Attention-deficit/hyperactivity disorder (ADHD) in children

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In general, a child shouldn’t receive a diagnosis of attention-deficit/hyperactivity disorder unless the core symptoms of ADHD start early in life — before age 12 — and create significant problems at home and school on an ongoing basis.

There is no test to diagnose ADHD. However, a diagnosis may include:

Medical examination to rule out other causes of symptoms

Information such as medical records, medical histories, school records, etc.

Interviews or questionnaires with family members, teachers, or others who are familiar with your child, like caregivers, coaches, and babysitters

The American Psychiatric Association published the Diagnostic and Statistical Manual of Mental Disorders DSM-5.

ADHD Rating Scales: A tool to collect and evaluate information on your child

Diagnosing ADHD in young children

It is very difficult to diagnose ADHD in young children. It’s possible to confuse ADHD with developmental issues such as delayed language.

Children who are younger than preschool age and suspected to have ADHD will need an evaluation by a specialist. This could be a speech pathologist a developmental pediatrician, or a psychiatrist or psychologist.

ADHD and other conditions

Several medical conditions and treatments can cause symptoms similar to ADHD. Examples include:

Language or learning problems

Depression and anxiety are mood disorders

Seizure disorders

Hearing or vision problems

Autism spectrum disorder

Mental or behavioral effects of medical problems or medications

Sleep disorders

Brain injury

Treatment

Medication, behavior therapy, and counseling are all standard treatments for ADHD. They can alleviate many symptoms but do not cure ADHD. You may need to experiment a bit before you find the right treatment for your child.

Stimulant medication

At the moment, stimulant drugs are prescribed most often for ADHD. Stimulants seem to balance and boost levels of brain chemicals known as neurotransmitters. These medications can help reduce the symptoms of hyperactivity and inattention.

Examples include:

Amphetamines. These include dextroamphetamine (Dexedrine), dextroamphetamine-amphetamine (Adderall XR, Mydayis), and lisdexamfetamine (Vyvanse).

Methylphenidates. This includes methylphenidate, Ritalin, and other brands, as well as dexmethylphenidate, or Focalin.

There are stimulant drugs in both short-acting (short-acting) and long-acting (long-acting) forms. There is a long-acting patch (Daytrana), which can be worn around the hip.

It may take a while to find the right dose for your child. The dose may also need to be changed if your child experiences side effects or matures. Ask your doctor if stimulants can have side effects.

Certain health risks associated with stimulant medications

Certain research suggests that stimulant medication used to treat ADHD may increase the risk of certain mental symptoms.

Heart problems. The increased blood pressure and heart rate may be caused by stimulant medications, but the risk of adverse effects such as sudden death or serious adverse reactions is not proven. The doctor should examine your child’s heart condition and family history of heart disease before prescribing stimulant medications. They should also monitor your child while they are using stimulant medications.

Psychiatric disorders. Stimulant medication use may increase the risk of agitation, and psychotic or manic-like symptoms. If your child’s behavior changes or becomes worse, or if they see or hear things that are not real while taking stimulant medications, contact the doctor right away.

Other medications

Some other medications that can be used to treat ADHD include:

Atomoxetine (Strattera)

Antidepressants like bupropion (Wellbutrin SR and Wellbutrin XL)

Guanfacine (Intuniv)

Clonidine (Catapres, Kapvay)

Antidepressants and Atomoxetine work more slowly than stimulants and can take up to several weeks to fully take effect. These are good alternatives if your child cannot take stimulants due to health issues or if they cause severe side effects.

Suicide risk

Even though this has not been proven, there have been concerns raised about a possible slight increase in suicidal thoughts among children and teens who take antidepressants or non-stimulant ADHD medications. If you see any signs of suicidal thoughts or depression in your child, contact their doctor.

Give medications safely

Your child must take the correct amount of medication prescribed. Parents may worry about stimulants and the potential for abuse or addiction. When your child follows the doctor’s prescription, stimulant medications are safe. You should take your child to the doctor regularly to see if medication adjustments are needed.

To keep your child’s medications safe and to ensure that they get the right dose at the right time: Keep your child’s medication safe, and make sure they are getting the correct dose at the appropriate time.

Give medication carefully. Give medications carefully.

Keep your medication in a childproof container at home. Store medications out of reach of children. Overdoses of stimulant drugs can be fatal.

Do not send medication with your child to school. You can deliver any medication to the school nurse, health office, or other appropriate staff.

ADHD Behavior Therapy

Children with ADHD may benefit from counseling, parenting skills training, social skills coaching, and behavior therapy. These services can be provided by a therapist, psychologist, or social worker. Some children with ADHD also suffer from anxiety disorders or depression. Counseling can help both ADHD as well as the co-existing condition.

Some examples of therapy include:

Behavior therapy. Teachers and parents can learn strategies for changing behavior, such as timeouts and token reward systems.

Social skills training. Social skills training can be used to teach children appropriate social behavior.

Parenting skills training. It can help parents understand their child’s behaviors and develop strategies to guide them.

Psychotherapy. This is a way for older children with ADHD, who are more mature to discuss issues that concern them and explore negative behavior patterns. They can also learn how to manage their symptoms.

Family therapy. Family therapy helps parents and siblings cope with the stress that comes with living with someone with ADHD.

When teachers, parents, and therapists work together, the best results are achieved. Learn about ADHD and the services available. Refer your child’s teacher to reliable information sources to help them in the classroom.

New medical device

The U.S. Food and Drug Administration has approved a new medical tool to treat ADHD in children aged 7-12 years who do not take ADHD prescription medication. It is only available with a prescription and it is called the Monarch external Trigeminal Nerve Stimulation System (DNS).

The eTNS device is about the size of a mobile phone and can be used by parents at home when their child is asleep. The device sends signals to the child’s brain by sending low-level electrical stimulation through a wire and a patch on the forehead.

You must discuss the possible side effects, precautions, and expectations when considering eTNS. Your healthcare provider can provide you with all the information and instructions.

Continued treatment

If your child has ADHD, they should be seen by a doctor every 3 to 6 months until the symptoms are stabilized.

If your child is experiencing any side effects from medication, such as irritability or difficulty sleeping, or if their ADHD symptoms are not improving, call your doctor.

Lifestyle and home remedies

It’s difficult to give recommendations for all children because ADHD is complex, and every person with ADHD has a unique personality. Some of these suggestions can help you create an environment where your child will succeed.

Children at home

Your child will love you for it. Children need to know that they are loved and appreciated. If you only focus on the negative, it can damage your relationship with your child and negatively affect their self-esteem and confidence. A smile, a touch on the shoulder, or a hug will show your child that you care. You can praise your child for certain behaviors.

Improve your self-esteem. Art projects, dance or music lessons, and martial arts classes are often good for children with ADHD. Select activities that are suited to their abilities and interests. Children have unique talents and interests which can be developed. Self-esteem is built up by small, frequent achievements.

When giving directions to your child, use simple words and show them. Speak slowly, quietly, and with great specificity. One direction at a given time. Make eye contact before and during giving directions.

Identify difficult situations. Avoid situations that can be difficult for your child. For example, avoiding long presentations and shopping in stores or malls where the variety of products is overwhelming.

Discipline can be enforced with timeouts and other appropriate measures. Begin with a firm, loving approach that rewards positive behavior and discourages bad behavior. Your child should have a timeout that is short but long enough to allow him or her to regain control. It is important to defuse and interrupt out-of-control behavior. It is also expected that children accept the consequences of their choices.

Work on your organization. Assist your child in maintaining a daily activity and assignment chart or notebook. Also, ensure that your child has a quiet study area. Sort objects into groups and place them in designated areas in your child’s bedroom. Help your child to keep their environment uncluttered and organised.

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