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Attention Deficit Hyperactivity Disorder (ADHD)

Additional information about child and adolescent ADHD is available from:

National Institute of Mental Health

American Academy of Child & Adolescent Psychiatry

For information on treatments for ADHD that are available through CARE-NET, see Studies.

 

  

What is ADHD?

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common chronic health conditions and mental disorders affecting school-aged children. Prevalence is reported to be 4 to 12% in community samples of children in the U.S., with a conservative estimate being 3 to 5 % of school-aged children. Boys are approximately three times more likely to be affected than girls. The diagnosis refers to a family of related chronic neurobiological disorders that interfere with an individual’s capacity to regulate activity level, inhibit behavior, and attend to tasks in developmentally appropriate ways. Signs and symptoms of ADHD are typically present during the preschool period or in the early elementary school years, and the diagnosis requires that difficulties were present at or before age 7 years and create problems or impairment in at least two areas of the child’s life (e.g., at school, on the playground, on the bus, at home, or socially with peers).

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Symptoms

Children with ADHD may fit into three common patterns:

  • predominantly inattentive type (30 to 40%)
  • hyperactive-impulsive type (10%)
  • combined type (50 to 60%).

ADHD children who are predominantly inattentive (most common in girls) have the some or all of the following symptoms:

  • difficulty focusing on particular tasks
  • may skip from one uncompleted activity to another
  • be easily distracted by seemingly irrelevant stimuli
  • avoid tasks requiring focused attention
  • have difficulty following directions and completing tasks such as homework
  • fail to pay attention to details
  • make careless mistakes, seem disorganized
  • "spacey” or “dreamy”
  • lose or forget things like books, homework, and assignments.
  • complain of being “bored”, yet may have no trouble paying attention to activities that they find exciting or really enjoy

ADHD children who are hyperactive have some or all of the following symptoms:

  • seem to be “on the go” or in constant motion
  • appear restless or fidgety
  • have difficulty remaining seated
  • run or climb in situations where sitting or quiet behavior is expected
  • have difficulty thinking before they act, often without apparent regard to the consequences of their actions
  • may blurt out answers or inappropriate comments at school
  • intrude upon or interrupt others
  • have difficulty waiting in line or taking turns

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Treatment

Evidence continues to accumulate that ADHD is quite treatable (Greenhill et al., 2003). The Report of the Surgeon General on Mental Health considers support and education of parents and appropriate pharmacologic intervention to be the cornerstones of treatment, along with appropriate school placement (U.S. Department of Health and Human Services, 1999). AAP guidelines suggest that primary care clinicians (PCCs) should:

  • establish a treatment program within their practice that recognizes ADHD as a chronic condition and provides necessary education about the condition to patients and their families

  • collaborate with parents and educational professionals to establish realistic target outcomes or treatment goals to guide management

  • recommend initial treatment with stimulant medication and/or behavioral management

  • reevaluate the original diagnosis, treatment plan, and adherence to treatment should the initial approach to management prove unsuccessful, as well as reassess the potential impact of comorbid conditions

  • provide systematic follow-up consisting of monitoring both target outcomes and adverse effects of treatment using data provided from the child, parents, and teachers (American Academy of Pediatrics, 2001).  

There are three ways to treat ADHD.  They are:

  • Medication

  • Behavioral Treamtment

  • A combination of medication with behavioral treatment

Consult with your PCC to determine the best type of treatment for your child.

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