Healthy Minds

Emotional Growth

Attention Deficit Hyperactivity Disorder (ADHD)

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental disorders of childhood. It is usually first diagnosed in childhood and often lasts into adulthood.

Children with ADHD may have trouble paying attention, controlling impulsive behaviors (may act without thinking about what the result will be), or be overly active.

It is normal for children to have trouble focusing and behaving at one time or another. However, children with ADHD do not just grow out of these behaviors. The symptoms continue and can cause difficulty at school, at home, or with friends.

There are three different types of ADHD, depending on which types of symptoms are strongest in the individual.

Type 1: Inattention/Distractibility

  • Careless
  • Easily distracted
  • Avoid tasks requiring sustained attention
  • Difficulty concentrating and learning in school
  • Often doesn’t seem to listen
  • Struggle to follow instructions
  • Can’t organize
  • Loses important items
  • Forgetful in daily activities

Child must have 6 or more symptoms for > 6 months

Type 2: Hyperactivity/Impulsivity

Hyperactivity

  • Squirms and fidgets
  • Can’t stay seated, restless
  • Runs/climbs constantly
  • Can’t play/work quietly
  • “On the go”/ “Driven”
  • Talks excessively
  • Difficult sleeping

Impulsivity:

  • Blurts our answers
  • Can’t wait for turns
  • Grab things from people
  • Intrude/interrupts others
  • May have more accidents/injuries

Child must have 6 or more symptoms for > 6 months

Type 3: Combined Presentation

Symptoms of the above two types are EQUALLY present in the person. Because symptoms can change over time, the presentation may change over time as well.

Diagnosis

There is no “blood test” or single test to diagnose ADHD. Deciding if a child has ADHD takes a several step process.

One step of the process involves having a medical exam, including hearing and vision tests, to rule out other problems with symptoms like ADHD.

Another part of the process may include: parent and teacher questionnaires, clinical observations, school observations and standardized tests to administer to child.

Treatment

Behavior therapy for young children: Training for parents

The 2011 clinical practice guidelines from the American Academy of Pediatrics (AAP) recommend that behavior therapy is the first line of treatment for preschool-aged children (4-5 years of age) with ADHD.

Parent training in behavior therapy has the most evidence of being effective, but teachers and early childhood caregivers can use behavior therapy in the classroom as well.

Why should parents try behavior therapy first, before medication?

Behavior therapy is an important first step because:

  • Behavior therapy gives parents the skills and strategies to help their child.
  • Behavior therapy has been shown to work as well as medication for ADHD in young children.
  • Young children have more side effects from ADHD medications than older children.
  • The long-term effects of ADHD medications on young children have not been well-studied.

The Agency for Health Care Research and Quality (AHRQ) conducted a review in 2010 of all existing studies on treatment options for children younger than 6 years of age.

The review found enough evidence to recommend parent training in behavior therapy as a good treatment option for children under 6 with ADHD symptoms and for disruptive behavior, in general.

The review also identified four programs for parents of young children with ADHD that reduced symptoms and problem behaviors related to ADHD:

  • Triple P (Positive Parenting Program)
  • Incredible Years Parenting Program
  • Parent-Child Interaction Therapy
  • New Forest Parenting Programme

Acknowledgement:

The information in this page is adapted from Centers for Disease Control and Prevention.