If a child cannot learn the way I teach, then I must teach the way he learns.
--Anna Gillingham, educator and psychologist

Wednesday, October 16, 2013

ADHD Awareness

October is ADHD Awareness month so we thought it was only fitting to take the opportunity to discuss ADHD in further detail with all of you. So let's get started:
 
What is ADHD?
ADHD is characterized by hyperactivity, inattention and/or impulsivity. Most children demonstrate some level of inattentiveness, hyperactivity and impulsivity so the real question is when does that become a problem to the extent that they may be diagnosed with ADHD? Just because a child is more hyperactive or demonstrates a shorter attention span than their peers does not mean they have ADHD. Typically if a child has trouble in one setting but not another, such as school vs. home, they are likely struggling with something other than ADHD. A child with ADHD typically demonstrates symptoms indiscriminately based on their environment [1].
Prevalence
ADHD is the most commonly diagnosed behavioral disorder among children. Approximately 1 in every 10 children between the ages of 4-17 has been diagnosed with the disorder at some point in their life [2]. ADHD is more common in boys than girls and symptoms tend to vary based on gender. Boys are typically more hyperactive while girls more frequently demonstrate inattentiveness [1].
Causes
The causes of ADHD are largely unknown, but it is thought to be caused by interactions between genetics and environment. Factors such as blood relatives with ADHD, exposure to environmental toxins, maternal drug, alcohol or tobacco use during pregnancy, maternal exposure to poisons, and premature births are all thought to increase the risk of a child developing ADHD [1].
3 Types of ADHD
ADHD is typically characterized by three main symptoms including an inability to focus, hyperactivity and impulsivity. Based on symptoms, ADHD diagnoses have been characterized even further into three main categories [3]:
Inattentive type (Inability to focus well)
·         Lacks attention to important details

·         Makes careless mistakes on homework, tests, or various other tasks

·         Difficulty maintaining attention

·         Shifts from task to task without completing anything

·         Doesn’t seem to listen when spoken to

·         Easily distracted

·         Gets bored easily

·         Has trouble with organization

·         Frequently daydreams

·         Difficulty following directions

·         Slow to understand information
Hyperactive-impulsive type (hyperactivity & impulsivity)
·         Fidgets and squirms in seat

·         Difficulty staying seated or sitting still

·         Runs around or climbs excessively in situations where it is not appropriate

·         Talks excessively

·         Forgetful

·         Difficulty doing quite tasks (reading, etc)

·         Touches everything

·         Impatient

·         Blurts out comments at inappropriate times
Combined type
·         Shows signs of both Hyperactive-impulsive and Inattentive types
Some may outgrow ADHD, some never will and for others the symptoms merely change with age.
Risks
The implications of ADHD are often greater than merely the symptoms that accompany the disorder. Children with ADHD [1]:
·         Frequently face academic challenges and embarrassment from academic difficulties

·         Tend to have more accidents and injuries than their peers

·         Often face social challenges such as appropriate social behaviors and peer acceptance.

·         Tend to struggle with low self-esteem

·         Are at an increased risk for substance abuse
Testing
Only health care professionals can test for and diagnose an individual with ADHD. For a proper diagnosis, doctors will typically rule out other conditions that may result in similar symptoms including hearing impairments, sleep disorders, mood disorders, etc. [1]. ADHD is frequently accompanied by at least one other condition such as anxiety, a learning disability, or depression [1,3]. In some cases, symptoms become visible in children as young as 2 or 3 years old, however it is difficult to accurately diagnose such young children.
Treatment
ADHD can be effectively treated with counseling, medicine and support. Medications do not cure patients with ADHD, however they do allow individuals to better manage their symptoms. Every child requires a unique approach and not every child responds to medications so treatment plans tend to vary. Early diagnosis and treatment can be important to ensure your child successfully learns strategies to lessen the severity of symptoms.
Common stimulant drugs to address ADHD include Adderall, Focalin, Concerta, Ritalin, Daytrana, and Metadate. These drugs typically function by balancing and enhancing neurotransmitters and the way nerve cells interact, allowing children to focus better. Common non-simulant drugs include Strattera [1]. Non-stimulant drugs are typically not quite as effective as stimulant drugs, however they typically result in fewer side effects. Other options include high blood pressure medicines and antidepressants.
Therapy is also commonly used to address ADHD. With behavioral therapy, parents try to enforce behavioral alterations through rewards or withholding privileges [1,3]. Other strategies include psychotherapy, parenting skills training, family therapy and social skills training [1].
It is important to generate a positive, supportive home environment for children struggling ADHD. It is necessary to show children plenty of affection, highlight their strengths, take time to enjoy time with them, find ways to improve their self-esteem (such as art projects, etc), work on organization, use simple words when giving directions, try to maintain a regular schedule, identify difficult situations, make sure the child is rested and be patient [1]!
Alternative treatments that have been tried, but are not yet scientifically proven include yoga or meditation, special diets, vitamin or mineral supplements, herbal supplements, proprietary formulations, essential fatty acids, and neurofeedback training [1].
Is your child struggling in school as a result of ADHD?
Children struggling with ADHD frequently face challenges in the classroom setting. Ask about school programs to assist children with ADHD. A few steps you can take to help your child include:
·         Have your child professionally tested and get the diagnosis in writing

·         There are federal laws in place to help support children with ADHD and similar disabilities including:

o   Section 504 of the Rehabilitation Act provides opportunities for students with ADHD such as a quiet work place, giving tests in quiet places, breaking tests into small pieces and simple, clear directions for homework. Section 504 is typically the best option for students that only require minor changes to their academic routine. This law is a civil rights law meaning its main purpose is to ensure children with disabilities are not discriminated against and that they have equal opportunities within the classroom [4].

o   The Individuals with Disabilities Education Act (IDEA) provides individualized education programs (IEP). IDEA may work best for students with more intense needs by offering a greater range of services. IDEA also offers parents a greater ability to participate in educational decisions regarding their child [4].

§  IEPs are written documents with written goals based on their level of performance and a list of services.

·         Be patient and willing to figure out what works best for your child, which may take involving teachers, counselors and various services to ensure your child receives the appropriate support to thrive in a learning and social environment. Team efforts are typically the most successful, and require good communication and support between team members.

For more information on how Laughlin Children’s Center can help with evaluations and therapy, contact the Center at 412.741.4087 or learn more at www.laughlincenter.org.

References
  1. Mayo Clinic Staff. "Definition Attention-deficit/hyperactivity Disorder (ADHD) in Children." Mayo Clinic. Mayo Foundation for Medical Education and Research, 05 Mar. 2013. Web. 11 Oct. 2013. ‘
  2. Centers for Disease Control and Prevention. Increasing Prevalence of Parent-Reported Attention-Deficit/Hyperactivity Disorder among Children - United States, 2003 and 2007. MMWR 2010;59:1439-1443.
  3. "Attention Deficit Hyperactivity Disorder." A.D.A.M. Medical Encyclopedia. National Center for Biotechnology Information, 23 Mar. 2013. Web. 11 Oct. 2013.
  4. CHADD. "What We Know: Educational Rights for Children with ADHD in Public Schools." National Resource Center on ADHD, 2012. Web. 11 Oct. 2013.

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