“This Child Needs Help”
Attention Deficit Hyperactivity
Disorder
Many childhood mental illnesses escape
notice, but children with attention deficit hyperactivity disorder (ADHD) are
often the subject of great concern on the part of parents and teachers.
Children with ADHD---the most common of the psychiatric disorders that appear
in childhood---can’t stay focused on a task, act without thinking, can’t sit
still, and rarely finish anything. If untreated, the disorder can have long-term
effects on a child’s ability to make friends or do well at school or work. Over
time, children with ADHD may develop depression, lack of self-esteem, and other
emotional problems.
# Experts
estimate that ADHD affects 3 to 5 percent of school-age children.
# ADHD affects
two to three times as many boys as girls.
# Children with
untreated ADHD have higher than normal rates of injury.
# ADHD
frequently co-occurs with other problems, such as depression and anxiety
disorders, conduct disorder, drug abuse, or antisocial behavior.
Treatments
Research has shown that certain
medication, stimulants in most cases, and behavioral therapies that help
children sit still, pay attention, and focus on tasks are the most beneficial
treatments for children with ADHD.
Problems Faced by Families
ADHD can be reliably diagnosed when
appropriate guidelines are used. Ideally, a health care practitioner making a
diagnosis should include input from parents and teachers. But some health
practitioners make a diagnosis without all this information and tend to either
overdiagnose the disorder or underdiagnose it. Despite data showing that
stimulant medication is safe, there are widespread misunderstandings about the
safety and use of these drugs, and some health care practitioners are reluctant
to prescribe them. Like all drugs, the medications used to treat ADHD do have
side effects and need to be closely monitored.
Given the controversy in the health care
community, parents need to think carefully about treatment choices when their
child receives a diagnosis of ADHD. And when they pursue treatment for their
children, families face high out-of-pocket expenses because treatment for ADHD
and other mental illnesses is often not covered by insurance policies. In
schools, treatment plans are often poorly integrated. In addition, there are
few special education funds directed specifically for ADHD. All this leads to
children who do not receive proper and adequate treatment. To overcome these
barriers, parents may want to look for chool-based programs that have a team
approach involving parents, teachers, school psychologists, other mental health
specialists, and physicians.
Recent Research Findings
Magnetic resonance imaging research has
shown that the brains of children with ADHD differ from those of children
without the disorder. In addition, there appears to be a link between a
person’s ability to pay continued attention and the use of glucose--the body’s
major fuel---in the brain. In people with ADHD, the brain areas that control attention
use less glucose and appear to be less active, suggesting that a lower level of
activity in some parts of the brain may cause inattention.
Research shows that ADHD tends to run in
families, so there are likely to be genetic influences. Children who have ADHD
usually have at least one close relative who also has ADHD. And at least
one-third of all fathers who had ADHD in their youth have children with ADHD.
Even more convincing of a possible genetic link is that when one twin of an
identical twin pair has the disorder, the other is likely to have it too.
Data from 1995 show that physicians
treating children and adolescents wrote six million prescriptions to
stimulants---methylphenidate (Ritalin), dextroamphetamine (Dexedrine), and
pemoline (Cylert). Of all the drugs used to treat psychiatric disorders in
children, stimulant medications are the most well-studied. A 1998 Consensus
Development Conference on ADHD sponsored by the National Institutes of Health
and a recent, comprehensive scientific report confirmed many earlier studies
showing that short-term use of stimulants is safe and effective for children
with ADHD. Evidence is mounting that suggests stimulants are more effective
than behavioral therapies in controlling the core symptoms of ADHD---inattention,
hyperactivity/impulsiveness, and aggression. But the addition of behavioral
treatments seems to result in improved functioning, in terms of better social
skills and higher academic achievement. More studies are needed to assess the
combination of medication and behavioral therapies and to examine the long-term
use of stimulant medication.
For more information about Mental Illnesses - Contact:
The National Alliance on Mental Illness
NAMI of Greater
Chicago
1536 West Chicago Ave, Chicago, IL
60622
Phone: 312-563-0445