What Is ADHD?
The total number of children living with ADHD has crossed 6 million in the United States of America alone, according to the data provided by the CDC. About 11% of the children between the age group 4 to 17 are diagnosed with ADHD as per the parent report data given in 2016. It is not surprising that many children diagnosed with ADHD had at least some other form of behavioral disorder, personality problems like anxiety or conduct problem.
Attention Deficit Hyperactivity Disorder, shortly known as ADHD is a chronic problem affecting millions of children affecting their behavior, academics and self esteem. In many cases the behavior related issues reduce with age and in some children it continues beyond adulthood also. Children with ADHD have problems in sustaining attention and hence they perform poor in school.
There is no concrete treatment for ADHD but most of its symptoms can be improved with medications and psychotherapy. And it is very much essential for the parents to seek early intervention for getting it diagnosed and treated.
ADHD Signs and Symptoms
The warning signs of ADHD can be noticed from 3 years itself and the parents should get help from the doctor in case of doubt. Girls are more affected with this disorder than boys for reasons not known. And the symptoms can range from mild to severe depending on the individual child.
Primarily Inattentive Disorder
As given in the DSM manual of mental disorders the following 9 symptoms are seen in primarily inattentive disorder. A child is said to have ADHD if he/she has minimum 6 of the given list of symptoms. And remember the symptoms should be noticed in consistent manner for few months in different environment like home and school.
- The child does not pay attention either in school or at home or both and constantly makes mistakes in homework or doing small activities. He/she will not fully listen to the instructions even you say it personally and omits some work missing out some detail.
- The child cannot stay focused and concentrated in small tasks and even while playing. He/she will keep on changing the work/play leaving it unfinished and the child may have trouble listening to the conversations.
- Even while you are talking to the child directly he/she may appear unfocused giving an impression that his/her mind is somewhere else. The child may nod his head when you ask whether he has understood but keep doing the same mistake again due to attention deficit problem.
- The child may start doing homework or any other tasks quickly but have trouble in completing it, since he cannot follow the instructions. Such children often do not complete schoolwork and fails to note down the instructions given the class teacher.
- Children with ADHD cannot follow sequential tasks and games and they cannot keep things in order, in spite of repeated instructions. They have trouble in managing timeframe and meeting deadlines.
- The child may postpone or avoid doing the schoolwork that involves lengthy reading requiring good mental effort. Adolescents with this disorder may avoid filling up lengthy form or dislike writing reports etc.
- The child may keep on losing small items like pencils, books or materials needed for completing the homework, so that he can escape from doing it. This includes losing toys also if the game involves good brain work.
- They keep themselves engaged in some other thoughts and external stimuli and stay unfocused. In short they are easily distracted.
- The child with ADHD forgets even small chores and daily activities.
Primarily Hyperactive and Highly Impulsive
This is the second type of ADHD disorder. Some of the symptoms of children with this kind of disorder are listed below
- The child would be restless and often found tapping his/her hands or moving his feet. The child would have trouble in being seated for long.
- The child cannot tolerate sitting in the classroom and often leaves the place moving here and there. This is another behavior of restlessness and impulsive nature. The child refuses to sit while watching television or waiting in a doctor’s office.
- The child would want to be moving all the time except sleep time. He/she would run around or engage in climbing the chairs etc.
- Such children have problems indulging in playing or any kind of leisure activity silently.
- A child with ADHD acts largely by impulse and cannot stay still for few minutes also.
- Such children are talkative and never stop talking. They don’t have the patience to wait for their turn in classroom.
- When you are asking a question to them, they would interrupt you in the middle without having the patience to listen it properly. Such children keep on changing their games or pattern of activities and would readily start using the objects of their inmates without asking their permission.
For a child to be diagnosed as having ADHD, s/he should have some of the above signs at least for 6 months. Some children who are by nature adamant and have a dislike for school setting can mimic symptoms of ADHD. Parents have to be careful before deciding anything and watch if the child shows some signs both at school and at home.
There are so many healthy children those are hyperactive at some point of their lives. Preschoolers often have attention deficit and hence they cannot complete the given tasks. Even with adolescents attention deficit is a common problem if they are not interested in the subject. You cannot define a child to be ADHD just because he/she is energetic and highly active. Parents should look for the above symptoms for consistent period of time and assess their behavior both at home and at school before making a decision.
What exactly causes ADHD is not known. But number of factors like genetics, environmental factors and problems during developmental phase of a child can induce ADHD behavior. Exposure to poisonous chemicals like lead and arsenic can increase the risk of such behavior in children. Children who are born before the full-term (premature birth) are at increased risk for ADHD.
What Are The Consequences Of ADHD?
Children with ADHD have significant struggle in the school causing academic failure. Other children can underestimate such child triggering low self esteem. Such children have poor interaction with the adults and even with the peers and they have trouble in understanding questions. Often they are not accepted by the society which can degrade their esteem. Such children are at increased risk of becoming alcoholic or drug abuse during adolescent ages.
In addition to the above, ADHD can induce various psychological problems like anxiety, depression, learning disability, disruptive mood disorder, conduct disorder and bipolar disorder. Such children are more vulnerable for developing neurological problems than healthy ones.
How Do I Get My Child Tested For ADHD?
You can check with your family health care professional if your child shows some of the above signs both at home and school. Usually the symptoms would start in early stages of life, before the child completes 12 years.
There are no concrete tests available for ADHD, but based on the symptoms your doctor would complete medical exam to rule out other possible causes like neurological problems, psychiatric disorders and mood disorders. Certain medical issues can significantly affect the thinking and behavior of the child. He would then collect information about his medical history and his family history to know whether any of the siblings or relatives had these signs.
Your doctor would prepare a questionnaire meant for knowing about the behavior of the child in given circumstances. He may question his baby sitter, teacher and people from day care center. He may then refer your child to a psychotherapist or speech therapist for further evaluation. A psychotherapist can evaluate whether the child has dyslexia or learning difficulty or any other behavioral disorder in couple of sessions.
It is indeed difficult to diagnose ADHD based on the symptoms alone since many children can have delay in language development and have poor concentration.
How Do I Treat My Child With ADHD?
Mild cases of ADHD can be treated with psychotherapy and counseling sessions. For moderate to severe cases medications and training may be required. It may take several weeks or even months to find out which treatment works best for your son/daughter.
Behavior related with ADHD occurs when some changes happen in the chemicals of the brain known as neurotransmitters. Psycho stimulant drugs can help in balancing the chemical reaction of neurotransmitters and the symptoms can improve in short span of time.
Amphetamines like Dexedrine or adderall or destroamphetamine are prescribed to reduce hyperactive symptoms. Methylpenidates like concerta or metadata or Ritalin are given to boost the chemical balance in the brain. These medications are available as controlled release pills effectively lasting for extended periods.
As per the data given by the AAP, most of the children who use the above mentioned stimulant drugs have improvement in their symptoms and increase their focus. In due course, this helps in improving the self esteem of the child and the child learns to behave appropriately by suitable training course. This in turn helps in building relationship with teachers and peers.
Stimulant drugs given along with behavior therapy can help in overcoming most of the symptoms of ADHD. Your psychiatrist will decide on the right dosage for the child after testing with many drugs. These drugs can cause side effects and you can ask your doctor about the methods to reduce the side effects.
Heart problems can occur in children who take stimulant drugs and if your child already has some heart disease your doctor would prescribe suitable non-stimulant medications accordingly. Some of the non stimulant drugs given for ADHD are Kapvay, Strattera and Intuniv.
Antidepressants like Wellbutrin, Guanfacine and Clonidine are highly effective for improving the symptoms of hyperactivity but remember it may take time for getting the desired result.
Some of the stimulant drugs and antidepressants can cause suicidal thoughts in your children. Your doctor will explain about the possible signs of depression and contact your psychiatrist immediately if you notice any of such signs.
There is every chance that other children at your home can misuse these stimulant drugs and get addicted. You need to be careful in storing these medications and ensure that your child is getting the right dose as prescribed by your doctor. Children should not take their medications on their own without parental supervision.
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Behavioral therapy is highly effective for managing the symptoms of ADHD that can be given by psychotherapist or any mental health care provider. Counseling can help the child not only for improving their behavior but for boosting their self esteem. Older children can talk freely to the therapist and discuss with them about the issues and difficulties faced by them to find out ways to correct the negative behaviors.
Rewards and punishments serve as enhancing the desired behavior and reducing the unwanted behavior.
Parents can be trained with skills training to learn about the ways to adapt to ADHD children. Family therapy and social therapy are highly effective in helping the family people to overcome the stress while handling affected children. Active participation from the parents, teachers and other members of the family is needed to get quick response from the child.
Tips To Prevent ADHD
- One cannot totally prevent ADHD but can take steps to reduce the risk.
- If you are pregnant, avoid drinking and smoking which can disrupt the mental growth of the fetus causing ADHD.
- Protect your child from exposure to strong toxins like lead and cigarette smoke which can damage their brain.
- During the developing stage, restrict the child from watching television and using internet for extended hours.
- Setting small goals can have improvement in the child’s behavior.
- Insist the child to have direct eye contact while talking with him or her.
- Spend few minutes with your child to praise him/her even for completing small tasks.
- Make a clear practice for morning time and bedtime and stick on to the timings.
- Consult your doctor and talk with your child’s teacher early since it can reduce the impact of the child’s behavior.
Foods For ADHD Children : What To Eat and What To Avoid?
Several research studies supports that taking the right diet and nutrition can lower the impact of hypersensitivity, sleeping disorder and mood swings. As per the survey conducted by the Harvard Health Blog, people who ate diet rich in vegetables and fruits or wholesome diet have 35% better emotional balance and have less chance to develop depression than others.
Protein Rich Foods
- Children with ADHD can have high protein breakfast since it may help to accelerate alertness and thinking ability. It can also help in conducting signals through neurotransmitters for such children thus streamlining their behavior. On the contrary it you take foods that contain high carbohydrates it can cause sleepiness.
- Proteins, complex carbohydrates, fresh fruits and vegetables can help in optimal brain performance in ADHD children.
- It is true that one cannot get the balanced diet rich in nutrients from homemade food alone. Some kids are choosy in eating foods and in such cases you can rely on natural supplements that contain zinc, iron, vitamins, valerian, ginkgo and plenty of other nutritional supplements available in the market. Omega 3 supplements help in reducing the ADHD symptoms and also they help in decreasing the detrimental effects of some medications.
- However discuss with your doctor before giving your child any supplements. He would prescribe the right dose of supplement customized for your child.
Foods To Avoid
- Children with ADHD should totally avoid processed foods, foods that contain strong colors and flavors, and foods that contain chemical preservatives. Such foods can actually make symptoms worse than doing any good.
- There is no concrete evidence that certain chemicals present in the processed food items increases hyperactivity. But they are generally not good for your health. In this aspect avoid giving the children foods coated with artificial dyes and colors. Any food that adds color to the mouth cavity may contain dyes in it.
- Avoid chemical preservatives like butylated hydroxyanisole and sodium nitrate that is present largely in many carbonated drinks.
- And more importantly, limit the intake of candy and sweet items for your children.
- Avoid giving any kind of fast foods to your child.
- If you are planning to give new food to your child monitor his/her activities for the next day, since some foods like milk, wheat, peanuts, soy foods and even eggs can cause allergic reaction increasing hyperactivity.
Children with ADHD should follow daily exercise pattern as their routine. Aerobic exercise helps in improving the metabolism in many ways. It boosts one’s memory, improves focus and concentration and helps the child to sustain attention. If done on daily basis, exercises can reduce the impulsive nature of the child making them almost normal in behavior.
Doing exercises daily can cause several changes in the chemicals of the brain. It helps in releasing endorphin hormones that regulates the sensation of mood swings. Physical exercises increase the secretion of norepinephrine and it reorganize serotonin levels. By increased secretion of these vital hormones in the brain, the child can become more focused and attentive showing visible improvement in day-to-day activities.
It has been mentioned in the Journal of Abnormal psychology that in a study conducted for ADHD children were seen to be in less mood changes and more attentive after doing 30 minutes of exercises before school hours.
Children born with ADHD cannot sustain their attention on the same thing for more than few minutes. This can be significantly improved by giving proper brain training therapy. Brain training helps in holding the information you see or read for several seconds and use it when required, says a clinical psychologist Ari Tuckman, Pennsylvania. Working memory is the foundation for improving concentration and problem solving skills, according to him.
Cogmed and neuro-feedback are some of the brain training methods that improves working memory and increases focus.
Meditation and Yoga
Maintaining self discipline and doing daily challenges becomes a struggle for many children with hyperactivity disorder. Mindfulness activity and exercises can help in reducing the anxiety and alertness in those children. Similarly practicing meditation on daily basis can help in achieving focus and reduced distraction. It enables the children to reduce the stress level thereby calming them to improve their concentration on academics.
Tips For Parents
It is really challenging for the parents to manage the children with ADHD since their energy levels are very high as compared with parents. Parents can try using simple rewards like praising the child or buying his favorite toy etc. Parents should not be strict with them since it may worsen the symptoms; instead they can get results by positive parenting approach.
You need to reinforce the child with appraisal each time he/she behaves in appropriate manner. If you scold or punish them they may feel ashamed and scared making them vulnerable to socially unacceptable behavior.