Home>>Family Medicine>>ADHD

Attention Deficit/Hyperactivity Disorder (ADHD)

What is attention-deficit/hyperactivity disorder (ADHD)?
Attention deficit/hyperactivity disorder (ADHD) is the most common mental health problem in children. Children with ADHD often have problems with paying attention, being unable to sit still and doing things without thinking first. It is also called attention deficit disorder (ADD).

The disorder begins in the preschool years and may last into adulthood. About half of children with ADHD also have learning problems such as a reading disability. About half of ADHD children and teenagers have behavior problems which may include breaking rules, talking back and hitting other children.

ADHD is more common in boys than in girls. Girls are more likely to have trouble paying attention, while boys are more likely to be hyperactive.

How does it occur?
The exact cause of ADHD has not yet been found, however ADHD does seem to run in families. If a parent, uncle or grandparent has ADHD, other family members may also develop it. People with ADHD have several small differences in the brain. These differences are in the front part of the brain (an area involved in self-control) and in some parts in the center of the brain.

Much research has looked at whether ADHD is caused by sugar or other food additives such as preservatives and coloring, however evidence has not connected these with ADHD. Allergies are not a common factor in causing ADHD either.

What are the symptoms?
The symptoms of ADHD (especially hyperactivity) usually appear by age two or three, and by first grade at the latest. There are three main symptoms of attention deficit/hyperactivity disorder: distractibility, impulsiveness and hyperactivity.

Children and teens with ADHD:

  • Are distracted by what is going on around them
  • Have trouble waiting in line or taking turns
  • Start many projects but do not finish things
  • React quickly without thinking of the outcome
  • Are quick to anger
  • Fidget and cannot sit still
  • Walk, run or climb around when others are seated
  • Get bored very quickly

There are three forms of attention deficit/hyperactivity disorder:

  • Combined ADHD: The child has all of the main symptoms: distractibility, poor impulse control, and hyperactivity.
  • Predominately inattentive: The child has problems with focus and attention. This form of ADD is often missed because there may be very little hyperactivity or impulsivity. This form is especially common among girls.
  • Predominately impulsive-hyperactive: Poor self-control is the main problem.

How is ADHD diagnosed?
Your healthcare provider will ask about the symptoms and will observe your child's behavior for signs of ADHD. Parents and teachers may be asked questions about ADHD symptoms. Your child may need to see a mental health professional for tests of attention and self-control. There are no useful physical tests such as blood tests or brain scans for diagnosing ADHD. To properly diagnose attention deficit/hyperactivity disorder, it must be clear that the symptoms persist and interfere in a major way with daily life.

How is it treated?
The treatment of ADHD may involve:

  • Learning coping skills: Children with ADHD learn to manage situations that distract and over-excite them. They should learn to study in quiet places and to take frequent breaks. In a classroom, they do best at individual desks rather than at a table with others. They also often find that background instrumental music is helpful. Children with ADHD need help learning how to organize, as well as more structure and daily routine than most people.
  • Behavioral training: Behavior programs may help a child with ADHD develop a longer attention span and be able to sit still.
  • Medicines: Since the 1920s, medicines such as methylphenidate (Ritalin) and dextroamphetamine (Dexedrine) have been used for the treatment of ADHD. They are stimulants and appear to stimulate the self-control areas of the brain. Another medicine often used is dextroamphetamine/amphetamine (Adderall). These medicines do not slow you down, but rather increase self-regulation. About 70 percent of children with ADHD improve with these medicines. The most common side effects are loss of appetite and trouble getting to sleep. Your child's dosage will be gradually adjusted to reduce side effects. In some cases medicines are used only on school days. When these medications are not effective, there are others available that can help with ADHD.

Claims have been made that many health foods and nutritional supplements help with ADHD. Limiting sugar, food additives or food colorings is not effective in treating ADHD. However, omega fatty acid supplements and certain vitamins and minerals may help symptoms of ADHD.

How long do the effects of ADHD last?
About half of people with ADHD seem to "grow out of it" by their early twenties. The other half show either a slight change or no change in symptoms as they grow into adulthood. Being more patient and better able to sit still are the most common improvements seen between late childhood and young adulthood.

What can I do to help my child?
There are many ways to help manage ADHD:

  • When a child needs to read or concentrate, have them work away from the distracting sounds of television, radio or others talking. However, low-level background sound such as white noise or instrumental music can be helpful.
  • Encourage your child to do tasks in short blocks of time with breaks in between.
  • Teach your child how to use a planner and how to organize schoolwork.
  • Most school districts have special programs to help children with ADHD. Find out what services are available through the school district or your community to help.
  • Help your child to follow a very structured daily routine.
  • If your child has trouble slowing down at bedtime, a planned quiet time before bedtime and background music when falling asleep are often helpful.
  • Encourage your child to exercise regularly.
  • Help your child get enough sleep.
  • Help your child eat a healthy diet.
  • Limit your child's caffeine intake.