Attention-deficit/hyperactivity disorder (AD/HD or ADHD)
ATTENTION PARENTS AND TEACHERS! LEARN TO DEAL WITH INATTENTIVE, HYPERACTIVE & IMPULSIVE KIDS
ADHD is a disorder of the brain and behavior. It affects about 3 to 5% of children. The symptoms start before seven years of age. Global prevalence for children is approximately 5%, with wide variability dependent on research methodologies utilized in studies. Attention Deficit Hyperactivity Disorder, ADHD, is one of the most common mental disorders that develop in children. Children with ADHD have impaired functioning in multiple settings, including home, school, and in relationships with peers. If untreated, the disorder can have long-term adverse effects into adolescence and adulthood.
Symptoms:
The most common symptoms of ADHD are:
Impulsiveness:
acting before thinking of consequences, jumping from one activity to another, disorganization, tendency to interrupt other peoples’ conversations
Hyperactivity:
restlessness, often characterized by an inability to sit still, fidgeting, squirminess, climbing on things, restless sleep.
Inattention:
easily distracted, day-dreaming, not finishing work, difficulty listening.
Subtypes:
ADHD has three subtypes:
Predominantly hyperactive-impulsive
Most symptoms (six or more) are in the hyperactivity-impulsivity categories.
Fewer than six symptoms of inattention are present, although inattention may still be present to some degree.
Predominantly inattentive
The majority of symptoms (six or more) are in the inattention category and fewer than six symptoms of hyperactivity-impulsivity are present, although hyperactivity-impulsivity may still be present to some degree.
Children with this subtype are less likely to act out or have difficulties getting along with other children. They may sit quietly, but they are not paying attention to what they are doing. Therefore, the child may be overlooked, and parents and teachers may not notice that he or she has ADHD.
Combined hyperactive-impulsive and inattentive
Six or more symptoms of inattention and six or more symptoms of hyperactivity-impulsivity are present.
Most children have the combined type of ADHD
Causes
A specific cause of ADHD is not known. There are, however, a number of factors that may contribute to ADHD including genetics, diet and social and physical environments.
Genetic factors
Studies indicate that the disorder is highly heritable and that genetics are a factor in about 75% of ADHD cases. Hyperactivity also seems to be primarily a genetic condition however other causes do have an effect.
Researchers believe that a large majority of ADHD cases arise from a combination of various genes, many of which affect dopamine ( a chemical in the brain) transporters. The broad selection of targets indicates that ADHD does not follow the traditional model of a “genetic disease” and should therefore be viewed as a complex interaction among genetic and environmental factors.
Environmental factors
Environmental factors implicated include alcohol and tobacco smoke exposure during pregnancy and environmental exposure to lead in very early life. Complications during pregnancy and birth-including – premature birth-might also play a role.
Diet
Additives
Studies have found that dietary elimination of artificial food coloring and preservatives provides a statistically significant benefit in children with Sugar regulation. A number of studies have found that sucrose (sugar) has no effect on behavior and in particular it does not exacerbate the symptoms of children diagnosed with ADHD.
Omega-3 supplement
Preliminary research suggests that Omega-3 supplementation might be effective in the treatment of ADHD; however some of the studies give conflicting results.
Social factors
There is no compelling evidence that social factors alone can cause ADHD.[ Many researchers believe that relationships with caregivers have a profound effect on attentional and self-regulatory abilities. A study of foster children found that a high number of them had symptoms closely resembling ADHD, while other researchers have found behavior typical of ADHD in children who have suffered violence and emotional abuse.
Head injury
ADHD patients have been observed to have higher than average rates of head injuries, however current evidence does not indicate that head injuries are the cause of ADHD in the patients observed
Pathophysiology
One study states that a delay in development of certain brain structures like frontal cortex and temporal lobe occurs by an average of three years of age. These structures are responsible for the ability to control and focus thinking. On the other hand the motor cortex develops faster than normal. It indicates the slower development of behavioral control and faster development for advanced motor development may cause increased attention deficits and hyperactivity.
Another study states that there is unusual thinness of the cortex of the right side of the brain, accounting for about 30% of genetic risk for ADHD. Also it has been seen that this region normalizes in thickness during the teen years showing improvement in clinical symptoms
Additionally, SPECT scans found people with ADHD to have reduced blood circulation (indicating low neural activity), and a significantly higher concentration of dopamine transporters in the striatum which is in charge of planning ahead. Medications focused on treating ADHD (such as methylphenidate) work by reducing dopamine reuptake in certain areas of the brain, such as those that control and regulate concentration. As dopamine is a stimulant, this increases neural activity and thus blood flow in these areas (blood flow is a marker for neural activity).
Treatment:
Treatments can relieve many of the disorder’s symptoms, but there is no cure. With treatment, most people with ADHD can be successful in school and lead productive lives. Researchers are developing more effective treatments and interventions, and using new tools such as brain imaging, to better understand ADHD and to find more effective ways to treat and prevent it. Methods of treatment usually involve some combination of medications, behavior modifications, life-style changes, and counseling.
Lifestyle
Aerobic fitness may improve cognitive functioning and neural organization related to executive control during pre-adolescent development, though more studies are needed in this area. One study suggests that athletic performance in boys with ADHD may increase peer acceptance when accompanied by fewer negative behaviors
Medications
The most common type of medication used for treating ADHD is called a “stimulant.” Although it may seem unusual to treat ADHD with a medication considered a stimulant, it actually has a calming effect on children with ADHD. Many types of stimulant medications are available. A few other ADHD medications are non-stimulants and work differently than stimulants. For many children, ADHD medications reduce hyperactivity and impulsivity and improve their ability to focus, work, and learn. Medication also may improve physical coordination.
However, a one-size-fits-all approach does not apply for all children with ADHD. What works for one child might not work for another. One child might have side effects with a certain medication, while another child may not. Sometimes several different medications or dosages must be tried before finding one that works for a particular child. Any child taking medications must be monitored closely and carefully by caregivers and doctors.
Stimulant medications come in different forms, such as a pill, capsule, liquid, or skin patch. Some medications also come in short-acting, long-acting, or extended release varieties. In each of these varieties, the active ingredient is the same, but it is released differently in the body. Long-acting or extended release forms often allow a child to take the medication just once a day before school, so they don’t have to make a daily trip to the school nurse for another dose. Parents and doctors should decide together which medication is best for the child and whether the child needs medication only for school hours or for evenings and weekends, too. buy vyvanse online