Truly, there is no denying the energy and short attention spans of children. But when does this signal a problem? Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children. And according to the Centers for Disease Control, 9.4 percent of American children ages two to 17 have it. So we asked Annette Rothman, APRN with Renown Health, to answer some common questions about it.
What are some symptoms?
The core symptoms include poor attention, impulsivity and hyperactivity.
How do you differentiate ADHD from your kid just being a kid?
Explicitly, symptoms of ADHD will be causing a strain in all aspects of your child’s life – at home, school and in other settings. With this in mind, ADHD symptoms are present for at least six months.
What are the types of ADHD?
There are three types of the disorder that fall under the ADHD umbrella.
1. ADHD Combined Presentation including symptoms of poor concentration, impulsivity and hyperactivity. This is most common in males.
2. ADHD Inattentive Presentation includes symptoms of poor attention. This type is common in females. I describe them as the “quiet strugglers.” As a result, they may not be on a teacher’s radar, while those with hyperactive symptoms are. These kids are easily distracted and forgetful. They might have a hard time keeping focused.
3. ADHD Hyperactive-Impulsive Presentation includes only hyperactive or impulsive symptoms, without inattention. For this reason, these children will be in constant motion and fidget excessively. This is the least common presentation of ADHD.
What causes it?
For the most part, ADHD is hereditary. Overall, 70-80% of cases are genetically transmitted. In fact, close relatives often have the symptoms.
Other risk factors include:
- Maternal alcohol intake during pregnancy.
- Smoking during pregnancy. In fact, the most important way to prevent ADHD is by avoiding maternal nicotine use during pregnancy.
- Premature birth.
- Low apgar score after birth (method summarizing a newborn’s health based on Appearance, Pulse, Grimace, Activity, Respiration)
- Lead exposure.
Is it more prevalent in the last few years or are we better at diagnosing it?
The incidence of ADHD is similar globally. It is diagnosed by clinical interview and/or observation. Surprisingly, no psychological tests are available to confirm the diagnosis. With this in mind, an accurate diagnosis is key. Many times other medical or mental health diagnoses can mimic it.
What treatment options are available for children?
Using multiple methods of treatment (multimodal) is generally best. These include:
- Treatment without medications. This includes cognitive behavioral therapy, with evidence-based education about the diagnosis, including organizational skills training.
- Medications can often be helpful. The gold standard treatment medications are the psychostimulants.
- Requesting accommodations at school, home and work, can also help your child succeed.
What about the first FDA-approved medical device for children with ADHD?
In April 2019, the FDA approved the first non-drug, medical device to treat ADHD. The system is called Monarch external Trigeminal Nerve Stimulation (eTNS). It is a prescription-only device to treat patients with ADHD from ages 7-12 years old, not taking a prescription medication. It works by delivering a small electrical impulse via a patch on the child’s forehead. As a result, signals are sent to parts of the brain relating to ADHD.
What long-term impact do symptoms have?
For some, ADHD can present moderate to severe life impairment. If left untreated, frequency of abusing substances goes up two to threefold. Also the chance of car accidents and contracting STDs also increases twofold. There are other challenges including: self-esteem struggles (depression), anxiety, problems at home, low grades, relationship problems and work concerns.
Ways to help your child
- Enroll them in organizational skills training and cognitive behavioral therapy.
- Provide a nutritious diet rich in proteins.
- For the school years, apply for a 504 Plan (developed to ensure a child with a disability identified under the law attending an elementary, or secondary educational institution, receives accommodations to ensure their academic success) or an IEP (Individualized Educational Plan).
- Request your child sit in the front of the classroom to help avoid distraction.
- Complete homework in a quiet setting free from interruptions.
- Supplement with omega-3 fatty acids, as they have some evidence of being beneficial.
- Limit screen time. Excessive screen time trains the brain to be distracted.