Disease: Attention Deficit Hyperactivity Disorder
in Children (ADHD in Children or
Childhood ADHD)

Childhood attention deficit hyperactivity disorder (ADHD in children) facts

  • Attention deficit hyperactivity disorder (ADHD) is a mental-health condition that has characteristics of difficulty concentrating, controlling impulses, and/or excessive activity.
  • Though there is no particular cause of ADHD, there are many social, biological, environmental factors that may raise one's risk of developing or being diagnosed with the disorder.
  • There are three kinds of ADHD: predominately inattentive, predominately hyperactive/impulsive, and the combined (inattentive, hyperactive, and impulsive).
  • While medications are commonly used in the treatment of ADHD, behavioral therapy is important in improving the child's ability to function as well.
  • The most common medications used to treat ADHD are the stimulant medications.
  • About 85% of children with ADHD are at risk for having the disorder in adulthood.
  • Much of the latest research on ADHD in children focuses on how exposure to environmental toxins may increase the risk of developing this condition.

What is attention deficit hyperactivity disorder (ADHD)?

ADHD, also often called ADD, refers to a mental-health condition called attention-deficit/hyperactivity disorder. People with ADHD have problems with impulse control, excessive activity, and/or concentration. Statistics show that up to 7% of children and teens are thought to suffer from this disorder at any time, with up to 11% of children being given the diagnosis at some point during their childhood. Physicians diagnose boys with childhood ADHD at a rate of more than twice that of girls. That is thought to be at least partly due to the diagnosis in girls being missed because of gender differences in ADHD symptoms.

What are risk factors and causes of ADHD in children?

Although there is no single cause for ADHD, there are a number of biological, environmental, and social factors that seem to increase the risk of a person developing the disorder. Brain imaging studies show that the brains of people with ADHD tend to be smaller, the connections between certain parts of the brain are fewer, and the regulation of the neurochemical dopamine tends to be less than in people who have the disorder.

Learn more about: dopamine

Risk factors for ADHD that can occur in the womb include maternal stress, as well as smoking during pregnancy and low weight at birth. Being male and having a family history of ADHD increase the likelihood that an individual is diagnosed with ADHD. Socially, low family income and low paternal education are risk factors for developing ADHD. Behavioral expectations based on the culture of an area, from a school district, town, state, or country can influence how often this diagnosis is made.

What are signs and symptoms of ADHD in children?

ADHD symptoms include the following:

Inattention
  • Often makes careless mistakes or fails to pay adequate attention to detail
  • Trouble paying attention during tasks or leisure activities
  • Does not seem to be listening and appears to zone out when spoken to directly
  • Frequently fails to complete instructions or to complete work tasks or chores
  • Often has trouble organizing a task or activity
  • Frequently avoids, dislikes, or resists participating in tasks that require sustained focus
  • Often loses things needed to complete tasks or activities
  • Easily distracted by extraneous input or unrelated thoughts
  • Often forgetful
Hyperactivity/impulsivity
  • Often engages in fidgeting or tapping hands or feet
  • Frequently has trouble staying seated
  • Often feels restless
  • Has trouble engaging in leisure activities quietly
  • Engages in multiple activities at once
  • Frequently talks excessively
  • Frequently interrupts others talking
  • Trouble waiting his or her turn
  • Often intrudes on others

The fact that children with ADHD may be able to highly focus on activities they enjoy, even to a fault, does not mean that they do not have the disorder. The difference in attention of ADHD children is that they tend to be less able to pay attention consistently, particularly when faced with less pleasurable activities. Their trouble sitting still may involve engaging in behaviors like running or climbing in situations where it is inappropriate. While symptoms like insomnia, tantrums, otherwise quick temper or difficulty managing their anger, as well as low frustration tolerance are not specific to ADHD or required for its diagnosis, many children, teens, and adults with this illness have these symptoms.

Are there ADHD tests? How do physicians diagnose ADHD in children?

In order for a child to receive an ADHD diagnosis, he or she must demonstrate six symptoms of inattention or six symptoms of combined hyperactivity and impulsivity, while an older teen or adult need only exhibit five of either group of symptoms. The symptoms should start before 12 years of age, be present in more than one setting (for example, home and school), be severe enough to cause problems for the individual, and not be able to be better explained by another condition for the diagnosis of ADHD. There are three kinds of ADHD: predominately inattentive presentation, predominately hyperactive/impulsive presentation, and the combined (inattentive, hyperactive, and impulsive) presentation.

Many health-care professionals, including licensed mental-health therapists, primary-care providers, psychiatrists, psychologists, psychiatric nurses, and social workers may help make the diagnosis of ADHD in children. One of these professionals will likely conduct or refer for an extensive medical interview and physical examination as part of the assessment. One of the key aspects of evaluating children and teens for ADHD is determining whether the behaviors being exhibited are part of normal behavior or of ADHD. Individuals with ADHD also often have a learning disability. This illness is sometimes associated with a number of other mental-health problems, like the effects of trauma, as well as depression, bipolar disorder, obsessive compulsive disorder and other anxiety disorders, Asperger's syndrome, and other autism-spectrum disorders. Childhood ADHD is also often associated with other behavior disorders, like conduct disorder and oppositional defiant disorder. Therefore, the health-care professional will likely screen for signs of depression, manic depression, anxiety, and other mental-health symptoms. The symptoms of ADHD may also be the result of a number of medical conditions or can be a side effect of various medications. For this reason, health-care professionals often perform routine laboratory tests during the initial evaluation to rule out other causes of symptoms. Occasionally, an X-ray, scan, or other imaging study may be needed. As part of this examination, the sufferer may be asked a series of questions from a standardized questionnaire or self-test to help establish the diagnosis. Some ADHD symptom checklists for children include the Vanderbilt Rating Scale and the Connors' Rating Scales.

What are the treatments for ADHD in children? What are possible side effects of ADHD medications?

While medications are often prominent in the treatment of ADHD, behavioral treatments that address the interactions that the child with ADHD has with his or her parents, peers, and in school are also important in improving the child's ability to function. Mental-health professionals therefore often work with parents to develop specialized parenting skills and with teachers to provide academic accommodations, thereby encouraging and reinforcing the child's strengths, decreasing the child's counterproductive behaviors, and maximizing the child's academic success. They also may enlist the child in a social-skills group of their peers to improve the ADHD child's ability to make and keep friends.

Children with ADHD often benefit from being prescribed medication. The most common medications used to treat this disorder are the stimulant medications. Perhaps the oldest prescribed stimulant for the treatment of ADHD is Ritalin. However, given the longer days that older children and teens have compared to young children, stimulants that last longer are usually prescribed for those age groups. Examples of these prescribed drugs include long-acting preparations of methylphenidate, like Daytrana patches, Quillivant-XR liquid, Ritalin-LA, Concerta, and dexmethylphenidate (Focalin-XR), as well as the long-acting amphetamine salt Adderall-XR. Long-acting stimulants also include lisdexamfetamine (Vyvanse). However, shorter-acting stimulants like amphetamine salt (Adderall), dextroamphetamine sulfate (Zenzedi), and methylphenidate preparations, like Focalin and Metadate, may be more suitable for younger children so they are less likely to have trouble sleeping at night. Daytrana and a liquid form of methylphenidate called Quillivant XR can be useful in younger children because these two medications do not present trouble swallowing for children. Vyvanse can also be useful in that regard since its capsules can be opened and put in liquid or on food. Also, the effect of the Daytrana patch comes out of the child's system soon after the patch is removed, allowing parents to have more control over how long they would like the medication effect to last each day.

Learn more about: Ritalin | Daytrana | Concerta | Focalin | Adderall | Vyvanse | Metadate | Quillivant XR

Some children and adolescents may need to take a nonstimulant medication for treatment of ADHD. For those whose symptoms early in the morning or late in the evening are an issue, stimulants may not be the optimal medication treatment. For others, side effects like low appetite, insomnia, tremors, depression, loss of exuberance, irritability, less frequently tics, and rarely hallucinations may make it unwise for the child to take a stimulant medication. While stimulant treatment of people with ADHD who have no history of drug abuse tends to contribute to a decreased likelihood of developing a substance-abuse problem later on, those who have a recent history of alcohol or other drug abuse may make the small but real addiction potential of stimulants a reason not to prescribe a medication from that group. For children who either experience suboptimal effects, side effects, or significant side effects of stimulants, nonstimulant medications like guanfacine (Tenex or Intuniv), clonidine (Catapres or Kapvay), or atomoxetine (Strattera) may be considered. The prescription dietary supplement Vayarin has also been found to be effective in treating childhood ADHD.

Learn more about: Tenex | Intuniv | Catapres | Kapvay | Strattera

Children who suffer from ADHD are at higher risk for developing mood problems during adulthood. They may therefore benefit from medications that have been found to be helpful for people who have both ADHD and depression or anxiety, like bupropion (Wellbutrin) or venlafaxine (Effexor).

Learn more about: Wellbutrin | Effexor

While further research is needed to determine the potential effectiveness of home or natural remedies for treatment of ADHD, a number of parents use such treatments without drugs in an attempt to help their children. Such alternative treatments include vitamin supplements and restrictions to the child’s diet. A significant limitation of these remedies includes the difficulty in implementing them. The Feingold diet (developed in the 1970s) involves omitting food additives in an attempt to alleviate ADHD symptoms. While the Feingold diet may help some individual children, it has long ago been deemed ineffective for most.

Lifestyle improvements have been found to help reduce some symptoms in some children. Such improvements include regular exercise and ensuring the person receives adequate sleep every night. In fact, there is research that indicates that regular physical activity can measurably decrease ADHD symptoms, particularly in young children. Children who have trouble sleeping may benefit from over-the-counter medications that are not habit forming, such as melatonin.

What are complications and the prognosis of ADHD in children?

Current estimates are that 85% of children receiving the diagnosis of ADHD are at risk for having the disorder in some form as an adult. About one-third of those children may seem to grow out of it; however, that does not occur for all symptoms. The remaining two-thirds of children with ADHD continue to have most symptoms, but those symptoms may look differently in adulthood than in childhood. An example of that is the toddler, preschooler, or older child who has more trouble sitting compared to other children of the same age and gender still may grow up into an adult who gets bored easily. While there have been some well-founded concerns raised about the significant increase in how often ADHD is diagnosed, particularly in boys, treatment for children who truly qualify for the diagnosis is important in preventing the complications of this disorder in adulthood. Adults with ADHD may also experience significant co-occurring psychiatric and life problems, such as borderline and impulse personality problems, legal problems, substance abuse, and a significant risk for depression and anxiety disorders. Fortunately, children who receive treatment for this condition tend to be less likely to develop many of the complications associated with ADHD.

Is it possible to prevent ADHD in children?

Studies indicate that breastfeeding up to 6 months of age may help protect individuals from developing ADHD. As environmental and social insults like maternal drug use, medical, and emotional issues are risk factors for developing ADHD, prevention or treatment of those issues can help prevent or decrease the severity of this condition.

What is the latest research on ADHD in children?

Much of the latest research on ADHD in children focuses on how exposure to environmental toxins may increase the risk of developing this condition. For example, studies indicate that exposure to fluoride and other chemicals can increase the likelihood that a child develops ADHD. Also, research indicates that mothers who use acetaminophen (Tylenol) during pregnancy may be at higher risk of having a child with ADHD, particularly with more frequent use and during more than one trimester of the pregnancy.

Learn more about: Tylenol

What are signs and symptoms of ADHD in children?

ADHD symptoms include the following:

Inattention
  • Often makes careless mistakes or fails to pay adequate attention to detail
  • Trouble paying attention during tasks or leisure activities
  • Does not seem to be listening and appears to zone out when spoken to directly
  • Frequently fails to complete instructions or to complete work tasks or chores
  • Often has trouble organizing a task or activity
  • Frequently avoids, dislikes, or resists participating in tasks that require sustained focus
  • Often loses things needed to complete tasks or activities
  • Easily distracted by extraneous input or unrelated thoughts
  • Often forgetful
Hyperactivity/impulsivity
  • Often engages in fidgeting or tapping hands or feet
  • Frequently has trouble staying seated
  • Often feels restless
  • Has trouble engaging in leisure activities quietly
  • Engages in multiple activities at once
  • Frequently talks excessively
  • Frequently interrupts others talking
  • Trouble waiting his or her turn
  • Often intrudes on others

The fact that children with ADHD may be able to highly focus on activities they enjoy, even to a fault, does not mean that they do not have the disorder. The difference in attention of ADHD children is that they tend to be less able to pay attention consistently, particularly when faced with less pleasurable activities. Their trouble sitting still may involve engaging in behaviors like running or climbing in situations where it is inappropriate. While symptoms like insomnia, tantrums, otherwise quick temper or difficulty managing their anger, as well as low frustration tolerance are not specific to ADHD or required for its diagnosis, many children, teens, and adults with this illness have these symptoms.

Are there ADHD tests? How do physicians diagnose ADHD in children?

In order for a child to receive an ADHD diagnosis, he or she must demonstrate six symptoms of inattention or six symptoms of combined hyperactivity and impulsivity, while an older teen or adult need only exhibit five of either group of symptoms. The symptoms should start before 12 years of age, be present in more than one setting (for example, home and school), be severe enough to cause problems for the individual, and not be able to be better explained by another condition for the diagnosis of ADHD. There are three kinds of ADHD: predominately inattentive presentation, predominately hyperactive/impulsive presentation, and the combined (inattentive, hyperactive, and impulsive) presentation.

Many health-care professionals, including licensed mental-health therapists, primary-care providers, psychiatrists, psychologists, psychiatric nurses, and social workers may help make the diagnosis of ADHD in children. One of these professionals will likely conduct or refer for an extensive medical interview and physical examination as part of the assessment. One of the key aspects of evaluating children and teens for ADHD is determining whether the behaviors being exhibited are part of normal behavior or of ADHD. Individuals with ADHD also often have a learning disability. This illness is sometimes associated with a number of other mental-health problems, like the effects of trauma, as well as depression, bipolar disorder, obsessive compulsive disorder and other anxiety disorders, Asperger's syndrome, and other autism-spectrum disorders. Childhood ADHD is also often associated with other behavior disorders, like conduct disorder and oppositional defiant disorder. Therefore, the health-care professional will likely screen for signs of depression, manic depression, anxiety, and other mental-health symptoms. The symptoms of ADHD may also be the result of a number of medical conditions or can be a side effect of various medications. For this reason, health-care professionals often perform routine laboratory tests during the initial evaluation to rule out other causes of symptoms. Occasionally, an X-ray, scan, or other imaging study may be needed. As part of this examination, the sufferer may be asked a series of questions from a standardized questionnaire or self-test to help establish the diagnosis. Some ADHD symptom checklists for children include the Vanderbilt Rating Scale and the Connors' Rating Scales.

What are the treatments for ADHD in children? What are possible side effects of ADHD medications?

While medications are often prominent in the treatment of ADHD, behavioral treatments that address the interactions that the child with ADHD has with his or her parents, peers, and in school are also important in improving the child's ability to function. Mental-health professionals therefore often work with parents to develop specialized parenting skills and with teachers to provide academic accommodations, thereby encouraging and reinforcing the child's strengths, decreasing the child's counterproductive behaviors, and maximizing the child's academic success. They also may enlist the child in a social-skills group of their peers to improve the ADHD child's ability to make and keep friends.

Children with ADHD often benefit from being prescribed medication. The most common medications used to treat this disorder are the stimulant medications. Perhaps the oldest prescribed stimulant for the treatment of ADHD is Ritalin. However, given the longer days that older children and teens have compared to young children, stimulants that last longer are usually prescribed for those age groups. Examples of these prescribed drugs include long-acting preparations of methylphenidate, like Daytrana patches, Quillivant-XR liquid, Ritalin-LA, Concerta, and dexmethylphenidate (Focalin-XR), as well as the long-acting amphetamine salt Adderall-XR. Long-acting stimulants also include lisdexamfetamine (Vyvanse). However, shorter-acting stimulants like amphetamine salt (Adderall), dextroamphetamine sulfate (Zenzedi), and methylphenidate preparations, like Focalin and Metadate, may be more suitable for younger children so they are less likely to have trouble sleeping at night. Daytrana and a liquid form of methylphenidate called Quillivant XR can be useful in younger children because these two medications do not present trouble swallowing for children. Vyvanse can also be useful in that regard since its capsules can be opened and put in liquid or on food. Also, the effect of the Daytrana patch comes out of the child's system soon after the patch is removed, allowing parents to have more control over how long they would like the medication effect to last each day.

Learn more about: Ritalin | Daytrana | Concerta | Focalin | Adderall | Vyvanse | Metadate | Quillivant XR

Some children and adolescents may need to take a nonstimulant medication for treatment of ADHD. For those whose symptoms early in the morning or late in the evening are an issue, stimulants may not be the optimal medication treatment. For others, side effects like low appetite, insomnia, tremors, depression, loss of exuberance, irritability, less frequently tics, and rarely hallucinations may make it unwise for the child to take a stimulant medication. While stimulant treatment of people with ADHD who have no history of drug abuse tends to contribute to a decreased likelihood of developing a substance-abuse problem later on, those who have a recent history of alcohol or other drug abuse may make the small but real addiction potential of stimulants a reason not to prescribe a medication from that group. For children who either experience suboptimal effects, side effects, or significant side effects of stimulants, nonstimulant medications like guanfacine (Tenex or Intuniv), clonidine (Catapres or Kapvay), or atomoxetine (Strattera) may be considered. The prescription dietary supplement Vayarin has also been found to be effective in treating childhood ADHD.

Learn more about: Tenex | Intuniv | Catapres | Kapvay | Strattera

Children who suffer from ADHD are at higher risk for developing mood problems during adulthood. They may therefore benefit from medications that have been found to be helpful for people who have both ADHD and depression or anxiety, like bupropion (Wellbutrin) or venlafaxine (Effexor).

Learn more about: Wellbutrin | Effexor

While further research is needed to determine the potential effectiveness of home or natural remedies for treatment of ADHD, a number of parents use such treatments without drugs in an attempt to help their children. Such alternative treatments include vitamin supplements and restrictions to the child’s diet. A significant limitation of these remedies includes the difficulty in implementing them. The Feingold diet (developed in the 1970s) involves omitting food additives in an attempt to alleviate ADHD symptoms. While the Feingold diet may help some individual children, it has long ago been deemed ineffective for most.

Lifestyle improvements have been found to help reduce some symptoms in some children. Such improvements include regular exercise and ensuring the person receives adequate sleep every night. In fact, there is research that indicates that regular physical activity can measurably decrease ADHD symptoms, particularly in young children. Children who have trouble sleeping may benefit from over-the-counter medications that are not habit forming, such as melatonin.

What are complications and the prognosis of ADHD in children?

Current estimates are that 85% of children receiving the diagnosis of ADHD are at risk for having the disorder in some form as an adult. About one-third of those children may seem to grow out of it; however, that does not occur for all symptoms. The remaining two-thirds of children with ADHD continue to have most symptoms, but those symptoms may look differently in adulthood than in childhood. An example of that is the toddler, preschooler, or older child who has more trouble sitting compared to other children of the same age and gender still may grow up into an adult who gets bored easily. While there have been some well-founded concerns raised about the significant increase in how often ADHD is diagnosed, particularly in boys, treatment for children who truly qualify for the diagnosis is important in preventing the complications of this disorder in adulthood. Adults with ADHD may also experience significant co-occurring psychiatric and life problems, such as borderline and impulse personality problems, legal problems, substance abuse, and a significant risk for depression and anxiety disorders. Fortunately, children who receive treatment for this condition tend to be less likely to develop many of the complications associated with ADHD.

Is it possible to prevent ADHD in children?

Studies indicate that breastfeeding up to 6 months of age may help protect individuals from developing ADHD. As environmental and social insults like maternal drug use, medical, and emotional issues are risk factors for developing ADHD, prevention or treatment of those issues can help prevent or decrease the severity of this condition.

What is the latest research on ADHD in children?

Much of the latest research on ADHD in children focuses on how exposure to environmental toxins may increase the risk of developing this condition. For example, studies indicate that exposure to fluoride and other chemicals can increase the likelihood that a child develops ADHD. Also, research indicates that mothers who use acetaminophen (Tylenol) during pregnancy may be at higher risk of having a child with ADHD, particularly with more frequent use and during more than one trimester of the pregnancy.

Learn more about: Tylenol

Source: http://www.rxlist.com

While medications are often prominent in the treatment of ADHD, behavioral treatments that address the interactions that the child with ADHD has with his or her parents, peers, and in school are also important in improving the child's ability to function. Mental-health professionals therefore often work with parents to develop specialized parenting skills and with teachers to provide academic accommodations, thereby encouraging and reinforcing the child's strengths, decreasing the child's counterproductive behaviors, and maximizing the child's academic success. They also may enlist the child in a social-skills group of their peers to improve the ADHD child's ability to make and keep friends.

Children with ADHD often benefit from being prescribed medication. The most common medications used to treat this disorder are the stimulant medications. Perhaps the oldest prescribed stimulant for the treatment of ADHD is Ritalin. However, given the longer days that older children and teens have compared to young children, stimulants that last longer are usually prescribed for those age groups. Examples of these prescribed drugs include long-acting preparations of methylphenidate, like Daytrana patches, Quillivant-XR liquid, Ritalin-LA, Concerta, and dexmethylphenidate (Focalin-XR), as well as the long-acting amphetamine salt Adderall-XR. Long-acting stimulants also include lisdexamfetamine (Vyvanse). However, shorter-acting stimulants like amphetamine salt (Adderall), dextroamphetamine sulfate (Zenzedi), and methylphenidate preparations, like Focalin and Metadate, may be more suitable for younger children so they are less likely to have trouble sleeping at night. Daytrana and a liquid form of methylphenidate called Quillivant XR can be useful in younger children because these two medications do not present trouble swallowing for children. Vyvanse can also be useful in that regard since its capsules can be opened and put in liquid or on food. Also, the effect of the Daytrana patch comes out of the child's system soon after the patch is removed, allowing parents to have more control over how long they would like the medication effect to last each day.

Learn more about: Ritalin | Daytrana | Concerta | Focalin | Adderall | Vyvanse | Metadate | Quillivant XR

Some children and adolescents may need to take a nonstimulant medication for treatment of ADHD. For those whose symptoms early in the morning or late in the evening are an issue, stimulants may not be the optimal medication treatment. For others, side effects like low appetite, insomnia, tremors, depression, loss of exuberance, irritability, less frequently tics, and rarely hallucinations may make it unwise for the child to take a stimulant medication. While stimulant treatment of people with ADHD who have no history of drug abuse tends to contribute to a decreased likelihood of developing a substance-abuse problem later on, those who have a recent history of alcohol or other drug abuse may make the small but real addiction potential of stimulants a reason not to prescribe a medication from that group. For children who either experience suboptimal effects, side effects, or significant side effects of stimulants, nonstimulant medications like guanfacine (Tenex or Intuniv), clonidine (Catapres or Kapvay), or atomoxetine (Strattera) may be considered. The prescription dietary supplement Vayarin has also been found to be effective in treating childhood ADHD.

Learn more about: Tenex | Intuniv | Catapres | Kapvay | Strattera

Children who suffer from ADHD are at higher risk for developing mood problems during adulthood. They may therefore benefit from medications that have been found to be helpful for people who have both ADHD and depression or anxiety, like bupropion (Wellbutrin) or venlafaxine (Effexor).

Learn more about: Wellbutrin | Effexor

While further research is needed to determine the potential effectiveness of home or natural remedies for treatment of ADHD, a number of parents use such treatments without drugs in an attempt to help their children. Such alternative treatments include vitamin supplements and restrictions to the child’s diet. A significant limitation of these remedies includes the difficulty in implementing them. The Feingold diet (developed in the 1970s) involves omitting food additives in an attempt to alleviate ADHD symptoms. While the Feingold diet may help some individual children, it has long ago been deemed ineffective for most.

Lifestyle improvements have been found to help reduce some symptoms in some children. Such improvements include regular exercise and ensuring the person receives adequate sleep every night. In fact, there is research that indicates that regular physical activity can measurably decrease ADHD symptoms, particularly in young children. Children who have trouble sleeping may benefit from over-the-counter medications that are not habit forming, such as melatonin.

Source: http://www.rxlist.com

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