Attention: help for children with ADHD

ADHD usually shows itself in the preschool or early school years, and it’s marked by hyperactivity, a poor attention span and impulsive behavior. If your child has these problems on a continuing basis (more than just the “back-to-school” fidgets), a visit with your pediatrician may be in order.

Try as you might, you can’t make your son finish his homework. The view out the window beckons, and he keeps breaking his pencil point and playing with the cat. Every two minutes he’s up and running around.

He may have attention-deficit/hyperactivity disorder (ADHD), a neurobehavioral condition that, according to a 2007 study, affects nearly 9 percent of American children. ADHD usually shows itself in the preschool or early school years, and it’s marked by hyperactivity, a poor attention span and impulsive behavior. If your child has these problems on a continuing basis (more than just the “back-to-school” fidgets), a visit with your pediatrician may be in order.

“Basically, ADHD is diagnosed behaviorally, based on reports about the child—and, if the child is older, it can include self-reports,” says Barbie Zimmerman-Bier, M.D., chief of Developmental and Behavioral Pediatrics at The Children’s Hospital at Saint Peter’s University Hospital. It’s not just the blackboard and the school books that can offer a clue, she says. Sometimes social problems, too, can point to ADHD. “Kids might be missing some social cues because they’re inattentive or daydreaming,” she says.

When a child is evaluated for ADHD, says Dr. Zimmerman-Bier, doctors investigate his or her nutritional health and how much and how well he or she is sleeping. Some clinicians evaluate whether the child displays abnormalities in brain-wave patterns.

It’s important to rule out other conditions that may be causing the problem and “masquerading” as ADHD. In 2002, a Mayo Clinic study found that at least 50 percent of those diagnosed with the condition really had other problems instead of or in addition to ADHD—such as dyslexia, depression, anxiety, central auditory processing disorders (trouble filtering out background noise and focusing on hearing what’s important) and Asperger’s syndrome, a kind of autism marked by difficulty in responding to social cues.

Treatment for ADHD usually starts with behavioral interventions—tutoring, resource room or parental action to enforce an improvement in diet, leisure activities and sleep habits. But sometimes these interventions are not enough, says Dr. Zimmerman-Bier.

If behavioral changes don’t bring improvement, medications may be needed. These come in two basic classes: nonstimulants such as atomoxetine (Strattera) and guanfacine (Intuniv) and stimulants such as methylphenidate (Ritalin) and amphetamine salts (Adderall). These medications raise the levels of certain neurotransmitters present in the brain, making distraction less likely. But ADHD medications may also have temporary side effects such as weight loss, sleep difficulties or a slowing in growth. So you and your doctor should weigh the pros and cons of medications carefully.

“The treatment of ADHD depends greatly on the child’s own medical history,” explains Dr. Zimmerman- Bier. “What’s right for one child may not be right for another.”

To learn more about ADHD . . .

Consult these sources:
National Institute of Mental Health; www.nimh.nih.gov/health/topics/attention-deficit-hyperactivitydisorder-adhd/index.shtml
Centers for Disease Control and Prevention; www.cdc.gov/ncbddd/adhd/
National Resource Center on AD/HD, a program of Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD); 800-233-4050; www.help4adhd.org