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Parents
are distressed when they receive a note from school saying
that their child "won't listen to the teacher" or "causes
trouble in class." One possible reason for this kind of behavior
is Attention-Deficit Hyperactivity Disorder (ADHD).
Even though
the child with ADHD often wants to be a good student, the
impulsive behavior and difficulty paying attention in class
frequently interferes and causes problems. Teachers, parents,
and friends know that the child is "misbehaving" or "different"
but they may not be able to tell exactly what is wrong.
Any child
may show inattention, distractibility, impulsivity, or hyperactivity
at times, but the child with ADHD shows these symptoms and
behaviors more frequently and severely than other children
of the same age or developmental level. ADHD occurs in 3-5%
of school age children. ADHD must begin before the age of
seven and it can continue into adulthood. ADHD runs in families
with about 25% of biological parents also having this medical
condition.
A child
with ADHD often shows some of the following:
- trouble
paying attention
- inattention
to details and makes careless mistakes
- easily
distracted
- loses
school supplies, forgets to turn in homework
- trouble
finishing class work and homework
- trouble
listening
- trouble
following multiple adult commands
- blurts
out answers
- impatience
- fidgets
or squirms
- leaves
seat and runs about or climbs excessively
- seems
"on the go"
- talks
too much and has difficulty playing quietly
- interrupts
or intrudes on others
A child
presenting with ADHD symptoms must have a comprehensive evaluation.
A child with ADHD may have other psychiatric disorders such
as conduct disorder, anxiety disorder, depressive disorder,
or manic-depressive disorder. Without proper treatment, the
child may fall behind in schoolwork, and friendships may suffer.
The child experiences more failure than success and is criticized
by teachers and family who do not recognize a health problem.
Research
clearly demonstrates that medication can be helpful. Stimulant
medication such as methylphenidate, dextroamphetamine, and
pemoline can improve attention, focus, goal directed behavior,
and organizational skills. Other medications such as guanfacine,
clonidine, and some antidepressants may also be helpful.
Other
treatment approaches may include cognitive-behavioral therapy,
social skills training, parent education, and modifications
to the child's education program. Behavioral therapy can help
a child control aggression, modulate social behavior, and
be more productive. Cognitive therapy can help a child build
self esteem, reduce negative thoughts, and improve problem
solving skills. Parents can learn management skills such as
issuing instructions one step at a time rather than issuing
multiple requests at once. Education modifications can address
ADHD symptoms along with any coexisting learning disabilities.
A child
who is diagnosed with ADHD and treated appropriately can have
a productive and successful life. If a child shows symptoms
and behaviors like those of ADHD, parents may ask their pediatrician
or family physician to refer them to a child and adolescent
psychiatrist, who can diagnose and treat this medical condition.
For additional/related
information see other Facts for Families:
Learning
Disabilities (#16),
Conduct
Disorders (#33),
Manic-Depressive
Illness in Teens (#38),
Questions
to Ask about Psychiatric Medications for Children and Adolescents
(#51),
Comprehensive
Psychiatric Evaluation (#52).
Article
#6 Updated 5/99
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