Attention-deficit hyperactivity disorder, or ADHD, is the official name of a disorder sometimes loosely referred to as "hyperactivity" in a child. ADHD is associated with limited attention span, excessive and uncontrolled physical activity and poor impulse control.
ADHD affects far more boys than girls, and it can become apparent by age four or five. A typical boy with this disorder may seems like a whirlwind of unstoppable energy, careening from one activity or game to the next. In gatherings of children or adults, he may become wild and unmanageable.
Children with ADHD find it nearly impossible to sit still or engage in a quiet activity for more than a few minutes. As a result, they almost always have problems at school.
ADHD needs to be treated. In addition to frustrating parents and teachers, ADHD may cause a child to place himself or others in danger. What's more, a child with ADHD may develop low self-esteem, as his inappropriate behavior sets him apart from other children. In some cases, especially in girls, ADHD does not include hyperactivity. Sometimes stimulant therapy works in these situations.
WHAT CAUSES ADHD?
The exact cause is still unknown, but recent research points strongly to a biological basis for the disorder.
WHEN SHOULD I SUSPECT ADHD?
Remember that high energy, impulsiveness and inattentiveness are normal characteristics in childhood, and all children will display some, or even all, of these symptoms from time to time. A definite pattern of symptoms must be evident for a diagnosis of ADHD.
HOW CAN THE PEDIATRICIAN TELL IF MY CHILD HAS ADHD?
Generally, parents or nursery school teachers notice the possible problem and mention it to the pediatrician. The doctor may administer tests to eliminate the possibility of certain neurological or physical disorders. If ADHD seems likely, it is useful to have the child evaluated by a team of child development specialists to determine if there are associated problems. A member of the team may observe the child at home and at school, and have parents and teachers answer a questionnaire about the child's behavior. Overall, the team looks for specific behaviors such as lack of concentration, distraction, daydreaming, impulsivity or out-of-control behavior.
WHAT TREATMENTS ARE AVAILABLE?
Children with the disorder are often treated with a drug of the stimulant class. In adults, such drugs can cause agitation and nervousness, but they can have the opposite effect on children with ADHD and increase their ability to concentrate. In some children, these drugs have side effects, including appetite suppression, sleeplessness and, rarely, delayed growth. For this reason, children must be evaluated carefully before receiving drug treatment. Close medical monitoring is also important while the child is on medication.
Counseling may help the child deal with the social adjustment problems and low self-esteem that frequently accompany the disorder. A child with ADHD may also benefit from a behavior modification program. This means a system of rewards and punishments that the child can depend upon to be enforced. To be most effective, the program should be set up in conjunction with the child's teacher, to ensure that rules are consistent at home and school.
COPING WITH ADHD
There is no known way to prevent ADHD. However, identifying and treating the problem as soon as possible will help control the symptoms and make life easier.
RECOGNIZING ATTENTION-DEFECIT HYPERACTIVITY DISORDER
According to the American Psychiatric Association, your child may have ADHD if he shows at least eight of these behaviors for at least six months before the age of seven:
• Frequent fidgeting or squirming when seated
• Difficulty remaining seated when required to sit
• Easy distractibility by noises, sights and other stimuli
• Difficulty taking turns
• Difficulty following through on instructions
• Tendency to blurt out answers before a question is completed
• Difficulty sustaining attention in play and work
• Frequent shifting of activities without completing any task
• Difficulty playing quietly
• Excessive talking
• Frequent interruptions or intrusions on others
• Inattention to what others are saying
• Tendency to lose things
• Tendency to engage in dangerous activities
HELPING A CHILD WITH ADHD
• Provide a structured and predictable environment.
• Avoid overly stimulating places such as malls and grocery stores.
• Do not expect the child to concentrate on a task for extended periods. If he can focus on an activity for three minutes, set a modest goal of concentrating for five minutes, not ten or twenty.
• Help the child reach this concentration goal by setting a timer for the desired time. When your child can remain with the same play activity for five minutes without getting distracted, reward him with praise and positive physical contact.
• Set up these trial periods several times a day. As the child is able to accomplish the goal, make the time longer.
• When the child engages in unwanted behavior, redirect him; suggest another, less disruptive activity, and if necessary, guide him into the alternate activity.
GETTING HELP
• Children with ADHD are at risk for other behavioral problems, learning disabilities, low self-esteem and relationship problems. For this reason it is imperative that ADHD children get help.
