Children with Hyperactive

http://www.iium.edu.my/medicine/mahir/resources/adhd

Children with Hyperactive

ATTENTION DEFICIT-HYPERACTIVE DISORDER (ADHD)
1. What is attention deficit-hyperactive disorder (ADHD)?
ADHD a developmental disorder in which the onset of hyperactive and inattentive symptoms develop
before age 7 years old. The characteristics of ADHD are persistent activity or inattention. The core
symptom of this disorder is short attention. Due to short attention, it explains why sufferers are also
having hyperactive.

2. How diagnosis of ADHD is done?

Psychiatrists normally use DSM-IV (Diagnostic criteria by American Psychiatric Association as a guidance
in making the diagnosis. According to DSM IV, 6 or more symptoms of hyperactivity or inattention are
required. Other forms of scales that could also be used in helping the doctor to come a right diagnosis
are Parents checklist, teachers checklist and also Conners Checklist.

3. What are the signs of inattention?

Children suffer with attention deficit fail to give attention to details or make careless mistakes in
school. They also have difficulty paying attention during play. Frequently they seem not to have heard,
even they maintain eye contact.

4. What the signs of hyperactivity?

They are more active than peers of similar age and same gender. They fidget with their hands or feet
and squirm in their seats. In the classroom they often get out from their seat and intrude on other
students.

5. What are the causes of ADHD?

The cause remains unknown. Recent evidence demonstrates that patients with ADHD have metabolic
deficiencies of adrenergic amines in central nervous system, but cause of such chnges is unknown.

6. How frequent is the incidence of ADHD in children?

Generally the incidence of ADHD in population is 4% in girls and 8-10% in boys. Therefore it is obviously
more common in boys.

7. What are the treatments available for ADHD?

Treatment of ADHD includes interventions at home, school and medications. At home; parents can
organize the child with predictable environment. Bedtime, mealtimes, homework and playtime can be
scheduled. Special reward system e.g. star-chart may be useful. In school; special structured school
programme and classes schedule are beneficial. Class situation such less distractions and breaks in
between the lesions are useful.

8. Can behavioral therapy to be used to modify hyperactivity?

In most scientific reports behavioral therapy is useful. However when behavior therapy and medications
are compared, most improvements appear to result from medication.

9. What medications are helpful?

Almost all patients need morning dose and most an early afternoon dose. Medication is best targeting
the patients symptoms over 4-hour periods.

1. Methyphenidate (Ritalin) is usually started at about 0.25 mg/kg and the dose is gradually increased
to an effective level (1mg/kg). The side effects are rarely serious. Insomnia is common in early
treatment or if the dose is given late in the day. Stomach discomfort may due to sympthomimetic
effect. Minimal weight loss; recent studies have shown the growth inhibition which previously been
reported is only a delay. During school break they can have medication holiday as well to minimize
this side effect.

2. Dextroamphetamine; is twice as potent as methyphenidate.

10. What are the long term prognoses? (common question by parents)
About 30-50% has an associated learning disability. Although 1/3 may have problems like auto accidents,
divorces and job changing during childhood, 2/3 will become normal adults. 50% of children with ADHD
lose their hyperactivity in adolescence but inattention often persists into adulthood. However with
proper treatment and early intervention, better outcomes of this disorder are realistic.

11. Does the medication cause brain damage or addiction to my child? (common question by parents)
The answer is defenitly not.

12. What will happen if I refuse to give medication to my kid? (common question by parents)
The kid will not be able to concentrate in his classes and eventually in a long run he/she will have
learning delay.

Regards

Dr Ramli Musa
http://www.kidzgrow.com.my/forum/viewthread.php?tid=168

Attention Deficit Hyperactivity Disorder - ADHD

What is ADHD?

Attention-deficithyperactivity disorder (ADHD) is a medical condition characterized bydifficulties with

inattention or hyperactivity and impulsivity.

Symptomsof inattention, or hyperactivity and impulsivity must be severe enoughto cause impairment
in the daily functioning of the person in at leasttwo settings: at home, in school, in the community or
in the workplace.

ADHDis a serious public health problem. Sufferers have higher rates ofother psychiatric and
behavior disorders and are at greater risk forproblems in academic performance, career attainment
and accidentalinjury.

TheU.S. Surgeon General, the American Medical Association (AMA), theAmerican Psychiatric
Association, the American Academy of Child andAdolescent Psychiatry (AACAP), the American
Psychological Associationand the American Academy of Pediatrics (AAP), among others,
allrecognize ADHD as a valid disorder.

Priorto the age of 5, ADHD symptoms may be difficult to accurately diagnose,because many
preschoolers are highly active and prone to being easilydistracted and overly impulsive. As the
young child gets older,problems with hyperactivity, inattention, or impulsivity tend to standout, gaps
in school performance become clearer, and problems withbehavior or learning become more of
concern to parents and teacherscausing referrals to health providers and educators to determine if
aproblem with ADHD exitis.

Prevalence of ADHD
Inthe United States, ADHD affects about seven percent of the population.However, ADHD exists
throughout the world. Children with ADHD have beenidentified in every country in which this
condition has been studied.ADHD is three to five times more common in boys than girls.

ADHDused to be thought of as a childhood disorder with symptoms diminishingduring adolescence

and outgrown by adulthood. We now realize that, moreoften than not, children with ADHD continue
to exhibit the disorderthrough adolescence and into adult years. The lack of consensus on thecriteria
and procedures for the diagnosis of ADHD in adults impedes ourunderstanding of the prevalence of
this condition in the adultpopulation. Adult prevalence has been estimated between two to
fourpercent.
ADHDcan have a profound effect on a persons quality of life. Children andadolescents with the
disorder often have difficulty with socialization,school performance and behavior. Adults with ADHD
can exhibit problemsin college, in the work force and in social relationships. Failure toperform as
well as others can lead to problems with self-esteem,anxiety and depression.

Healthcare professionals have been diagnosing and treating children andadolescents with ADHD for
dozens of years. In fact, almost half thereferrals to mental health practitioners in schools, clinics or
privatepractices are to treat children and adolescents who have problemsrelated to inattention,
hyperactivity, or impulsivity. Earlyidentification and proper treatment can improve the quality of life
forthose with ADHD leading to improved school and work performance, socialadjustment and
success in accomplishing ones goals.

Problems with Self-Regulation

ADHDaffects a persons ability to regulate behavior and attention. Studentswith ADHD often have
problems sustaining attention, controllinghyperactivity and managing impulses. The brain is
responsible forself-regulationplanning, organizing and carrying out complex behavior.These are
called executive functions of the brain. Executivefunctions refer to the variety of functions within the
brain thatactivate, organize, integrate and manage other functions (Barkley,2005; Brown, 2005,
Cooper-Kahn et al., 2008).

Difficultiesin self-regulation exist to some degree in everyone. Many people haveexperienced

problems with concentration. Sometimes it's a result ofbeing tired, bored, hungry or distracted by
something. We have all hadtimes when we were overly restless or hyperactive, we couldn't sitstill
and pay attention, became overly impatient, or too easily excitedand too quick to respond. Does this
mean we all have ADHD? No. althoughproblems with self-regulation are found in everyone from
time to time,these problems are far more likely to occur in people with ADHD. Andthey lead to
significant impairment in ones ability to function athome, in school, at work or in social situations.

Types of ADHD
TheDiagnostic and Statistical Manual of Mental Disorders (DSM IV-TR),published by the American
Psychiatric Association in 2000, provideshealth[size=-1]careprofessionals with the criteria that need
to be met to diagnose aperson with ADHD. To receive a diagnosis of ADHD, a person must exhibita
certain number of behavioral characteristics reflecting eitherinattention or hyperactivity and
impulsivity for at least six months toa degree that is maladaptive and inconsistent
with developmentallevel. These behavioral characteristics must have begun in childhood,must be
evident in two or more settings (home, school, work, community)and must not be due to any other
mental disorder such as a mooddisorder, anxiety, learning disability, etc.

There are three types of ADHD. Some children with ADHD show symptoms of inattention and are
not hyperactive or impulsive. Others only show symptoms of hyperactivity-impulsivity. Most,
however, show symptoms of both inattention and hyperactivity-impulsivity.

Predominantly inattentive type

Predominantly hyperactive-impulsive type
Combined type
Whilethe term ADHD is the technically correct term for either of the threetypes indicated above, in
the past, the term attention deficit disorder(ADD) was used, and still is by many. For the past ten
years ADD andADHD have been used synonymously in publications and in public policy.

References

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders
DSM-IV-TR (4th ed.). Washington, DC: Author.

Barkley, R.A. (2005). Attention-Deficit Hyperactivity Disorder: A handbook for diagnosis and
treatment. (3rd ed.) New York: Guilford Press

Barkley, R. A. (2005). ADHD and the nature of self-control. New York: Guilford Press.

Brown, T. E. (2005). Attention deficit disorder: The unfocused mind in children and adults. New
Haven,CT: Yale University Press.

Brown, T.E. (2000) [size=-1]Attention-deficit disorders and comorbidities in children, adolescents,

and adults. Washington, D.C.: American Psychiatric Press, Inc.

International Consensus Statement on AD/HD. January 2002. Clinical Child and Family Psychology
Review, 5 (2), 89-111.

Jensen,P.S., & Cooper, J.R. (2002). Attention Deficit HyperactivityDisorder: State of science best
prac-tice. New Jersey: Civic ResearchInstitute.

Johnston, C. (2002) TheImpact of Attention Deficit Hyperactivity Disorder on Social andVocational

Functioning in Adults. In P.S. Jensen & J.R. Cooper(Ed.), Attention Deficit Hyperactivity Disorder:
State of the science best practices (pp 6-1 6-16) New Jersey: Civic Research Institute, Inc.

Recommended Reading

Barkley, R. A. (2000). Taking charge of ADHD. The complete authoritative guide for parents.New
York: Guilford Press.

]Brown, T.E. (2000). Attention-deficit disorders and comorbidities in children, adolescents, and
adults. Washington, D.C.: American Psychiatric Press, Inc.

Brown, T. E. (2005). Attention deficit disorder: Theunfocused mind in children and adults. New
Haven,CT: Yale University Press.

Cooper-Kahn, J., & Dietzel, L. (2008). Late, Lost, and Unprepared: A parents guide to helping
children with executive functioning. Maryland: Woodbine House.

Hallowell, E., & Ratey, J. (1994). Driven to distraction. New York: Pantheon Books

Nadeau, K. G., & Quinn, P. (2002) Understanding women with AD/HD. Silver Spring, MD:
Advantage Books.

Parker, H.C. (2005). The ADHD workbook for parents. Plantation, FL: Specialty Press, Inc.

Solden, S. (2002). Journeys through ADDulthood. New York: Walker & Company.
Internet Resources

Centers for Disease Control and Prevention (NCBDDD)

CDCs National Center on Birth Defects and Developmental Disabilities

http://www.rightdiagnosis.com/a/attention_deficit_hyperactivity_disorder/stats-
country.htm#extrapwarning

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