Childhood ADHD
This page was written by Dr. Staci Ngoc-Tram Vo
What is ADHD?
Attention deficit hyperactivity disorder (ADHD) is often misunderstood in the Asian culture. Often Asian parents believe a child who may be inattentive, hyperactive, or impulsive are misbehaving and require increased discipline. This belief however can be detrimental to a child with ADHD as ADHD is associated with a higher risk other mental illnesses such as oppositional defiant disorder/conduct disorder, anxiety disorders, depressive disorders, and substance abuse. The sooner the child is identified and treatment is initiated the better the outcome.
How is the diagnosis of ADHD made?
The diagnosis of ADHD is made when problems with hyperactivity, inattention, and/or impulsiveness are beyond the normal range with regards to the child’s development and age. The symptoms must be present for at least six months, the symptoms are present before the child is 7 years old, there must be clear impairment in at least two settings (school, work, social, etc.). The symptoms of ADHD fall into two general catagories: inattention and hyperactivity/impulsivity. Children can have one set of symptoms or both.
Inattentive symptoms include (must have at least 6 or more in at least a 6 month period):
· failing to pay attention to details or makes careless mistakes in schoolwork, work, or other activities
· difficulty sustaining attention in tasks
· often does not follow through on instructions, fails to finish work (schoolwork, chores, etc.)
· often has difficulty organizing tasks and activities
· often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort
· often loses things necessary for tasks or activities (assignments, pens, pencils, books, etc)
· often easily distracted by extraneous stimuli
· often forgetful in daily activities
hyperactive/impulsive symptoms include (must have at least 6 or more in at least a 6 month period):
· often fidgets with hands or feet or squirms in seat
· often leaves seat in classroom or other situations where remaining seated is expected
· often runs about or climbs excessively in situations where it isn’t appropriate (in older children or adults can be feelings of restlessness)
· often has difficulty playing or engaging in leisure activities quietly
· often “on the go”, like a “machine or motor”
· often talks excessively
· often blurts out answers before questions have been completed
· often has difficulty awaiting turn
· often interrupts or intrudes on others
What should you do if you suspect your child has ADHD?
You should seek an evaluation either with your child’s primary care physician (pediatrician) or a child and adolescent psychiatrist. The clinician will interview you, the child, and often will send you home with questionnaires to be filled out both by yourself (the parents) and by the child’s teachers. If a medication is recommended often repeat questionnaires are used to assess whether the treatment is effective.
What are the various treatment options for ADHD?
It is important to seek treatment once you suspect your child may have ADHD to prevent further complications associated with ADHD (such as substance abuse, depression, and anxiety disorders). Medications and therapy are the current modalities of treatment we have for children with ADHD. Stimulant medications are typically used for treatment of ADHD (Adderall, Ritalin, concerta, Dexedrine, etc.) other medication options include: atomoxetine, wellbutrin, clonidine, tenex. It is important to discuss with your child’s physician the benefits, risks, and alternatives with the different treatment options. Some therapy options include: parent education and training, behavioral modification, cognitive behavioral therapy, and relaxation techniques. Children with ADHD often need increased parental support. Parents can implement a reward system, help them with organization and time management, provide clear directions and establish reasonable expectations.
References:
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC.
Pliszka S; AACAP Work Group on Quality Issues. Practice parameter for the assessment and treatment of children and adolescents with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry. 2007 Jul;46(7):894-921.
What is ADHD?
Attention deficit hyperactivity disorder (ADHD) is often misunderstood in the Asian culture. Often Asian parents believe a child who may be inattentive, hyperactive, or impulsive are misbehaving and require increased discipline. This belief however can be detrimental to a child with ADHD as ADHD is associated with a higher risk other mental illnesses such as oppositional defiant disorder/conduct disorder, anxiety disorders, depressive disorders, and substance abuse. The sooner the child is identified and treatment is initiated the better the outcome.
How is the diagnosis of ADHD made?
The diagnosis of ADHD is made when problems with hyperactivity, inattention, and/or impulsiveness are beyond the normal range with regards to the child’s development and age. The symptoms must be present for at least six months, the symptoms are present before the child is 7 years old, there must be clear impairment in at least two settings (school, work, social, etc.). The symptoms of ADHD fall into two general catagories: inattention and hyperactivity/impulsivity. Children can have one set of symptoms or both.
Inattentive symptoms include (must have at least 6 or more in at least a 6 month period):
· failing to pay attention to details or makes careless mistakes in schoolwork, work, or other activities
· difficulty sustaining attention in tasks
· often does not follow through on instructions, fails to finish work (schoolwork, chores, etc.)
· often has difficulty organizing tasks and activities
· often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort
· often loses things necessary for tasks or activities (assignments, pens, pencils, books, etc)
· often easily distracted by extraneous stimuli
· often forgetful in daily activities
hyperactive/impulsive symptoms include (must have at least 6 or more in at least a 6 month period):
· often fidgets with hands or feet or squirms in seat
· often leaves seat in classroom or other situations where remaining seated is expected
· often runs about or climbs excessively in situations where it isn’t appropriate (in older children or adults can be feelings of restlessness)
· often has difficulty playing or engaging in leisure activities quietly
· often “on the go”, like a “machine or motor”
· often talks excessively
· often blurts out answers before questions have been completed
· often has difficulty awaiting turn
· often interrupts or intrudes on others
What should you do if you suspect your child has ADHD?
You should seek an evaluation either with your child’s primary care physician (pediatrician) or a child and adolescent psychiatrist. The clinician will interview you, the child, and often will send you home with questionnaires to be filled out both by yourself (the parents) and by the child’s teachers. If a medication is recommended often repeat questionnaires are used to assess whether the treatment is effective.
What are the various treatment options for ADHD?
It is important to seek treatment once you suspect your child may have ADHD to prevent further complications associated with ADHD (such as substance abuse, depression, and anxiety disorders). Medications and therapy are the current modalities of treatment we have for children with ADHD. Stimulant medications are typically used for treatment of ADHD (Adderall, Ritalin, concerta, Dexedrine, etc.) other medication options include: atomoxetine, wellbutrin, clonidine, tenex. It is important to discuss with your child’s physician the benefits, risks, and alternatives with the different treatment options. Some therapy options include: parent education and training, behavioral modification, cognitive behavioral therapy, and relaxation techniques. Children with ADHD often need increased parental support. Parents can implement a reward system, help them with organization and time management, provide clear directions and establish reasonable expectations.
References:
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC.
Pliszka S; AACAP Work Group on Quality Issues. Practice parameter for the assessment and treatment of children and adolescents with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry. 2007 Jul;46(7):894-921.