A young child may act up from time to time. A parent may think their child will grow out of this behavior or that it can be corrected. The challenge for parents becomes greater when the unpredictable behavior continues and is actually related to symptoms of attention deficit hyperactivity disorder (ADHD).
ADHD is a brain disorder that interferes with functioning and development and can cause difficulty in school, at home and in social settings. It is usually first diagnosed in childhood.
“Raising a child with ADHD can be real challenging, depending on the type and severity of the child’s symptoms. Fortunately, there are many treatment options, including medication and behavior therapy or a combination of both that can effectively manage the condition,” says Nicholas Levy, MD, a pediatrician at Scripps Coastal Medical Center Encinitas.
There is no single test to diagnose ADHD. Instead, symptoms are evaluated over a period to determine how persistent they are. This is usually done with input from parents, caregivers and schoolteachers.
If your child has been diagnosed with ADHD or you want to learn more about this condition, the following are six frequently asked questions about ADHD in kids.
ADHD is one of the most common neurodevelopmental disorders of childhood. More than six million children have been diagnosed with ADHD, according to the Centers for Disease Control and Prevention (CDC).
Inattention, impulsivity and hyperactivity are principal characteristics of ADHD.
“Children with ADHD may talk out of turn, move around when asked to stay still, forget to follow instructions and lose their possessions,” says Dr. Levy. “Underlying all of this is the unifying problem of not suppressing impulses well.”
“Thoughts, feelings and ideas that arise have to be acted on which may lead to increased movement or impulsive blurting out or may lead to the child simply following a new train of thought or daydreaming,” he says.
(Adults with ADHD tend to become impatient when waiting in line, drive too fast and may engage in risk taking behaviors. As patients get older their hyperactivity often subsides.)
ADHD can be difficult to diagnose or understand. One of the most damaging misconceptions is that people with ADHD lack motivation or are lazy because of their difficulties managing their behaviors. It is damaging because kids with ADHD often end up feeling “stupid” when they don’t do well in school and suffer significantly from low self-esteem.
The fact is that children all like to do well. Children tend to quickly tire of activities that they’re not good at and spend more time doing something they excel in. For ADHD kids who have tried very hard to do well in school and continually fall short of the mark, this could help explain why they might stop trying.
Another misconception is that ADHD is more common in the United States than in the rest of the world. The frequency of this disorder is the same in all countries and in all cultures.
It is true, however, that ADHD will have less of an impact in some cultures while other cultures are much less forgiving of certain behaviors. In the US, there tends to be a great deal of emphasis on time management and organization, which are far more difficult for children with ADHD than for their peers.
Yet another misconception is that people outgrow ADHD. But ADHD lasts into adulthood for at least one-third of children with ADHD, according to the CDC.
What happens with adults is that hyperactivity diminishes or becomes much more subtle ( leg shaking, finger twitching). Many adult ADHD patients have resources available to help them stay organized and manage their time.
There are many conditions that might look like ADHD.
If children are not seeing or hearing well, they often appear inattentive. Today all school children are screened for vision and hearing, but more subtle issues, such as learning disabilities and auditory processing disorders, may be missed.
Emotional problems can also make children inattentive. If there is conflict between their parents or if they are being bullied at school, the anxiety this produces will prevent them from paying attention to schoolwork. Mental disorders like bipolar disorder, high functioning autism, anxiety and depression may all create states that may appear like inattention.
Children who have been exposed to lead or who have deficiency in iron or magnesium may also have problems in school and seem inattentive.
“If you’re concerned about whether your child might have ADHD, talk to your pediatrician to see if the symptoms fit the diagnosis, is part of another condition, or is occurring at the same time as ADHD,” Dr. Levy says. A diagnosis of ADHD may also be made by a mental health professional.
The most important part of treatment for ADHD is creating structure for the child and understanding their limitations. There needs to be ongoing supervision and help with organization and planning.
ADHD medications can be extremely valuable for ADHD patients and should allow them to feel more integrated and in control of their emotions and their thought processes. Stimulant medications, such as methylphenidate (Ritalin), and amphetamine (Adderall), improve the amount of neurotransmitter in the pathways of the brain that allow us to suppress impulses and are considered a mainstay of medication management.
Parents need to educate themselves and learn how children with ADHD tend to respond. They need to create as much structure as possible and not set their children up for failure by demanding behaviors that they are not capable of producing.
They should make sure that there is not excessive screen time, that the child is exercising regularly and that the diet is nutritious and does not contain preservatives, corn syrup solids and food dyes wherever possible.
“It is often helpful to find an activity that the child is naturally gifted in, which can provide an opportunity for them to excel at something and improve their self-esteem,” Dr. Levy says.
Parents of children with ADHD should maintain a strong channel of communication with their children’s teachers and work closely to keep them on task.
For example, if parents know about long-term projects right when they are given (rather than the night before when the child falls to pieces), they can help the child break the work up into manageable sections and work on the project a little at a time.
Teachers can also help by double-checking that homework assignments are written down and that homework is being turned in when it’s due. It is best if this can be achieved without singling out the child in front of the rest of the class.