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Attention deficit hyperactivity disorder (ADHD) is a neurobehavioral disorder that manifests in higher levels of hyperactivity, impulsivity, and attentiveness than what is otherwise considered typical. While we don’t always know the exact cause, those with ADHD process hormones that regulate mood, activity levels, and decision-making differently in the brain.
As children enter into school, ADHD symptoms can become more obvious and begin to negatively affect a child’s relationships, academic performance, and other aspects of life. Instead of labeling the condition as a problem, it’s important to consider how we can help our kids be happy and healthy as they live their lives. With an accurate diagnosis and ongoing support, there are several treatment options that can help kids with ADHD to be successful at home, in school, and with peers. Here’s what you need to know.
1. ADHD symptoms may look different in boys compared to girls.
Kids with ADHD often exhibit symptoms in one of two categories. Some tend to be more hyperactive or impulsive than their peers, frequently tapping their hands or feet, squirming in their seat at mealtimes or school, or having a hard time waiting. Others tend to be more inattentive, making seemingly careless mistakes, daydreaming, or getting easily distracted.
Although ADHD affects nearly 10 percent of children in the United States, boys are twice as likely to be diagnosed. A reason for this may be that boys and girls can display different symptoms. Sometimes, boys have a tendency to exhibit more hyperactive symptoms, which may be disruptive in school settings and harder to ignore. In contrast, girls with ADHD sometimes demonstrate more inattentive symptoms, which can be easier to miss. Although this is not always the case, these differences may lead to girls being undiagnosed or not getting diagnosed until they are older.
If you suspect your child is exhibiting symptoms of ADHD, it’s important to talk to your pediatrician. Your child’s doctor can help to rule out other conditions or identify other contributing factors. If your child is diagnosed with ADHD, your pediatrician may also work closely alongside child psychologists and psychiatrists who can help to guide and support you and your family.
2. Diagnosis requires persistent symptoms in multiple settings.
Although signs and symptoms of ADHD may appear in early childhood, most kids are diagnosed around school age when the pressures and demands of school begin to create challenges. For example, children with ADHD may struggle to sit still for long periods of time in the classroom or have difficulty focusing and completing homework. When these difficulties become more obvious and begin to affect the child’s function at school or in relationships with parents, teachers, and/or peers, it may be time to talk to your pediatrician.
Diagnosis requires persistent ADHD symptoms in two or more settings for at least six months. There is no one single test that diagnoses the condition. Rather, your pediatrician will gather information to thoroughly understand your child. Your child’s doctor will likely ask questions related to your child’s:
- Birth and prenatal history
- Developmental milestones
- Medical history, as well as the family’s medical history
- Exposure to psychosocial stressors
- Experience with any new transitions (e.g., bringing a new baby home)
- And more
Your child’s teachers may also be involved in this process, given that one of the settings that a child exhibits ADHD symptoms is typically school.
A common screening tool used to help diagnose ADHD is the National Institute for Child’s Health Quality (NICHQ) Vanderbilt Assessment Scales. This rating tool screens for certain behaviors as well as other often related disorders, such as oppositional defiant disorder. If your pediatrician feels uncertain about your child’s diagnosis, they may involve other pediatricians specializing in developmental pediatrics as well as psychologists and psychiatrists to assist in making the diagnosis.
3. Lifestyle changes may help you manage your young child’s ADHD symptoms.
It’s important to know that there is no amount of sleep or special elimination diet that will cure your child’s ADHD. In fact, there is no definite cure for ADHD. However, having a healthy sleep routine and well-rounded diet is important for everyone's mood and behavior, so it’s always good to find ways to get your child to eat balanced meals and get enough sleep. And, there are many ways we can help to manage symptoms.
In our youngest populations, it’s common to begin ADHD treatment with a trial of behavioral therapy. This can help kids learn to manage environmental controls and equip their parents with tools and strategies to help their children succeed. One such strategy is to implement structure and routine, which is especially helpful for kids with ADHD. Knowing what to expect and observing similar, predictable patterns can help to alleviate tension points where kids may otherwise be distracted or forgetful. Clear, visual charts can help your child know and understand what they’re supposed to be doing which can keep them on task. For example, if your child struggles with homework, having a dedicated homework area and a checklist of things they need to do to complete their homework can help them to successfully complete it.
In addition, children with ADHD benefit from praise for the good things they are doing. Because ADHD-related behaviors can be perceived as distracting, many kids are constantly being corrected which can impact their self-esteem. Finding areas where they are successful, whether it’s music, sports, or other activities, can present opportunities for encouraging them and helping to build their confidence and self-worth.
4. Medication may be an effective treatment option for your child.
Treatment for ADHD is important. Left untreated, kids with ADHD are more likely to have higher rates of depression and anxiety, which is linked to many other comorbidities. In addition, untreated ADHD could contribute to more participation in high-risk behavior, such as speeding while driving or using illegal drugs or alcohol. A gap in school performance can also impact their future, making it harder to join the workforce or be successful in college.
Fortunately, there are various medications that have proven to be effective in kids with ADHD. The first line of medical ADHD treatment is often a stimulant medication, which can help them to do what they need to do at home and at school. These medications may be long-acting, lasting 10 to 12 hours, or short-acting, with a duration of two to four hours. However, there is no one-size-fits-all solution when it comes to medication. Often, it takes some trial and error with different kinds and doses of stimulants to determine which one will be most effective and well-tolerated.
While most kids respond well to stimulant medications, non-stimulants may also be an option for a child struggling with atypical adverse side effects. These may also be helpful for kids who have other comorbidities but this is a decision made on a case-by-case basis, as recommended by your child’s doctor.
5. ADHD treatment effectiveness should be evaluated regularly.
If your child begins taking medication, your doctor will reevaluate them every few weeks to see how well it is helping and learn whether or not your child is experiencing any unwanted side effects. Because medication works quickly, we can easily make changes to their medication regimen until we find the best medication and dosage.
As your child grows, their needs may change, so it’s important to stay connected to your pediatrician and communicate regularly about your child. For some kids, puberty can affect the way their body metabolizes medication, so a change in dosing may be necessary. Other kids with ADHD may learn to better manage their symptoms as they enter into adulthood and be able to wean off medication. All kids may still benefit from clear structure, expectations, and routine so they can learn to gradually take responsibility for themselves.
ADHD may create some hurdles for your child, but it doesn’t have to be a “problem.” ADHD is manageable, but what will work best varies by individual child. Your doctor is here to help determine what is most useful in keeping your child happy, healthy, and safe.