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  Attention Deficit Disorder

Attention Deficit Disorder, also called ADD is a psychological disorder commonly diagnosed in early childhood, marked by chronologically inappropriate behaviors: impulsivity, inattention, and irregular activity levels. Currently, the disorder is under the umbrella of AD/HD, and the term is not used as widely as in the past. AD/HD is the most common mental disorder to develop in children.

Attention Deficit Disorder
Attention Deficit Disorder


Symptoms:

The three principal behaviors of AD/HD are hyperactivity, inattention and impulsivity. Symptoms occur early in a child’s life. These symptoms are typical at certain age levels. Therefore, it is important that a child suspected of having AD/HD be examined thoroughly by a professional with experience with AD/HD.

Symptoms appear over a course of time usually beginning with impulsiveness and hyperactivity. Inattention may not be apparent for more than a year after the first appearance of the first two symptoms. Because of common misconceptions children may be labeled, as being unable to sit still, unmotivated or worse, a discipline problem.

When these symptoms begin to impact school performance and participation, friendships or home life it is time to seek an examination by a professional. When inattentiveness is the primary symptom, AD/HD may not easily be diagnosed.

The DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders) states that there are three patterns of behavior that indicate a diagnosis of AD/HD. The three patterns of behavior are consistent inattentiveness (1), hyperactivity and impulsivity(2) (more than typical peers) or a combination(3) of the three (inattentiveness and hyperactivity and impulsivity). Therefore there are three types of AD/HD – hyperactive-impulsive type, predominately inattentive type (previously called ADD) and the combined type – both inattentive and hyperactive-impulsive symptoms.

Causes:

Many parents will question their own parenting or worse others will. Currently there is little empirical data that AD/HD is caused by social factors or parenting ability or methods. Causes have been linked to genetics, food allergies, food additives and sugar. There is no single cause for AD/HD.

AD/HD has been diagnosed in conjunction with other disorders such as learning disabilities, Tourette Syndrome, Fragile-X syndrome, Oppositional Defiance Disorder, Anxiety, Conduct Disorder and Bipolar disorder.

Diagnosis:

Diagnosis must be made by a professional with experience. According to the NIMH, diagnosis should be made by a professional such as psychiatrists and psychologists, developmental/behavioral pediatricians, or behavioral neurologists that are trained in differential diagnosis.

Regardless of the professional chosen a complete history of the child and medical exam should be performed to rule out anything that may cause AD/HD like symptoms such as

• Undetected seizures, such as in petit mal or temporal lobe seizures
• A sudden change in the child's life—the death of a parent or grandparent; parents' divorce; a parent's job loss
• Hearing problems
• Medical disorders that may affect brain functioning
• Learning disability

The specialist should look at school reports; speak with the family and educators of the child to get a complete history. A correct diagnosis will enable families to seek appropriate treatment, educational modifications and behavior management strategies.

Treatment:

Children with AD/HD need to be treated on an individual basis. There is no wholesale treatment option for AD/HD patients. Each case should be evaluated determining which medication and/or behavioral therapy will be most appropriate. The needs of the child and personal history should be the driving factors for treatment choices.

Psychiatrists and pediatricians and neurologists can prescribe medications for AD/HD treatment. Medications from the stimulant class have been used for decades. Stimulants work on the neurotransmitter dopamine. A non-stimulant drug has recently been approved by the USFDA. Strattera®, (generic name: atomoxetine) works on the neurotransmitter norepinephrine. Current evidence (and there needs to be more studies) indicates that seventy-percent of children with ADHD who take axtomoxetine show significant improvement in their symptoms.

Some children require a combination of medications. It is important to consult a physician to find the correct dosage of medication. This will require careful tracking in changes of behaviors such as focus, learning, and school work. Families and physicians should work closely with educators to monitor the child’s progress. Side effects of stimulants are related to the dosage – the higher the dose, usually more side effects appear. Common side effects are decreased appetite, increased anxiety, irritability and sleeplessness. Fluctuating appetites should be respected by family members and educators – the child should be permitted to eat when hungry and nutritional food should be available when appetites are strong.

It is important to realize that medications don’t cure AD/HD, they only remediate the symptoms. Behavioral therapy, support and counseling will help a child with AD/HD handle everyday situations and improve their self-esteem.

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