ADHD (Attention Deficit Hyperactivity Disorder)

Attention Deficit Hyperactivity Disorder, most commonly referred to as ADHD is a neurological disorder, characterized by behavioral or developmental issues, most often in children. Symptoms of ADHD may persist into adulthood. Although there many ways to manage ADHD, there has been no definitive cure till date.

In most cases, children with ADHD are diagnosed when they start school. Hyperactive kids may have trouble paying attention and have difficulty controlling impulses, acting without regarding the consequences.

Although it is normal for children to have difficulty in paying attention, at some time or the other, a child with ADHD does not grow out of this behavior, causing them to fall behind in school. As a result, they may get into trouble with their teachers and may have difficult interactions with friends and family.

Signs to Look out for in Children with ADHD

Children with ADHD daydream or forget and lose their belongings often. They may be extremely restless, not being able to sit still or in one place for very long and tend to fidget and squirm when told to do so. They may have a tendency to talk too much and it may seem that they are not listening, even when spoken to directly. A hyperactive child with an impulsive nature, may take unnecessary risks and act without thinking, making seemingly careless mistakes in simple, routine tasks. He or she may be easily distracted, unable to focus or pay attention to details, which makes it difficult to complete homework or schoolwork. They may also find it tough to wait for their turn and tend to interrupt or intrude in conversations or while playing games. This may lead to them being perceived as rude or badly behaved and make social interactions, strained.

Causes of ADHD

There are ongoing studies to find out the exact cause of ADHD. Genetics has proven to be a predominant factor, however other causes like brain injury, exposure to environmental contaminants like lead, or tobacco and alcohol abuse during pregnancy, premature delivery or low birth weight have also proven to be risk factors.

Diagnosis of ADHD

It is very important that the diagnosis of ADHD be done by certified medical professionals like child neurologists, as it involves a multi-step process, ruling out other conditions which may present in similar ways like anxiety, depression, learning disabilities. The process also involves a comprehensive medical examination, including vision and audiology or hearing tests. Clinical neurologists are trained in extensive history taking from the child, parents and teachers, to establish patterns in behavior and severity of the symptoms of ADHD in order to make an accurate diagnosis. There are often two main categories of ADHD that are diagnosed, predominantly Inattentive Presentation and predominantly Hyperactive-Impulsive Presentation, or a combination of the two.

There are many scales used as diagnostic tools ,like Vanderbilt and Inclen ADHD amongst many others that help physicians to evaluate children for ADHD. The All India Institute of Medical Sciences (AIIMS) developed and validated a tool for diagnosis of ADHD, modifying the INDT-ADHD (International Clinical Epidemiology Network [INCLEN] Diagnostic Tool for Attention Deficit Hyperactivity Disorder), based on DSM-5,(Diagnostic and Statistical Manual, Fifth edition) which is the diagnostic criteria established by the AAP (American Academy of Paediatrics). The tool was modified to suit India’s socio-economic and cultural contexts.

Along with these tools,  the child’s IQ and executive functions also needs to be assessed to detect areas of strengths and weaknesses, on which therapy is based and indication for drug therapy is based.

Treatment of ADHD

In most cases, treatment of ADHD has shown good results when tackled with a combination of behaviour therapy and medication. For preschool-aged children with ADHD, awareness and training, education and engagement for parents, teachers and peers, has shown more positive results and should be tried before trying medication .Well drawn out treatment plans usually involve monitored activities, regular follow up and learning to make changes if needed, along the way and requires a multi-pronged approach, involving the child, family and school authorities. Maintaining a healthy lifestyle also has its benefits in children with ADHD,  which involves healthy eating habits, adequate exercise, limiting screen time and getting the required  amount of sleep. Specific skills like organizational training can also help.

However, under the guidance of a neurologist, medication may be advised for children with persistent or severe symptoms.

  • Stimulants, containing methylphenidate and amphetamine, increase brain levels of dopamine , a chemical neurological transmitter that helps with motivation, attention, and movement.
  • Nonstimulantsdo not work as quickly as stimulants, but can help children who do not tolerate stimulants very well. Examples are :atomoxetine, guanfacine), and clonidine.

Each group of medicines have their own side effects and must be given under the supervision of a qualified practitioner. Doses may have to be adjusted to find a balance between the benefits and side effects , in order to find a combination that works best for the child.

Disclaimer: The above information is for awareness and education purposes only and cannot be used for diagnosis or treatment of any condition. Please consult with a physician for any concerns or questions.







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