ATTENTION DEFICIT HYPERACTIVE DISORDER (ADHD)
Last Updated : 12/23/2010
Dr Vihang N Vahia
Q. What is

Attention Deficit Hyperactivity disorder (ADHD)

?

ADHD is a persistent and pervasive disorder characterized by poor attention span, overactivity and impulsive behavior far in excess of behavior by other children in that age group. This behavior makes it difficult for the child to adjust and adapt to the social environment inspite of having normal intelligence. ADHD is usually noticed in children below 7 years of age. The

following features are usually seen in children with ADHD

: -
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The child may make frequent mistakes at school.


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The child may not be able to play the same game for a long time.


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The child cannot follow instructions


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The child cannot organize work


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The child is forgetful in daily activities and tends to lose things.


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The child is very fidgety


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The child may walk away from class or from situations where the child is expected to remain seated. (e.g. climb tables, cupboards etc)


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They will be continuously talking


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They tend to interrupt & disturb others.



Q. How is ADHD diagnosed?
ADHD is a clinical diagnosis. It is diagnosed by overactivity in a child causing impairment of regular activities (The child disturbs both self & others). It is usually diagnosed when a child starts talking and walking.

Q. What is the

treatment of ADHD

?

ADHD is due to an abnormality in the reticular activating system of the brain. Drugs that increase the reticular activating system (RAS) stimulation are used successfully in the treatment of ADHD. The two drugs commonly used are methylphenidate and amphetamine. Methylphenidate is used in the dose of 5-10mg in the morning everyday. (The drug is given even on weekends & during vacations). These drugs have to be taken under a doctor's guidance, as they are habit forming and cause loss of appetite. This treatment is required for many years. However, the disorder attenuates as the child grows older and hence life long medication is not required.

Q. How can I, as a parent, help in the treatment of ADHD ?
Parents can definitely help in the treatment of children with ADHD. They should reward positive behavior of the child and reprimand negative behavior. The reprimand should be proportional to the intensity of the negative behavior and should always be predictable /consistent. It should not remain that the child is scolded sometimes and just let off other times. The parents should use persuasive firmness while dealing with these children.

PARENTS SHOULD PREACH WHAT THEY PRACTICE AND PRACTICE WHAT THEY PREACH

In school also, the teachers should be persuasive and yet firm. Before a child resumes school, the ADHD should be controlled else the child may be socially stigmatized.

Q. I have a child with ADHD and I am expecting another child. What are the chances that my next child will also have ADHD ?
There is no direct linkage of genetic transmission of ADHD. However, the younger child may assume the older sibling as a role model and develop overactivity. Hence, what is required is effective parenting.

Q. Does any particular diet help children with ADHD ?
No particular diet has been found useful in patients with ADHD.

Q. Can family feuds cause ADHD ?
Family disruptions or broken homes do not lead to ADHD but it may definitely aggravate or lengthen the disability.

Q. What is the

prognosis of a child with ADHD

?

Prognosis of a child with ADHD depends on how alert are the parents.
- If parents neglect the symptoms, the child may be considered as mentally delayed leading to social stigma. It may also lead to decreased progress in the development of the child (i.e. the progress may not be proportional to the potential) The child may become upset and hostile because of being misunderstood.
- If ADHD is properly dealt & treated, it usually heals/remits down, as ADHD is a self-limiting condition in most cases.

Q. My child aged 5 years does not sit still for more than few minutes. She finds it hard to concentrate and disturbs the class often. What should I do ?
Your child has a low attention span. However, before labeling your child as ADHD, it is imperative to rule out physical causes of restlessness in your child (commonest being worms). Also, consult your doctor to rule out epilepsy (an EEG may be recommended), psychosis, depression, anxiety etc. Many children with learning disabilities may suffer from short attention, as they may be depressed as they are unable to comprehend regular studies. Finally, your child may be having too many sensory inputs and as a result may be irritable.

Q. My child tends to day dream a lot and appears to be in his dream world. What should I do ?
Dreaming is a part of growing up and is considered normal. Abnormal day dreaming is when the dreams are so intense that they interfere with day to day activity. If your child has abnormal day dreaming, consult your doctor for further evaluation.

Q. How does one get ADHD ?
Though the exact cause of ADHD is still not known, it is postulated that these children suffer from minimal brain damage either prenatal, at time of birth or even in the neonatal age group.

Q. Is ADHD a hereditary condition ?
The incidence of ADHD is seen more frequently in first-degree relatives, in off springs of parents having depression, anxiety & personality disorders. Incidence is also higher in children of parents with alcohol & drug abuse. However, one should also remember that the severity and symptoms of ADHD also depend on the upbringing of the child.

Q. My child has ADHD. Does it affect the intelligence ?
Usually ADHD is seen in children with normal intelligence. IQ testing may show pseudo-retardation (i.e. the child may have normal IQ, but due to overactivity, testing may show a false low IQ)

Q. Is ADHD a life long condition? Can my child outgrow it ?
No, ADHD is not a life long condition. It is usually outgrown by the time the child becomes an adolescent.

Q. How do adults with ADHD behave ?
Usually children outgrow ADHD, as they grow older. Few preadolescents and adolescents may have residual symptoms. For them, the treatment is usually behavioral and cognitive therapy. There are anecdotal reports of various other therapies that have been tried like dance therapy, swimming, exercise, horse - riding etc to channelise their energies and increase their concentration.



Contributor Information and Disclosures



First Created : 12/21/2000

References

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