How is attention-deficit/hyperactivity disorder diagnosed?
ADHD is the most commonly diagnosed behavior disorder of childhood. A pediatrician, child psychiatrist, or a qualified mental health professional usually identifies ADHD in children. A detailed history of the child’s behavior from parents and teachers, observations of the child’s behavior, and psychoeducational testing contribute to making the diagnosis of ADHD. Because ADHD is a group of symptoms, diagnosis depends on evaluating results from several different sources, including physical, neurological, and psychological testing. Certain tests may be used to rule out other conditions, and some may be used to test intelligence and certain skill sets. Consult your child’s doctor for more information.
Treatment for attention-deficit/hyperactivity disorder
Specific treatment for attention-deficit/hyperactivity disorder will be determined by your child’s doctor based on:
- Your child’s age, overall health, and medical history
- Extent of your child’s symptoms
- Your child’s tolerance for specific medications or therapies
- Expectations for the course of the condition
- Your opinion or preference
Major components of treatment for children with ADHD include parental support and education in behavioral training, appropriate school placement, and medication. Treatment with a psychostimulant is highly effective in most children with ADHD.
Treatment may include:
- Psychostimulant medications. These medications are used for their ability to balance chemicals in the brain that prohibit the child from maintaining attention and controlling impulses. They help “stimulate” or help the brain to focus and may be used to reduce the major characteristics of ADHD.
Medications that are commonly used to treat ADHD include the following:
- Methylphenidate (Ritalin, Metadate, Concerta, Methylin)
- Dextroamphetamine (Dexedrine, Dextrostat)
- A mixture of amphetamine salts (Adderall)
- Atomoxetine (Strattera). A nonstimulant SNRI (selective serotonin norepinephrine reuptake inhibitor) medication with benefits for related mood symptoms.
- Lisdexamfetamine (Vyvanse)
Psychostimulants have been used to treat childhood behavior disorders since the 1930s and have been widely studied. Traditional immediate-release stimulants take effect in the body quickly, work for 1 to 4 hours, and then are eliminated from the body. Many long-acting stimulant medications are also available, lasting 8 to 9 hours, and requiring 1 daily dosing. Doses of stimulant medications need to be timed to match the child’s school schedule to help the child pay attention for a longer period of time and improve classroom performance. The common side effects of stimulants may include, but are not limited to, the following:
- Decreased appetite
- Stomach aches
- Rebound activation (when the effect of the stimulant wears off, hyperactive and impulsive behaviors may increase for a short period of time)
Most side effects of stimulant use are mild, decrease with regular use, and respond to dose changes. Always discuss potential side effects with your child’s doctor.
Antidepressant medications may also be administered for children and adolescents with ADHD to help improve attention while decreasing aggression, anxiety, and/or depression.
- Psychosocial treatments. Parenting children with ADHD may be difficult and can present challenges that create stress within the family. Classes in behavior management skills for parents can help reduce stress for all family members. Training in behavior management skills for parents usually occurs in a group setting which encourages parent-to-parent support. Behavior management skills may include the following:
- Point systems
- Contingent attention (responding to the child with positive attention when desired behaviors occur; withholding attention when undesired behaviors occur)
Teachers may also be taught behavior management skills to use in the classroom setting. Training for teachers usually includes use of daily behavior reports that communicate in-school behaviors to parents. Behavior management techniques tend to improve targeted behaviors (such as completing school work or keeping the child’s hands to himself or herself), but are not usually helpful in reducing overall inattention, hyperactivity, or impulsivity.