Attention Deficit Hyperactivity Disorder (ADHD) in Children and Adolescents
ADHD is a medical condition that affects 5% to 8% of school-age children. It is characterized by a pattern of inattention and/or hyperactivity with impulsivity beyond what is expected for a child’s age. Symptoms must be present in more than one setting (for example, both at school and at home), and the symptoms must impact a child’s functioning in everyday life (socially or academically). ADHD tends to run in families, and it is not uncommon for another family member’s ADHD to be recognized after a child is diagnosed. It is important that a child receive a comprehensive evaluation by a psychologist or child psychiatrist to exclude other possible causes of the child’s symptoms as well as to evaluate for other commonly co-existing conditions such as anxiety, depression, learning disorders, and behavioral disorders.
ADHD is a very treatable condition. Early recognition and treatment of ADHD is crucial, as treatment can greatly improve a child’s quality of life and have a positive ripple effect on those around them. As a child sees himself succeeding in a variety of ways, he will have an improved self-image. In the long run, treatment of ADHD can increase academic and professional achievement as well as help individuals maintain important social relationships.
The American Academy of Pediatrics recommends behavioral therapy as first line treatment for ADHD in preschoolers (age 4 or 5). This consists of parents and/or teachers receiving training in behavior management techniques. For children age 6 and older (6 to 18 years old), a combination of medication and behavioral therapy is recommended. As children mature, therapy options expand to include executive function coaching (a.k.a. “ADHD coaching”) whereby kids learn time management and organizational strategies. Other therapies include social skills training and individual cognitive behavioral therapy (CBT). CBT is particularly important when other problems such as anxiety or depression also exist.
When treating ADHD with a medication, a stimulant will be the first medication tried in the majority of cases. Stimulants are highly effective in treating the core ADHD symptoms of inattention and hyperactivity. Counter to what one might think, stimulants do not rev up hyperactivity, but rather they enhance performance in areas of the brain involved with regulating attention and impulse control. The optimal medication and dosage will provide the greatest efficacy while minimizing side effects. Adding behavioral therapy can lead to further gains in academic performance, social skills, and emotional well-being.