ADHD – A Lifetime of Distractions…

What is AD (H)D?  A common neurobehavioral condition… it’s neither a mindset you can “snap out of” nor a behavior you can “slap out of” anyone. Defined as developmentally inappropriate level of inattention, coupled with hyperactivity or impulsivity before the age of 7 years, resulting in clinically significant functional impairment in 2 or more settings. Symptoms need to be present for at least six months, can change with age and can be life-long.

What causes it?  Children with ADHD do not make enough chemicals in key areas in the brain that are responsible for organizing thought. Research shows a genetic link in ADHD.

Is ADHD a Learning Disability (LD)?  ADHD and LD are 2 different kinds of challenges, but they do often come together. Other disorders that accompany ADHD are: Oppositional Defiant Disorder (ODD) /Conduct Disorder (CD)/ Anxiety/Depression/ Bipolar and Tourettes Disorder… otherwise known as co-morbidities which may be seen in 50% -90% of patients with ADHD.

How common is ADHD? The world wide prevalence is 5.2% as uncovered by a Brazilian research team. Found to be more common in boys.

Things that don’t cause ADHD?  Bad parenting/ too much or too little sugar/ food colourings and additives/ food allergies/ lack of vitamins.

How is ADHD diagnosed?   There is no test to diagnose ADHD. Recognition of the core symptoms of ADHD by parents and teachers (i.e. Inattention, hyperactivity, impulsivity) should prompt evaluation by a Paediatrician. The diagnosis requires that a child meet the DSM-ΙV criteria.

How is ADHD treated?   Medication is the most powerful, single treatment, but choice of medication, behavioral therapy or combination depends on the nature of the child’s problems.  Behavioral intervention may decrease dose of medication required. Medication may make it easier to implement a successful behavioral program. Medication would include psychostimulants i.e. Methyphenidate (Ritalin,Concerta) or non-stimulants i.e. Atomoxetine (Straterra). Recent studies indicate that stimulants do not contribute to risk for later substance abuse or dependance.  In fact, treatment with stimulants may lower this risk. Many other treatments, although widely used, are not effective with ADHD (eg.  Restricted Diets). Because ADHD is a chronic condition, a long term plan that includes goals for your child should be in place. Regular feedback and monitoring is essential in order to maximize efficacy of medication, target outcomes, and adverse effects. NB! You may feel desperate for a “silver bullet” that will cure your child. Some alternative treatments may sound reasonable but if they are not scientifically proven, you risk spending time, money and hope on false promises.

Tips for parents of kids with ADHD:                                                                                                                                                       

1) Focus on your child’s good qualities.

2) Tell your child what you want them to do instead of what you don’t want them to do.

3) Provide immediate, constructive feedback often, throughout the day (brief, specific and descriptive)

4) Ensure regular meals and healthy snacks.

5) Ensure Vigorous exercise.

6) Watch them more closely for impulsive behavior to ensure safety.

7) Ensure good sleep routine.

8)Help with social and communication skills

9)Be consistent

10) Make a schedule.

11) Simple house rules (rewards and punishments).

12) Homework routine.

“Everybody is a Genius, but if you judge a fish by its ability to climb a tree it will live it’s whole life believing that it is stupid.” Einstein

Specialist Paediatrician                                                                                                                                                                                          Dr. Roshni Naicker                                                                                                                                  MBBCh(WITS)/DCH(S.A)/FCPaed(S.A)

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