What is attention deficit hyperactivity disorder

Introduction

Attention deficit hyperactivity disorder is a condition in which the child is inattentive or hyperactive. Inattentive refers to kids having difficulty focusing as they are distractive in nature. Hyperactive are children who are inpatient. They cannot sit for long periods during school hours and often get up and walk in the classroom.

Statistics

This disorder affects around 3% to 5% of school-age children. It is twice as common in boys as in girls.

Causes

No single cause has been identified for this disorder. It is caused by both genetic and environmental factors. Genes play a more important role.

Clinical features

The behaviors that are common in ADHD include
  • Inattentiveness
  • Impulsive behavior
  • Hyperactivity

An inattentive child has trouble listening at school, is careless and easily distracted. They might also have difficulty staying focused and are often forgetful and loose things.

An impulsive child might hardly be able to wait for his turn in school while playing games. They may push or interrupt others.

Hyperactive children are fidgety and have trouble being quiet. They're often restless and do things like running around and climbing on furniture.

Effects

If the child has any symptoms of ADHD it is required that the parents pay close attention to the safety of the child. These children are more prone to accidents and hurt themselves frequently They tend to have conflicts with their peers and behave aggressively.

Diagnosis

Diagnosis of ADHD is largely clinical based on the observed signs and symptoms. The following guidelines confirm a diagnosis of ADHD

  • Symptoms occur in 2 or more settings, such as home, school, and social situations, and cause some impairment
  • Symptoms significantly impair the child's ability of daily activities such as schoolwork, relationships with siblings and friends.
  • Symptoms start before 12 years of age
  • Symptoms have continued for more than 6 months.

In addition to signs and symptoms diagnosis might also involve a physical and neurological examination

Treatment

Behavioural therapy should be initiated in children younger than 6 years. Medications are considered in moderate to severe ADHD and individuals unresponsive to behavioral therapy.

Medication that remain as a mainstay treatment for children with ADHD (6 yrs and older) includes:
Stimulants

Are among the first line agents for children with ADHD. The most commonly used compounds include methylphenidate and amphetamine based formulations.

Atomoxetine

Atomoxetine has been shown to be effective in children with ADHD and concomitant anxiety. This drug reduced anxiety while improving ADHD symptoms. Atomoxetine causes significant reduction in the anxiety and ADHD scores.

Tricyclic antidepressants

The tricyclic antidepressants such as Imipramine are also effective in controlling abnormal behaviors and improving cognitive impairments associated with ADHD. This drug is particularly useful when other FDA approved agents have failed and when anxiety or depressive symptoms co-occur with ADHD.

Other medications used for ADHD

  • Antidepressants (Bupropion, Trazodone)
  • Atypical antipsychotics (Risperidone, Aripiprazole)
  • Mood stabilizers (Carbamazepine)

These drugs are used when Stimulants, Atomoxetine, or Tricyclic antidepressants are ineffective for treating ADHD.

Non pharmacologic therapy

  • Parental training
  • Cognitive behavioral therapy
  • Contingency training

Prevention

This condition is primarily genetic in nature so primary prevention is not possible. However certain envirnomental measures while you are pregnant can decrease the risk of a child born with ADHD.

This includes
  • Avoid smoking or drinking while you are pregnant
  • Eat a well balanced healthy diet
  • Regular physical activity
  • Minimize your stress levels (yoga, meditation)

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