Childhood Mental Health: Attention Deficit Hyperactivity Disorder (ADHD)

Description

ADHD, once called hyperkinesis or minimal brain dysfunction , is one of the most common mental disorders among children. It affects 3 to 5% of all children. At least 1 child in every classroom in the United States needs help for the disorder (total estimated 2 million children). 2 to 3 times more boys than girls are affected. ADHD often continues into adolescence and adulthood, and can cause a lifetime of frustrated dreams and emotional pain.

Symptoms and Signs

ADHD can only be identified by looking for certain characteristic behaviours, and these behaviours vary from person to person. Scientists have not yet identified a single cause behind all the different patterns of behaviour, indeed they may never find just one. Rather, someday scientists may find that ADHD is actually an umbrella term for several slightly different disorders.
At present, ADHD is a diagnosis applied to children and adults who consistently display certain characteristic behaviours over a period of time.
The most common behaviours fall into three categories: inattention , hyperactivity , and impulsivity .

• Inattention . According to the DSM , signs of inattention include becoming easily distracted by irrelevant sights and sounds; failing to pay attention to details and making careless mistakes; rarely following instructions carefully and completely; losing or forgetting things like toys, or pencils, books, and tools needed for a task.
• Hyperactivity. Children who are hyperactive always seem to be in motion. They can't sit still. According to the DSM diagnostic criteria, some signs of hyperactivity include: feeling restless, often fidgeting with hands or feet, or squirming; running, climbing, or leaving a seat, in situations where sitting or quiet behaviour is expected.
• Impulsivity. Children who are overly impulsive seem unable to curb their immediate reactions or think before they act. According to the DSM diagnostic criteria, some signs of impulsivity include: blurting out answers before hearing the whole question; having difficulty waiting in line or for a turn.

Diagnosis and Treatment

Diagnosis is based on the symptoms presented according to the DSM criteria. Because everyone shows some of these behaviours at times, the DSM contains very specific guidelines for determining when they indicate ADHD. The behaviours must appear early in life, before age 7, and continue for at least 6 months. In children, they must be more frequent or severe than in others the same age. Above all, the behaviours must create a real handicap in at least two areas of a person's life, such as school, home, work, or social settings. So someone whose work or friendships are not impaired by these behaviours would not be diagnosed with ADHD. Nor would a child who seems overly active at school but functions well elsewhere.

For decades, medications have been used to treat the symptoms of ADHD. Three medications in the class of drugs known as stimulants seem to be the most effective in both children and adults. These are methylphenidate (Ritalin), dextroamphetamine (Dexedrine or Dextrostat), and pemoline (Cylert). For many people, these medicines dramatically reduce their hyperactivity and improve their ability to focus, work, and learn. The medications may also improve physical co-ordination, such as handwriting and ability in sports.
However, these medicines don't cure the disorder, they only temporarily control the symptoms. For lasting improvement, numerous clinicians recommend that medications should be used along with treatments that aid in these other areas. Many experts believe that the most significant, long-lasting gains appear when medication is combined with cognitive-behavioral therapy, emotional counselling, psychotherapy, social-skills training, parenting-skills training and practical support.

For an excellent booklet on this subject, contact the source for this page.

The information in this page is presented in summarised form and has been taken from the following source(s):
1. National Institute of Mental Health: http://www.nimh.nih.gov