ADHD: What Parents Should Know

What is ADHD?

Attention-deficit hyperactivity disorder (ADHD) is the name of a group of behaviors found in many children and adults. People who have ADHD have trouble paying attention in school, at home or at work. They may be much more active and/or impulsive than what is usual for their age. These behaviors contribute to significant problems in relationships, learning and behavior. For this reason, children who have ADHD are sometimes seen as being "difficult" or as having behavior problems.

ADHD is common, affecting 4% to 12% of school-age children. It's more common in boys than in girls. You may be more familiar with the term attention deficit disorder (ADD). This disorder was renamed in 1994 by the American Psychiatric Association (APA).

What are the symptoms of ADHD?

The child with ADHD who is inattentive will have 6 or more of the following symptoms:

• Has difficulty following instructions
• Has difficulty keeping attention on work or play activities at school and at home
• Loses things needed for activities at school and at home
• Appears not to listen
• Doesn't pay close attention to details
• Seems disorganized
• Has trouble with tasks that require planning ahead
• Forgets things
• Is easily distracted

The child with ADHD who is hyperactive/impulsive will have at least 6 of the following symptoms:

• Fidgety
• Runs or climbs inappropriately
• Can't play quietly
• Blurts out answers
• Interrupts people
• Can't stay in seat
• Talks too much
• Is always on the go
• Has trouble waiting his or her turn

What should I do if I think my child has ADHD?

Talk with your child's doctor. A diagnosis of ADHD can be made only by getting information about your child's behavior from several people who know your child. Your doctor will ask you questions and may want to get information from your child's teachers or anyone else who is familiar with your child's behavior. Your doctor may have forms or checklists that you and your child's teacher can fill out. This will help you and your doctor compare your child's behavior with other children's behavior.
Your doctor will do vision and hearing tests if these tests haven't been done recently.

Your doctor may recommend trying medicine to see if it helps control your child's hyperactive behavior. A trial of medicine alone cannot be the basis for diagnosing ADHD. However, it can be an important part of evaluating your child if ADHD is suspected.

It might be hard for your doctor to tell if your child has ADHD. Many children who have ADHD aren't hyperactive in the doctor's office. For this reason, your doctor may want your child to see someone who specializes in helping children who have behavior problems, such as a psychologist.

What causes ADHD?

Children who have ADHD do not make enough chemicals in key areas in the brain that are responsible for organizing thought. Without enough of these chemicals, the organizing centers of the brain don't work well. This causes the symptoms in children who have ADHD. Research shows that ADHD is more common in children who have close relatives with the disorder. Recent research also links smoking and other substance abuse during pregnancy to ADHD.

Things that don't cause ADHD:

• Bad parenting (though a disorganized home life and school environment can make symptoms worse)
• Too much sugar
• Too little sugar
• Aspartame (brand name: Nutrasweet)
• Food additives or colorings
• Food allergies or other allergies
• Lack of vitamins
• Fluorescent lights
• Too much TV
• Video games

What can I do to help my child?

A team effort, with parents, teachers and doctors working together, is the best way to help your child. Children who have ADHD tend to need more structure and clearer expectations. Some children benefit from counseling or from structured therapy. Families may benefit from talking with a specialist in managing ADHD-related behavior and learning problems. Medicine also helps many children. Talk with your doctor about what treatments he or she recommends.

What medicines are used to treat ADHD?

Some of the medicines for ADHD are methylphenidate (some brand names: Ritalin, Concerta), dextroamphetamine (brand name: Dexedrine), pemoline (brand name: Cylert), atomoxetine (Strattera), and a combination drug called Adderall. These medicines improve attention and concentration, and decrease impulsive and overactive behaviors. Other medicines can also be used to treat ADHD.

What can I do at home to help my child?

Children who have ADHD may be difficult to parent. They may have trouble understanding directions. Children who are in a constant state of activity can be challenging for adults. You may need to change your home life a bit to help your child. Here are some things you can do to help:

• Make a schedule. Set specific times for waking up, eating, playing, doing homework, doing chores, watching TV or playing video games, and going to bed. Post the schedule where your child will always see it. Explain any changes to the routine in advance.
• Make simple house rules. It's important to explain what will happen when the rules are obeyed and when they are broken. Write down the rules and the results of not following them.
• Make sure your directions are understood. Get your child's attention and look directly into his or her eyes. Then tell your child in a clear, calm voice specifically what you want. Keep directions simple and short. Ask your child to repeat the directions back to you.
• Reward good behavior. Congratulate your child when he or she completes each step of a task.
• Make sure your child is supervised all the time. Because they are impulsive, children who have ADHD may need more adult supervision than other children their age.
• Watch your child around his or her friends. It's sometimes hard for children who have ADHD to learn social skills. Reward good play behaviors.
• Set a homework routine. Pick a regular place for doing homework, away from distractions such as other people, TV and video games. Break homework time into small parts and have breaks.
• Focus on effort, not grades. Reward your child when he or she tries to finish school work, not just for good grades. You can give extra rewards for earning better grades.
• Talk with your child's teachers. Find out how your child is doing at school--in class, at playtime, at lunchtime. Ask for daily or weekly progress notes from the teacher.

Will my child outgrow ADHD?

We used to think children would "grow out" of ADHD. We now know that is not true for most children. Symptoms of ADHD often get better as children grow older and learn to adjust. Hyperactivity usually stops in the late teenage years. But about half of children who have ADHD continue to be easily distracted, have mood swings, hot tempers and are unable to complete tasks. Children who have loving, supportive parents who work together with school staff, mental health workers and their doctor have the best chance of becoming well-adjusted adults.