Attention deficit hyperactivity di... Health Article

Signs and tests

Too often, difficult children are incorrectly labeled with ADHD. On the other hand, many children who do have ADHD remain undiagnosed. In either case, related learning disabilities or mood problems are often missed. The American Academy of Pediatrics (AAP) has issued guidelines to bring more clarity to this issue.

The diagnosis is based on very specific symptoms, which must be present in more than one setting. The child should have a clinical evaluation if ADHD is suspected.

Evaluation may include:

• Parent and teacher questionnaires (Connors, Burks)
• Psychological evaluation of the child AND family including IQ testing and psychological testing
• Complete developmental, mental, nutritional, physical, and psychosocial examination

Treatment

The American Academy of Pediatrics has guidelines for treating ADHD:

• Set specific, appropriate target goals to guide therapy.
• Medication and behavior therapy should be started.
• When treatment has not met the target goals, evaluate the original diagnosis, the possible presence of other conditions, and how well the treatment plan has been implemented.
• Systematic follow-up is important to regularly reassess target goals, results, and any side effects of medications. Information should be gathered from parents, teachers, and the child.

ADHD can be a frustrating problem. Alternative remedies have become quite popular, including herbs, supplements, and chiropractic manipulation. However, there is little or no solid evidence for many remedies marketed to parents.

Children who receive both behavioral treatment and medication often do the best. Medications should not be used just to make life easier for the parents or the school. There are now several different classes of ADHD medications that may be used alone or in combination. Psychostimulants are the primary drugs used to treat ADHD. Although these drugs stimulate the central nervous system, they have a calming effect on people with ADHD.

These drugs include:

• Methylphenidate (Ritalin, Concerta, Metadate, Daytrana)
• Dexmethylphenidate (Focalin)
• Amphetamine-dextroamphetamine (Adderall)
• Dextroamphetamine (Dexedrine, Dextrostat)
• Lisdexamfetamine (Vyvanse)

The FDA has approved the nonstimulant drug atomoxetine (Strattera) for use in ADHD. Effectiveness appears to be similar to that of stimulants. Strattera is not addicting.

Some ADHD medicines have been linked to sudden death in children with heart problems. Talk to your doctor about which drug is best for your child.

The following may also help:

• Limit distractions in the child's environment.
• Provide one-on-one instruction with the teacher.
• Make sure the child gets enough sleep.
• Make sure the child gets a healthy, varied diet, with plenty of fiber and basic nutrients.