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Signs, Diagnosis And Treatment – Forbes Health

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It is estimated that more than 9% of children in the US have been diagnosed with attention-deficit/hyperactivity disorder (ADHD), making it one of the most common neurodevelopmental disorders in childhood. Parents and caregivers may notice kids with ADHD struggling to complete everyday tasks, being unable to sit still or appearing forgetful or absentminded.

Characterized by a pattern of inattention and hyperactivity/impulsivity, ADHD can sometimes interfere with everyday functioning and development—especially in kids. Here’s what you need to know about this mental health condition, including treatment options and some telltale signs it may be time to seek professional help.

What is ADHD?

ADHD is a neurodevelopmental condition linked to difficulty paying attention, poor impulse control and restless behavior. While most commonly diagnosed in childhood, it’s considered a chronic, life-long condition, with rates of adult diagnoses increasingly being reported.

Often used interchangeably with attention-deficit disorder (ADD), ADHD is actually the encompassing term for anyone who has been diagnosed with symptoms including inattentiveness, hyperactivity and difficulty concentrating. This change was made in 1987 by the American Psychiatric Association (APA). While the term ADD may still be used by some to describe non-hyperactive ADHD types, clinicians typically defer to the ADHD label, says Chloe Haaza Sica, Psy.D, a psychologist in Ambler, Pennsylvania.

What Can Cause ADHD in Children?

While the exact causes of ADHD are unknown, current research is exploring the link between ADHD and risk factors such as:

  • genetics
  • Prior brain injury
  • In utero exposure to environmental hazards, like lead, drugs or alcohol
  • Preterm birth
  • Low birth weight

There isn’t enough evidence to support the causational link between ADHD and lifestyle factors such as sugar intake or screen time, or environmental ones including poverty or family dysfunction, according to the Centers for Disease Control and Prevention (CDC). While these factors may exacerbate symptoms of ADHD in children, the current research does not find them to be a root cause of the disorder.

What Are the Different Types of ADHD?

Many may look at the symptoms of ADHD and consider it an all-encompassing condition, but there are three distinct subtypes within the disorder, according to the CDC. These include:

  • Predominantly Inattentive Presentation: Task management may be a struggle. Children in this category often have trouble concentrating and following instructions, and may appear forgetful or absent-minded.
  • Predominantly Hyperactive-Impulsive Presentation: Children living with this type appear physically restless and constantly active. They may have trouble sitting still for long or waiting their turn in conversations. They often exhibit impulsive, reckless behaviors and are more prone to accidents and injuries.
  • Combined Presentation: For children living with a combined presentation, they exhibit traits of both the inattentive and hyperactive-impulsive types in equal measure.

ADHD Symptoms in Children

Symptoms of ADHD typically begin before the age of 6, occur in more than one setting (at home and at school) and disrupt daily functioning or development, underlines the National Health Service. Symptoms may vary between types, research notes, with the following symptoms being the most prominent:

Intense presentation

  • Inability to focus
  • Easily distracted
  • Often forgetful or absentminded
  • Difficulty completing time-consuming tasks and/or jumping from task to task
  • Difficulty following instructions
  • Makes frequent mistakes
  • Difficulty listening
  • Struggles with organization
  • Frequently misplaces things
  • Avoids tasks that require focus

Hyperactive Presentation

  • Physically overactive, often climbing, squirting or running
  • Trouble sitting still, prone to fidgeting
  • Is often talking and/or has difficulty taking turns in conversation
  • Difficulty focusing on tasks
  • Impulsive, sometimes reckless behavior
  • Prone to interrupting others
  • Struggles to engage in tasks quietly

ADHD Symptoms in Children vs Adults

While once thought of as a childhood diagnosis, ADHD is increasingly diagnosed in adults as well. However, the common symptoms of adult ADHD are often easy to miss, as they can be much more subtle in adults than children — especially if an adult has learned to compensate for certain lifelong symptoms.

Some of the more common signs of adult ADHD are:

  • Feelings of self-doubt and being overwhelmed
  • Lack of attention to detail
  • Difficulty with focus and organization
  • forgetfulness
  • Restlessness and often feeling ‘on edge’
  • A quick temper
  • Frequently interrupting others
  • Making frequent small mistakes
  • Taking unnecessary risks

For individuals who were diagnosed with ADHD in childhood, they may find their symptoms change as they mature. Often, signs of hyperactivity and impulsivity decrease with age, while symptoms of inattentiveness can last a lifetime. Adults with ADHD may also develop coping methods over time that allow them to better manage their symptoms as they age.

How Is ADHD Diagnosed in Children?

Anyone can be diagnosed with ADHD, regardless of age or gender, says Anisha Patel-Dunn, DO, a psychiatrist in Bellevue, Washington. Similarly, triggers such as increased stress and poor sleep can vary throughout someone’s life.

Forgoing treatment for ADHD may lead to depression and anxiety, especially in children, continues Dr. Patel Dunn. This is because untreated ADHD symptoms may lead to a child feeling inadequate as they struggle to keep up with their peers, she continues.

An ADHD diagnosis can only be made by a mental health professional or a general practitioner. No single test can determine if a child has ADHD. Instead, the path to an official diagnosis includes a medical exam, a review of the patient’s history from parents and teachers and a screening for conditions that are either comorbid or present similar symptoms, such as anxiety, learning and language disorders, sleep apnea and oppositional defiant disorder. The criteria for diagnosing ADHD varies by age. According to the CDC:

  • Individuals up to 16 years old must persistently exhibit six or more symptoms for at least six months
  • Individuals age 17 through adulthood must persistently exhibit five or more symptoms for at least six months
  • Additionally, symptoms must have appeared before the age of 12, be present in two or more circumstances (such as home and school) and negatively impact the individual socially, academically or professionally

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Treating Children with ADHD

ADHD cannot be prevented, but intervening early can be hugely beneficial, says Amanda Stovall, MD, a pediatrician in Peoria, Illinois. An important piece of ADHD management is simply understanding the disorder. “When people understand how their brains function best, and can apply these skills to their study habits and job responsibilities, they can be successful,” continues Dr. Stovall.

Treatment for ADHD varies depending on a child’s age. It may include behavioral therapy, parent training and medications.

For children under 6 years oldthe American Academy of Pediatrics (AAP) recommends that treatment begins with parent training, empowering caregivers with skills and strategies to help manage their child’s behavior.

For children 12 years old and oldera combination of medications (either stimulants or non-stimulants), behavior therapy, parent training and classroom accommodations is recommended.

Consequences of Untreated ADHD In Children

The impulsivity and absent-mindedness characteristic of ADHD may put children at risk of physical injuries, mental health issues, bullying and self-harm.

“Children who go untreated for ADHD often struggle with not only their academic performance, but also socially and in the home,” says Dr. Stovall. Children may also have difficulty making and keeping friends, building self esteem and fighting feelings of insecurity, she adds. Additionally, caregivers can sometimes feel burned out and fatigued, resulting in a strained home life, Dr. Stovall says.

How Parents and Caregivers Can Support Kids with ADHD

In addition to therapy, classroom interventions and, in some cases, medication, there are plenty of ways parents and caregivers can offer support at home. Here are just some of the ways you can help your child after an ADHD diagnosis:

  • go slowly: Set reasonable expectations and encourage breaks while learning
  • Discover what works best for your child: What does your child need to enjoy learning, process information and retain facts?
  • Communicate with school: Students with ADHD may need an individualized education plan (IEP) or a 504 plan that affords them access to special programs or accommodations they need to thrive in school.

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