Childhood ADHD

Attention-deficit/hyperactivity disorder (ADHD) can manifest in children as inattention, excessive and inappropriate physical activity, or a combination of both types of behavior. Treatments include education, psychotherapy, and stimulant medications. For some individuals, ADHD is a lifelong condition.

Causes

• According to the National Institute of Mental Health, researchers have not pinpointed any specific cause of ADHD. The condition may have a genetic origin, and children whose mothers drank alcohol or smoked during pregnancy are more likely to have ADHD. Exposure to lead and consuming large amounts of certain food colorings may also lead children to develop ADHD.

Attention Deficit Symptoms

• Children with ADHD have trouble focusing on tasks, following instructions, and sitting still when necessary. These behaviors appear in different combinations in children with ADHD. The presence of six or more of the following symptoms indicates that a child has the predominantly inattentive type of ADHD:

  • Becomes bored with a task after only a few minutes
  • Becomes confused easily
  • Daydreams frequently
  • Does not seem to listen when spoken to
  • Gets easily distracted
  • Forgets things
  • Has difficulty focusing on one thing
  • Has difficulty organizing and completing a task
  • Has trouble completing or turning in homework assignments
  • Finds it difficult to learn new things
  • Finds it difficult to process information as quickly and accurately as others
  • Loses things (e.g., pencils, toys, assignments) needed to complete tasks or activities often
  • Misses details
  • Moves slowly
  • Struggles to follow instructions
  • Switches frequently from one activity to another

Hyperactivity Symptoms

• A child who exhibits six or more of the following symptoms has the predominantly hyperactive-impulsive type of ADHD:
  • Acts without regard for consequences
  • Fidgets and squirms while seated
  • Finds it difficult to work or play quietly
  • Interrupts others' conversations and activities often
  • Constantly in motion
  • Very impatient
  • Makes inappropriate comments
  • Runs around and touches and plays with everything in reach
  • Shows emotions without restraint
  • Talks nonstop

Prevalence

• Approximately 4.5 million American children suffer from ADHD, according to the Centers for Disease Control and Prevention. Rates of ADHD are highest among boys, children whose family income falls below the federal poverty line, and white children whose first language is English. In 2003, Alabama, Kentucky, Louisiana, and West Virginia were home to largest numbers of children between the ages of 4 and 17 years who had been diagnosed with ADHD.

Treatments

• Educational and psychological treatments for ADHD focus on teaching children how to get and stay organized and complete tasks. Counseling may also be offered to help children resolve emotional problems, learn social and communication skills, and think before acting. Parents have an important role in imparting and reinforcing these lessons by creating and maintaining daily schedules, keeping the home neat and orderly, giving children clear and consistent rules and instructions, and praising children when they follow rules and complete assignments.

  The U.S. Food and Drug Administration has approved the following brand-name drug products for treating ADHD:
  • Adderall (amphetamine from Shire)
  • Concerta (methylphenidate from Ortho-McNeil-Janssen)
  • Daytrana (methylphenidate from Shire)
  • Desoxyn (methamphetamine from Lundbeck)
  • Dexedrine (dextroamphetamine from GlaxoSmithKline)
  • Focalin (dexmethylphenidate from Novartis)
  • Metadate (methylphenidate from UCB)
  • Methylin (methylphenidate from Mallinkrodt)
  • Ritalin (methylphenidate from Novartis)
  • Strattera (atomoxetine from Lilly)
  • Vyvanse (lisdexamfetamine dimesylate from Shire)

  These medications can cause anxiety, headaches, insomnia, irritability, and loss of appetite. The stimulant medications---all of them except Straterra---slightly raise a patient's risk for heart attack, stroke, and sudden death.

Prognosis

• No cure exists for ADHD, and some children continue to experience symptoms of the condition into adulthood. Based on a survey of a random sample of 966 American adults, S. V. Faraone and J. Biederman estimated in the November 2005 Journal of Attention Disorders that 2.9 percent of U.S. residents over the age of 18 years met the clinical criteria for a diagnosis of ADHD.