Symptoms and Treatment of ADHD

For some of us, Attention Deficit Hyperactivity Disorder, or ADHD, may be an excuse for bad behavior in kids. But a new survey finds that doctors not only regard ADHD as a serious impairment to development and learning, they also consider it under-diagnosed in half of the children who have the disorder.

The survey polled teachers, parents and grandparents of children diagnosed with ADHD, adults diagnosed with the disorder, and a sampling of physicians who treat children.

Dr. Peter Jensen, director of the center for the advancement of children's mental health, professor of child psychiatry at Columbia University talks to us about the symptoms of ADHD and the treatment.

Interview with Dr. Peter Jensen

Formerly associated with the National Institutes of Health (NIH), Dr. Jensen was involved in one of the largest studies of ADHD, which was run by the NIH. Those findings were released about 9 months ago. In short, the report said there is a great deal of confusion over what the disorder is and that reaching a proper diagnosis and treatment is critical but requires great attention, more than having parents fill out a checklist of symptoms. It also underscored that both parents and children feel that there's a stigma attached to seeking treatment for "bad behavior." The NIH found that the treatment that worked best was properly prescribed medication and a very specific type of behavioral therapy.

What is ADHD

ADHD is a combination of symptoms of inattention and motor hyperactivity and impulsiveness that cannot be explained from normal causes. ADHD affects 3% to 5% of school aged children. There are substantial genetic factors. If you have identical twins and one has ADHD, the likelihood is that the other has an 80% chance of having it. The rate is clearly increased if one parent has the disorder, and the risk is increased even more if other family members have ADHD as well.

Diagnosis: need to first establish its presence, persistence and severity over time. Then rule out everything else. ADHD creates of profile of symptoms that has an early onset. It has a cluster of symptoms that creates a pattern of behavior that causes persisting impairment.

ADHD in Girls

Girls are probably more under-diagnosed than boys because they tend not to exhibit the hyperactivity symptoms of the disorder. They are more passive, dreamy, and removed. When they are diagnosed, it's several years later than boys. They have their own share of the inattentive symptoms but it's the hyperactive symptoms that get a child noticed. You can be zoning ou and get away with it. When you get to the adult years, the ratio between males and females with the disorder is equal, in childhood, boys are three to five to six time more likely to be diagnosed with the disorder than girls.

ADHD in Adults

Until about 10 years ago, it was thought that ADHD ended in adolescence or adulthood. Since then it has become clear that while the hyperactivity may end, other symptoms persist in some individuals and are exacerbated by layers of emotional difficulties that have been added to the core symptoms over time. There is often great anxiety about failing, depression, moderately increased risk of alcoholism and substance abuse. "I find that when you talk with a person who has ADHD and they describe the impact on their lives, it's heartbreaking," says Jensen. "Adults tell you they grew up being alled stupid, silly, airhead, ditz, and that those labels became self-fulfilling prophecies."

Symptoms in adults:

Needing to read things over and over
Procrastinating, putting off certain tasks
Difficulty conversing over any type of background noise or voices
Hard to engage, sustain attention, focus
Losing things you need for work
Failing to finish projects
Difficulty doing more than one thing
Difficulty organizing one's work
Losing train of thought in speaking
Not listening to someone you are talking to
Accidentally throwing things away
Daydreaming
Difficulties keeping conversation going
Failing to hear people speaking
Forgetting what you went to another part of the house for
Forgetting what you wanted when you walk into store
Interrupting others, blurting out answers

The study proved to us that despite the confusion and misinformation surrounding this disorder, all who were polled considered it a serious condition and one that could have far ranging impact on children's development and future. Experts recognize the seriousness of the problem.

Treatment

One of the keys to good treatment is the doctor/teacher connection. The child's self-esteem is being built in school. Parent/teacher feedback to the doctor is key in assessing the child's progress. Medication and treatment should be tailored to each child's needs. Despite the consensus that Ritalin, the drug that treats ADHD, is over-prescribed, we have no evidence of that. We cannot find meaningful negative effects either, other than some appetite suppression in children.

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