ATTENTION-DEFICIT HYPERACTIVITY DISORDER

General Information

DEFINITION--A pattern of behavior in children characterized by short attention spans, impulsivity, with or without hyperactivity. It is implicated in learning disorders and estimated to affect 5-10% of school-aged children.

SEX OR AGE MOST AFFECTED--Boys are affected 10 times more than girls. The symptoms may appear at ages 4 to 7 and peak between 8 and 10.

SIGNS & SYMPTOMS

• Squirms in seat; fidgets with hands or feet.
• Unable to remain seated when required to do so.
• Easily distracted.
• Blurts out answers before a question is finished.
• Difficulty in waiting turn in games and lines.
• Difficulty in following instructions.
• Unable to sustain attention in work or play activities.
• Shifts from one uncompleted project to another.
• Difficulty in playing quietly.
• Talks excessively.
• Interrupts or intrudes on others.
• Doesn't appear to listen.
• Loses items necessary for tasks.
• Often engages in dangerous activities without considering consequences.

CAUSES--Unknown. Many theories proposed, but none proven or disproven. It is thought to be biologic.

RISK INCREASES WITH--Family history of the disorder.

HOW TO PREVENT--No preventive measures known.

What To Expect

DIAGNOSTIC MEASURES--

• Care must be taken in diagnosis and no specific test is available. Many of the behavioral problems are common to all children. Usually 8 out of 14 of above symptoms and signs should be present. Formal educational and psychological assessment is necessary.
• A social history, medical history and school reports are necessary to aid in diagnosis.

APPROPRIATE HEALTH CARE

• Doctor's treatment and counseling for parents and child.
• Behavioral and cognitive therapies. These can involve the child with self-monitoring, role playing and self-recording. These therapies focus on strategies that alter the undesired behavior. A combination of these techniques and psychostimulent medications seem to have the greatest affect on controlling the symptoms.

POSSIBLE COMPLICATIONS

• Child may not grow out of difficulties. Later problems occur such as academic failure, antisocial behavior and sometimes, criminal behaviors.
• Problems carry on to adulthood with a high incidence of personality trait disorders.

PROBABLE OUTCOME--In some cases, the behavior disappears completely at puberty. In others, hyperactivity diminishes with age. However, a great number of these children grow into troubled teenagers and adults.

How To Treat

GENERAL MEASURES--

• Help your child at home by providing a structured environment, well-defined behavior limits and consistent parenting techniques. Get professional assistance if help is needed.
• Stay in close contact with the child's teacher. Arrange for extra lessons or tutoring if the child needs help with school subjects.

MEDICATION--Your doctor may prescribe stimulant drugs (e.g., methylphenidate). They appear to have a calming affect on children with the disorder. These drugs have unpleasant side effects such as sleep disturbances, depression, headache, stomach ache, loss of appetite, and stunted growth.

ACTIVITY--Structure your child's activity to the extent possible.

DIET--Diets that remove all food additives, special elimination diets or megavitamin therapy have been suggested. Most medical research indicates these diets benefit very few children. Many parents however, report dramatic changes in behavior after this treatment. Some of the change may be attributed to the extra attention the child receives with the preparation of special meals.

Call Your Doctor If

• You believe your child has symptoms of attention deficit hyperactivity disorder.
• Symptoms don't improve, or worsen after treatment is begun.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.