A Parent’s Guide to Understanding ADHD
What is ADHD?
ADHD stands for Attention Deficit Hyperactivity Disorder. It is one of the most common neurodevelopmental disorders of childhood. There are three different types of ADHD depending on the symptoms.
Predominantly Inattentive Presentation
Predominantly Hyperactive-Impulsive Presentation
Combined Presentation
Because symptoms can change over time, the presentation may change over time as well.
ADHD is a chronic condition of the brain that makes it difficult to control behavior. Boys are more than twice as likely as girls to be diagnosed with ADHD. Children with ADHD often have trouble getting along with others and struggle with school work. If left untreated, ADHD in some children will continue to cause serious, lifelong problems such as poor grades in school, run-ins with the law, failed relationships and the inability to keep a job.
What are the symptoms?
According to the DSM 5 TR, in order to be diagnosed with ADHD the symptoms have to be present for at least 6 months and they have to have six or more of the following symptoms for children up to 16 years or five or more for those 17 years and older and adults.
Predominantly Inattentive Presentation
Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or with other activities.
Often has trouble holding attention on tasks or play activities.
Often does not seem to listen when spoken to directly.
Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., loses focus, side-tracked).
Often has trouble organizing tasks and activities.
Often avoids, dislikes, or is reluctant to do tasks that require mental effort over a long period of time (such as schoolwork or homework).
Often loses things necessary for tasks and activities (e.g. school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones).
Is often easily distracted
Is often forgetful in daily activities.
Predominantly Hyperactive-Impulsive Presentation
Often fidgets with or taps hands or feet, or squirms in the seat.
Often leaves the seat in situations when remaining seated is expected.
Often runs about or climbs in situations where it is not appropriate (adolescents or adults may be limited to feeling restless).
Often unable to play or take part in leisure activities quietly.
Is often “on the go” acting as if “driven by a motor”.
Often talks excessively.
Often blurts out an answer before a question has been completed.
Often has trouble waiting their turn.
Often interrupts or intrudes on others (e.g., butts into conversations or games)
Combined Presentation
This presentation is given if there are enough symptoms of both criteria for inattention and hyperactivity-impulsivity over the last 6 months.
In addition to the above, the symptoms must be present before the age of 12 years. The symptoms must be present in two or more settings. (home, school, with friends, or in other activities). And there is clear evidence that the symptoms interfere with, or reduce the quality of social, school or work functioning.
Executive functioning is impaired with ADHD due to the frontal lobe of the brain being “sleepy”. You may notice with your child that they are unable to organize their schoolwork, backpack or room. They will struggle with time management and their ability to plan things. They will struggle with emotional regulation and struggle with sustaining motivation, even with preferred tasks.
How do you get your child tested?
The first step is to talk to your child’s health care provider about your concerns. They will go over the symptoms with you and see if your child fits the criteria. The diagnosis can be made by a mental health professional, like a licensed therapist, a psychiatrist or clinical psychologist, primary care provider or pediatrician. There is also comprehensive neuropsychological testing that can assess your child’s executive functioning (the brain functions that get impaired with ADHD).
Once the diagnosis is confirmed, the outlook for most children who receive treatment is encouraging. While there is no specific cure for ADHD, there are many treatment options available.
What different treatments are available?
There are a few treatments available for ADHD and depending on the child and how severe the symptoms are, you may need to use several of them at once.
Therapy:
Therapy can be beneficial to helping the child learn how to control impulses, work on paying attention and build social skills. Behavior therapy is the most common used for children with ADHD. Oftentimes, parents will be asked to participate to learn strategies that they can use with the child at home.
Medication:
For many people ADHD medication will reduce all of the symptoms and oftentimes is the best and fastest way to treat ADHD. There are several different types of medication that are available as well. Usually, doctors will start off with a stimulant. Although it seems unusual to treat ADHD with a stimulant it is very effective. Researchers believe that the stimulants are effective because they increase the brain chemical dopamine, which plays an essential role in thinking and attention.
Non-Stimulants are also an option but tend to take longer to start working than stimulants. They do help with improving focus, attention and impulsivity.
The last type of medication used are antidepressants. However, they are not approved by the FDA to specifically treat ADHD. They are used mostly with adults and affect the brain chemicals norepinephrine and dopamine.
For some parents, they are worried about giving their child medication and them turning into a “zombie”. However, research shows that when the child is on the right medication, they are able to fully be themself and let their personality shine. Anytime you are intruding medication into the mix it does take time to find the right one or combination. So it’s important to be patient with the process and not give up if one or two don’t work.
Occupational Therapy:
OT can help your child with improving certain skills, such as, organization, physical coordination, ability to do everyday tasks and control their “energy” levels.
Parenting Training:
Parenting training will revolve around the parent learning different ways to help their child’s behavior such as creating a routine, managing distractions, limiting choices, effective disciplining and using goals and praise or rewards. Often time, especially with younger children, changing how the parent approaches their child and their daily life can do wonders.
Again, oftentimes a parent will need to use more than one of the above methods to help their child manage their ADHD symptoms. ADHD is completely manageable and doesn’t need to be something that stops your child from learning or being successful at life. While ADHD continues into adulthood, helping your child develop their strengths, structure their environment and using medication when needed, adults with ADHD can lead very productive lives.