Attention Deficit Hyperactive Disorder (adhd)

Mary Kuttikadan
DNB (Pediatrics), Fellowship in Developmental Pediatrics
First Created: 12/21/2000  Last Updated: 02/03/2022

Patient Education

What is Attention Deficit Hyperactivity disorder (ADHD)?

ADHD (Attention-deficit/ hyperactivity disorder (ADHD) is on elf the most common neurobehavioral disorders of childhood and can profoundly affect children's well-being, academic achievement, and social interaction. Children with ADHD manifest symptoms from childhood and may continue to have symptoms well into adolescence and adulthood.

A diagnosis of ADHD is considered in individuals presenting with features of hyperactivity, inattention, and or impulsivity. In preschool, the main manifestation is hyperactivity. Inattention becomes prominent during elementary school. During adolescence, signs of hyperactivity are less common and may be confined to fidgetiness, restlessness, or impatience.

How is ADHD diagnosed?

ADHD is diagnosed on the basis of clinical criteria as mentioned in the DSM 5 (Diagnostic and Statistical Manual of Mental Disorders 5th edition). Any child through 4 to 18 years of age who presents with academic/behavioral issues, and symptoms of inattention, hyperactivity, and impulsivity should be assessed for ADHD. At times, learning difficulties or other behavioural conditions may co-exist along with ADHD.

The diagnosis can be done by a pediatrician or a developmental pediatrician

These features have to be present for a period of at least 6 months and there must be evidence to suggest that it is interfering with the current functioning of the individual in at least 2 settings (e.g. home, school, social, work)

To support the diagnosis, information is also obtained regarding behaviour in the home and school settings in the form of questionnaires and academic evaluations.

What is the treatment of ADHD?

In preschool children (4 to 6 years of age), Parent Training for Behaviour Management (PTBM) and behavioural classroom interventions are recommended. Methylphenidate may be considered if the above interventions don't provide significant improvement.

For children aged 6 to 12 years, FDA approved stimulant medications, along with PTBM and behavioural classroom interventions are recommended.

For children from 12 to 18 years, along with medications, education; and behavioural interventions are recommended. Once started the drugs have to be monitored and titrated to achieve maximum benefit.

How can I, as a parent, help in the treatment of ADHD?

Some strategies that parents and teachers can adopt for children with ADHD include

1. Maintaining a daily, consistent schedule

2. Using planners and checklists to help the child stay 'on task'

3. Keep a fixed space for study with minimal distractions

4. Reinforcing positive behaviour

Does any particular diet help children with ADHD?

No particular diet has been found useful in patients with ADHD.

Can family feuds cause ADHD?

Family disruptions or broken homes do not lead to ADHD but it may definitely aggravate or lengthen the disability.

What is the prognosis of a child with ADHD?

ADHD is associated with reduced school performance and academic attainment, peer conflicts. They may be subject to bullying and teasing. Adults may report issues with unemployment, performance in the workspace. Inadequate or variable self-application to tasks that require sustained effort is often interpreted by others as laziness, irresponsibility, or failure to cooperate.

My child aged 5 years does not sit still for more than a few minutes. She finds it hard to concentrate and disturbs the class often. What should I do?

Children with features suggestive of hyperactivity, need to be evaluated by a developmental paediatrician. A detailed history including birth history, family history, developmental milestones, social and academic performances has to be obtained. While ADHD may seem likely, other neurodevelopment conditions need to be ruled out.

How does one get ADHD?

ADHD has a strong familial association. Apart from familial, factors such as fetal alcohol exposure, maternal cigarette smoking, elevated lead levels may be contributory towards ADHD.

Is ADHD a hereditary condition?

ADHD is elevated in the first-degree biological relatives of individuals with ADHD.

Family interaction patterns in early childhood are unlikely to cause ADHD but may influence its course or contribute to secondary development of conduct problems.

My child has ADHD. Does it affect the intelligence?

While learning difficulties may coexist with ADHD, it does not affect intelligence.

Is ADHD a life long condition? Can my child outgrow it?

Recent guidelines for ADHD suggest that ADHD is a chronic condition. While children may not outgrow it, its presentation(as described above) varies across the life span. Encouraging strong family and school partnerships, timely psychosocial treatments and educational interventions go a long way ineffective management and enhancing the quality of life for persons with ADHD.

Attention Deficit Hyperactive Disorder (ADHD) Attention Deficit Hyperactive Disorder (ADHD) 2022-02-03
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