Attention Deficit Hyperactivity Disorder

By Adam Wisneski

Attention Deficit Hyperactivity Disorder is a mental disorder characterized by inattention, hyperactivity and impulsivity. The physiology of the disorder is currently unclear, but research suggests that ADHD is a result of abnormalities in the brain. Prenatal drug use, for example, could hinder brain development and lead to ADHD. The disorder can also develop after a head injury. Other scientists look to genetics to explain how a child develops ADHD.

About three to five percent of children in the United States have ADHD, which is more common in boys between the ages of six and 16. Diagnoses have increased dramatically since 1990, when more medications became available and public awareness of the disorder increased.

ADHD or not?

ADHD is difficult to diagnose due to the vagueness of the symptoms. According to the National Institute of Mental Health (NIMH), the symptoms of ADHD – inattention, hyperactivity and impulsiveness – must be present in more than one aspect of the child’s life (school, home, etc.) and be noticeable over several months. Symptoms must appear early in life – typically before age 7. Specialists diagnose ADHD by evaluating the behavioral symptoms relative to other children of the same age group. If the behaviors seem to be excessive or problematic, an ADHD diagnosis may be advisable. All children develop at different paces, and because an ADHD diagnosis is relative to other children’s behavior, children might be diagnosed incorrectly. Research shows that at least two to three children in every classroom of 30 students have ADHD.

Inattention – child appears to be daydreaming or has difficulty concentrating on one task

Hyperactivity – child feels the need to walk, run or climb around. Especially noticeable at school when the child is required to stay seated

Impulsiveness – child acts or reacts quickly without thinking

Causes

The causes of ADHD are unknown. Some doctors and neurologists speculate that genetics play a large role in its development. Research suggests that children who have at least one parent with ADHD are more likely to have ADHD as well. Poor nutrition, smoking during pregnancy and head injuries are some other causes being explored by scientists. Though no official conclusion has been drawn, researchers hypothesize that ADHD is more hereditary than a product of environmental factors. Scientific evidence has not yet shown the cause of ADHD.

Treatments

Undoubtedly, the treatment of ADHD draws the most controversy. Medication is the most popular treatment method, but little long-term research has been completed to show that ADHD drugs are safe for children. Meanwhile, consumption of ADHD in the United States has more that tripled since 1990. Americans consume about 90 percent of the World’s methylphenidate, commonly known as Ritalin. Some health professionals attribute overmedication to larger class sizes and children’s busier, more pressured lifestyles. Proponents of more natural treatments say that diet and other behavioral therapies are just as effective as medication.

Recent research by the NIMH suggests that a combination of medication and behavioral treatment is the best method of treatment. Choosing the right medication for a child can sometimes be a process of trial and error. The drug and its dosage should be adjusted to minimize side effects. Side effects may include insomnia, decreased appetite and irritability.

Stimulants are the most popular medications used to treat ADHD. Concerta, Adderol, Dexadrine and Ritalin are among the most well known. The FDA recently approved Stratterra, which is not a stimulant. Stimulants work on the neurotransmitter dopamine, while drugs like Stratterra work on norepenephrine. No research has been conducted to determine which type of drug works better or to examine the long-term effects these drugs have on children.

Psychiatrists, psychologists, behavioral pediatricians, neurologists and social workers (with proper training) can all diagnose ADHD. In any case, an experienced health professional should be consulted before medication is considered. The NIMH recommends that a health professional visit the child in different environments to observe behaviors. It also stresses the importance of follow-up counseling for any child on medication for ADHD.