In recent years, Attention Deficit Hyperactivity Disorder (ADHD) has been a subject of great public attention and concern. Children with ADHD-one of the most common of the psychiatric disorders that appear in childhood-can't stay focused on a task, can't sit still, act without thinking, and rarely finish anything. If untreated, the disorder can have long-term effects on a child's ability to make friends or do well at school or work. Over time, children with ADHD may develop depression, poor self-esteem, conduct disorders, problems with relationships, substance abuse, and other emotional problems. Therefore proper diagnosis and treatment is imperative. The causes of ADHD vary according to various resources, it is well known that there is a neurobiological link, as well as a connection to heredity.

• ADHD affects an estimated 4.1 percent of youths ages 9 to 17 in a 6-month period.
• About 2 to 3 times more boys than girls have ADHD.
• Children with untreated ADHD have higher than normal rates of injury.
• ADHD often co-occurs with other problems, such as depressive and anxiety disorders, conduct disorder, drug abuse, or antisocial behavior.
• Symptoms of ADHD usually become evident in preschool or early elementary years. The disorder frequently persists into adolescence and occasionally into adulthood.

Diagnosis and Treatment

Effective treatment depends on appropriate diagnosis of ADHD. A comprehensive medical evaluation of the child must be conducted to establish a correct diagnosis of ADHD and to rule out other potential causes of the symptoms. There are various checklists for rating ADHD symptoms that ideally are scored by the parents, the teachers as well as clinicians in diagnosing the disorder. Research has shown that certain medications, stimulants in most cases, and behavioral therapies that help children with ADHD control their activity level and impulsiveness, pay attention, and focus on tasks are the most beneficial treatments. Stimulants commonly prescribed for ADHD include methylphenidate (Ritalin(r)), dextroamphetamine (Dexedrine(r)), and amphetamine (Adderall(r)). These medications work by stimulating the part of the brain that is not allowing the child to focus or stay on task. Like all medications, those used to treat ADHD do have side effects and need to be closely monitored. Research shows that psychotherapy as well as biofeedback techniques can be very helpful to treat ADHD.

Problems Faced by Families

Parents need to carefully evaluate treatment choices when their child receives a diagnosis of ADHD. ADHD treatment implications take a concerted effort to combine medication use, psychotherapy, behavior modification techniques, support systems, and school approach. To overcome barriers to treatment, parents may want to look for mental health practitioners and school-based programs that have a team approach involving parents, teachers, school psychologists, other mental health specialists, and physicians. Tips for parents include the following:

• Seek current information on ADHD (CHADD listed below is a helpful resource with current information and local support groups)
• Seek a professional evaluation and treatment
• Seek to be your child's advocate
• Seek parent training for strategies to use with your child
• Seek assistance from your child's school district to develop strategies for academic and social success
• Seek support for yourself
• Support your child by telling your child that you love them unconditionally

Research Findings

Brain imaging

using a technique called magnetic resonance imaging (MRI) has shown that differences exist between the brains of children with and without ADHD. Research shows that ADHD tends to run in families, so there are likely to be genetic influences. Children who have ADHD usually have at least one close relative who also has ADHD. And at least one-third of all fathers who had ADHD in their youth has children with ADHD. Even more convincing of a possible genetic link is that when one twin of an identical twin pair has the disorder, the other is likely to have it too. Of all the drugs used to treat psychiatric disorders in children, stimulant medications are the most well studied. A 1998 Consensus Development Conference on ADHD sponsored by the National Institutes of Health and a recent, comprehensive scientific report confirmed many earlier studies showing that short-term use of stimulants is safe and effective for children with ADHD.

In December 1999, NIMH released results that indicate that the use of stimulants alone is more effective than behavioral therapies in controlling the core symptoms of ADHD-inattention, hyperactivity/impulsiveness, and aggression. In other areas of functioning, such as anxiety symptoms, academic performance, and social skills, the combination of stimulant use with intensive behavioral therapies was consistently more effective. (Of note, families and teachers reported somewhat higher levels of satisfaction for those treatments that included the behavioral therapy components.)

National Institute of Mental Health (NIMH)
Office of Communications and Public Liaison
Public Inquiries: (301) 443-4513
Media Inquiries: (301) 443-4536
E-mail: nimhinfo@nih.gov
Web site: http://www.nimh.nih.gov

Child and adolescent mental health information:
http://www.nimh.nih.gov/publicat/childmenu.cfm

Children and Adults with Attention Deficit Disorder (CHADD)
8181 Professional Place, Suite 201
Landover, MD 20785
Phone: 301-306-7070 and 800-233-4050
Fax 301-306-7090 web: www.chadd.org

Learning Disabilities Association of America
4156 Library Road
Pittsburgh, PA 15234
Phone: 412-344-0224 web: http://Idanatl.org/

The National Attention Deficit Disorder Association (ADDA)
P.O. Box 972
Mentor, OH 44061
Phone: 440-350-9595 fax:440-350-0223 web: www.add.org

National Center for Learning Disabilities
381 Park Ave South, Suite 1401
New York, NY 10016
Phone: 212-545-7510 fax: 212-545-9665
website: www.ncld.org

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