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Attention-deficit hyperactivity disorder (ADHD) is one of the
most common reasons children are referred for mental health
services. It affects as many as one in every 20
children. Although boys are three to four times more likely
than girls to experience ADHD, the disorder affects both boys and
girls.
What Are the Signs and Symptoms? There are three main types of
ADHD. One type is characterized by inattentiveness, one type
is characterized by hyperactive or impulsive behavior, and the
third type is combined - when children exhibit signs of both
types. Symptoms are often unnoticed until a child enters
school. To be diagnosed with ADHD, a child must show symptoms in at
least two settings, such as home and school, and the symptoms must
interfere with the child's ability to function at home or school
for at least six months. Specialists have agreed that at
least six symptoms from the following lists must be present for an
accurate diagnosis, and symptoms must begin by age 7.
Signs of inattentive
behavior:
- Difficulty following instructions
- Difficulty focusing on tasks
- Losing things at school and at home
- Forgetting things often
- Becoming easily distracted or having difficulty
listening
- Lacking attention to detail, making careless mistakes or being
disorganized
- Failing to complete homework or tasks
Signs of hyperactive
behavior:
- Fidgeting excessively
- Difficulty staying seated
- Running or climbing inappropriately
- Talking excessively
- Difficulty playing quietly
- Always seeming to be 'on the go'
- Blurting out answers or frequently interrupting
- Having trouble waiting his or her turn
- Interrupting or intruding on others
The presence of some symptoms, however, does not confirm a
diagnosis of ADHD. Just because a child has a lot of
energy or difficulty paying attention in school does not mean the
child has ADHD. An accurate diagnosis relies on the presence
of a range of symptoms and difficulties that prevent the child from
performing at an appropriate level for his or her age and
intelligence level. Teachers often first observe these
issues, and their input should be considered seriously.
How Does ADHD Affect School and
Social Life?
Symptoms of ADHD - such as trouble sitting still, paying attention
to details, and listening - can make school difficult for a child
with ADHD. Although most children with ADHD have normal or
above-normal intelligence, 40 to 60 percent have serious learning
difficulties. Many others have specific problems with
schoolwork or maintaining good grades, and face particular
challenges with assignments and tests that require focused
attention or lengthy writing, or have time limits. On a
social level, children with ADHD often have trouble developing
meaningful relationships with peers and family members. Other
children may find it frustrating to play with a child who has ADHD,
because classic symptoms include difficulty following rules,
waiting one's turn, or excessive talking.
What Other Disorders Commonly
Occur With ADHD?
Children and adolescents with ADHD are more likely than children
without the disorder to suffer from other mental disorders.
About one-half of all young people with ADHD have oppositional
defiant disorder; about one-quarter have an anxiety disorder; and
as many as one-third have depression and one-fifth have bipolar
disorder. Adolescents with untreated ADHD are at risk for
substance abuse disorders. Research shows that young people
treated for ADHD have lower rates of substance abuse than children
who go untreated.
What Causes ADHD?
ADHD is nobody's fault. Researchers believe that biology
plays a large role in the development of ADHD. Thirty to 40
percent of children diagnosed with ADHD have relatives with the
same disorder, suggesting that genes are at least partly
responsible. Brain scans reveal that the brains of children
with ADHD differ from those of children without the disorder.
Children with ADHD are thought to have problems with the part of
the brain that controls the organization and direction of thought
and behavior.
What Can Parents and Caregivers
Do?
Parents and other caregivers play a crucial role in ensuring that
their child receives the care that he or she needs. Children
with symptoms of ADHD should be referred to and evaluated by a
mental health professional who specializes in treating children,
unless your primary care doctor has experience in treating this
disorder. The diagnostic evaluation should include behavioral
observation in the classroom and at home. A comprehensive
treatment plan should be developed with the family, and, whenever
possible, the child should be involved in making treatment
decisions. Educational testing should be performed when
learning disabilities are present.
Treatment for ADHD is effective
for most children.
Early identification, diagnosis and treatment help children reach
their full potential. The most effective treatments for ADHD
include a combination of medication, behavioral therapy, and
parental support and education. Nine out of ten children
respond to medication, and 50 percent of children who do not
respond to an initial medication will respond to a second.
When ADHD co-occurs with another disorder, such as depression or
anxiety, a combination of medication and psychotherapy is shown to
be particularly effective. Although the value of medication
has been well documented, parents should feel free to discuss any
concerns about medication use with the child's doctor.
If your child or a child you
know is diagnosed with ADHD, be patient.
Even with treatment, symptoms may take time to improve.
Instill a sense of competence in the child or adolescent.
Promote his or her strengths, talents and feelings of
self-worth. Remember that the side effects of untreated ADHD
(such as failure, frustration, discouragement, social isolation,
low self-esteem and depression) may cause more problems than the
disorder itself.
Children's mental health matters! To learn more, talk to a
doctor or mental health professional, contact your local Mental
Health Association, or access the resources below:
National Mental Health Association, 800-969-NMHA, www.nmha.org
American Academy of Child and Adolescent Psychiatry, www.aacap.org American
Psychiatric Association, 888-357-7924, www.psych.org American
Psychological Association, 800-964-2000, www.apa.org Child and
Adolescent Bipolar Foundation, 847-256-8525, www.bpkids.org
Children and Adults with Attention-Deficit/Hyperactivity Disorder,
800-233-4050, www.chadd.org
Federation of Families for
Children's Mental Health, 703-684-7710,
Head Start
Mental Health Resources, 866-763-6481,
Knowledge Exchange Network, 800-789-2647, www.mentalhealth.org
National
Association of School Psychologists, 301-657-0270,
Children's Mental Health Matters is an initiative of the
National Mental Health
Association's Campaign for America's Mental Health. This
nationwide public education campaign is supported by a coalition of
national organizations and state and local Mental Health
Associations and their partners. Through this program, NMHA,
its affiliates and partners offer educational materials for
children and their families on a variety of topics including
anxiety disorders, attention deficit/hyperactivity disorder,
bipolar disorder and childhood depression, and mental wellness.
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