Understanding ADHD Health Article

ADHD is a condition of the brain that makes it difficult for children to control their behavior.  It is one of the most common conditions of childhood, affecting  6 to 9 percent of all school-age children. Boys are three times more likely than girls to be diagnosed with ADHD. The cause is unclear, but many children with ADHD have a close relative who had similar trouble as a youth.

"The average child with ADHD is not bouncing off the walls," says James M. Perrin, M.D., co-chairman of an American Academy of Pediatrics (AAP) committee on ADHD.

Pediatricians and psychiatrists look for three basic symptoms that show up in two or more settings, such as home and school:

• Hyperactivity

• Impulsiveness

• Inattentiveness

Under AAP guidelines, (based on criteria set forth by the American Psychiatric Association), doctors should look for several specific behaviors within those broad categories. The symptoms should last at least six months, appear by age 7 and significantly impair the child's ability to function in school, at home, or in social settings. Some examples:

• Inability to listen when spoken to directly.

• Frequent failure to follow instructions or complete chores.

• Frequent fidgeting or squirming in a seat.

• Acting as if driven by a motor.

• Often blurting out answers before questions are completed.

Depending on which symptoms are most prominent, ADHD is divided into three general subtypes:

• predominantly hyperactive/impulsive-type ADHD,

• predominantly inattentive-type ADHD,

• combined-type ADHD.

Treatment for ADHD varies for each child and often includes medication and behavior therapy. 

The most frequently prescribed medications for ADHD, and the most well-studied, are the stimulant medications.

"Ritalin does not solve all the problems, but it does help," says Dr. Perrin. "Parental involvement, structure in the home environment, behavioral therapy, all play a role."

Experts say, however, that dietary therapies (other than avoiding caffeine) don't play a role. Dietary supplements are being marketed for ADHD with no proof they work, federal officials say.

Helping a Child with ADHD

Whether a child diagnosed with ADHD is on medication or not, experts say parents can help by taking these steps:

• Educate yourself about the problem and the treatment. Prepare a list of questions for your pediatrician or child psychiatrist. Ask what books might help you understand. Two suggestions: ADHD: A Complete and Authoritative Guide, from the AAP, edited by Michael Rieff, M.D., and Taking Charge of ADHD -- A Complete Authoritative Guide for Parents, by Russell Barkley, Ph.D.

• Work closely with teachers to learn about your child's behavior in school. Initial your child's homework to show you've checked it. Ask the teacher about your child's two or three most significant problems.

• Join Children and Adults With Attention-Deficit/Hyperactivity Disorder (CHADD). This national group offers numerous local chapters that educate, inform and support parents.

• Explore behavioral therapy with a specialist who treats a lot of ADHD cases. Your pediatrician and local CHADD members can suggest a psychiatrist or psychologist.

• Establish a structured, nurturing home environment. You should provide a specific time for homework and for checking that it has been done, for instance.

• Set up a "daily report card." As part of it, offer a small reward system to reinforce desired behavior.

Pay attention to the big things. Don't make a fuss about the small stuff.