makes careless mistakes

• Often has difficulty maintaining attention in tasks or play activities

• Often does not seem to listen to what is being said

• Often does not follow through on instructions and fails to finish work or assignments

• Often has difficulties organizing tasks and activities

• Often avoids or strongly dislikes tasks such as schoolwork or homework that require sustained mental effort

• Often loses things necessary for tasks or activities; these can include school assignments, pencils, books, tools or toys

• Often is easily distracted by extraneous stimuli

• Often is forgetful in daily activities

An adult or child with the hyperactive form of ADHD has at least six of the following symptoms:

• Frequently fidgets with hands or feet, squirming in seat

• Leaves seat in classroom or in other situations in which remaining seated is expected

• Runs about or climbs excessively in situations where this behavior is inappropriate; in adolescents or adults, this may be limited to feelings of restlessness

• Has difficulty playing or engaging in leisure activities quietly

• Blurts out answers to questions before the questions have been completed

• Has difficulty waiting in lines or awaiting turn in games or group situations

An adult or child with the combined form has a combination of the symptoms listed for attentional and hyperactive forms.

Treatment

ADD can’t be cured, but the symptoms of ADD may be eased with certain kinds of medication and behavioral therapy or counseling. 

Medication works on the chemical balance in the brain to relieve symptoms so that the person with ADHD can concentrate on behavioral or cognitive therapy. The medications used to treat ADHD are classified as stimulant or non-stimulant medications. Stimulant medications are probably the most effective treatment. They include: methylphenidate (Ritalin, Metadate CD, Methylin ER, Ritalin SR); dexmethylphenidate (Focalin, Focalin XR); dextroamphetamine (Dexedrine); amphetamine mixtures (Adderall); and atomoxetine (Strattera). Non-stimulant medications include norepinephrine reuptake inhibitors, antidepressants and antihypertensive drugs.

Behavioral or cognitive therapy can help change certain behaviors, teach ways to improve time management and organizational skills, and offer methods to deal with the emotional effects of ADHD.

Treatment should be tailored to each person’s circumstances and other health conditions. Whatever treatment plan is developed, it should be evaluated on a regular basis to see if it should be changed.

Self-Care Steps for Parents

• Get an evaluation. A careful evaluation will look at how your child functions intellectually, socially, emotionally, physically and academically. Ideally, the professional doing the evaluation should observe your child during normal daily activities at home and at school, and at different times of the day.

• Stick to a routine and set firm limits at home and at school.

• Make sure your child's schoolwork matches his or her abilities. A class that's not suited to your child's academic skills can lead to inattention, boredom and frustration.

• Provide outlets for your child's physical energy.

• Make sure you find ways to cope. Parenting a hyperactive child can be challenging. Avoid becoming very critical, controlling or angry with your child. Remember -- and let your child know -- you don't like the behavior, but you love the child.

• Use other resources. Share your concerns with your child's doctor and teacher. They will provide information on help that is available in your community. Your child's doctor may prescribe medications.