What is ADHD?
Attention-Deficit/ Hyperactivity Disorder (ADHD) is a medical condition that affects a person's ability to regulate behavior and attention. ADHD is characterized by inattention, impulsivity and hyperactivity.
Researchers believe genetics play a large role in ADHD. Due to developmental and genetic factors that affect biochemical and metabolic function, 30 to 40 percent of children diagnosed with ADHD have relatives with the disorder. Recent advances in technology have allowed researchers to study the brain structure and functions more closely, revealing that the brains of children with ADHD differ from those of children without the disorder.
How Common is ADHD Among Children and Adolescents?
According to the National Institutes of Health (NIH), ADHD is one of the most common mental disorders among children. Today, ADHD affects approximately 3 to 5 percent of the school-age population - approximately one million children in the U.S. have ADHD - with boys diagnosed three to four times more often than girls. While boys are more likely to show signs of hyperactivity, girls with ADHD typically exhibit symptoms of inattention.
How is ADHD Diagnosed in Children and Adolescents?
Physicians or mental health professionals with appropriate training in treating ADHD are the best sources to obtain a proper diagnosis. Using the Diagnostic and Statistical Manual of Mental Disorders (DMS-IV) published by the American Psychiatric Association, health care professionals review criteria to evaluate a person with ADHD. A child must exhibit symptoms before the age of seven and within at least two settings (e.g. in school and at home). The criteria for diagnosing ADHD also requires that symptoms of inattention and/or hyperactivity-impulsivity have persisted for at least 6 months and that they are more frequent and severe - to the point of impairment - than typically observed in individuals at a comparable level of development.
How is ADHD Treated?
According to newly released guidelines for the treatment of ADHD, issued by the American Academy of Pediatrics, primary care clinicians should establish a treatment program that recognizes ADHD as a chronic condition. If appropriate, the clinician should recommend behavior therapy and/or stimulant medication to improve specific symptoms in children with ADHD.1 The combination of these two main types of treatment is often recommended as a total treatment program.
A total treatment program requires a coordinated effort among many people, including the child, the family, the school, physicians, and other health-care professionals. This approach includes parent education and training in ADHD, behavior management techniques, an appropriate school environment, family counseling, and medication.
There are more than 200 studies showing that stimulants, such as methylphenidate, are the most effective medications for managing the symptoms of ADHD. These medications are effective in decreasing impulsivity and hyperactivity, and increasing attention. Approximately 70 to 80 percent of children and adults with ADHD respond positively to medication.
The latest treatments for ADHD offer longer duration symptom control throughout the day. Twelve-hour, once-daily dosing is also available providing children and adolescents the option of taking medication once in the morning before school while benefiting from consistent symptom management through after-school activities, homework and family time.
Why Should Children and Adolescents with ADHD be Treated?
Left untreated, children with ADHD can suffer academically and experience behavioral, social and emotional problems through adulthood. Untreated ADHD is a significant risk factor for substance use disorders in adolescents. Adolescents treated for ADHD with medication reduced the likelihood of substance abuse by 85 percent.
How Does ADHD Affect the Social Development of Children and Adolescents?
Each component of ADHD places strain on social adjustment and achievement. Inattention to detail and distractibility contribute to poor performance in school, and in any activity that requires concentration. Impulsive responding can be seen in frequent interruptions, rude statements, and careless actions that annoy others and lead to social rejection. As adolescents, people with ADHD can drift to social contacts with other rejected kids who sometimes take an antisocial and conduct disordered stance. In sum, this is not a benign condition, so careful treatment and planning are required.
1. American Academy of Pediatrics (AAP). "AAP Releases New Guidelines For Treatment of Attention-Deficit/Hyperactivity Disorder," October 1, 2001 (news release published in the October issue of Pediatrics, the peer-reviewed scientific journal of AAP)
2. MTA Cooperative Group. (1998, October). A 14-month Randomized Clinical Trial of Treatment Strategies for Attention-Deficit/Hyperactivity Disorder. Paper presented at the annual meeting of the American Academy of Child and Adolescent Psychiatry, Anaheim, CA.
3. Biederman J, Wilens TE, Mick E, Faraone S, Spencer T: Protective effects of ADHD pharmacotherapy on subsequent substance abuse: A longitudinal study. Pediatrics 1999; 104(2); 20