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Attention Deficit Hyperactivity Disorder (ADHD)

 Attention Deficit Hyperactivity Disorder (ADHD)

This image shows the comparative dopamine levels of patients with ADHD and those without (source: www.bnl.gov).

National Institute of Mental Health

Attention Deficit Hyperactivity Disorder (ADHD) is a condition that becomes apparent in some children in the preschool and early school years. It is hard for these children to control their behavior and/or pay attention. It is estimated that between 3 and 5 percent of children have ADHD, or approximately 2 million children in the United States. This means that in a classroom of 25 to 30 children, it is likely that at least one will have ADHD.

ADHD was first described by Dr. Heinrich Hoffman in 1845. A physician who wrote books on medicine and psychiatry, Dr. Hoffman was also a poet who became interested in writing for children when he couldn’t find suitable materials to read to his 3-year-old son. The result was a book of poems, complete with illustrations, about children and their characteristics. “The Story of Fidgety Philip” was an accurate description of a little boy who had attention deficit hyperactivity disorder. Yet it was not until 1902 that Sir George F. Still published a series of lectures to the Royal College of Physicians in England in which he described a group of impulsive children with significant behavioral problems, caused by a genetic dysfunction and not by poor child rearing – children who today would be easily recognized as having ADHD. Since then, several thousand scientific papers on the disorder have been published, providing information on its nature, course, causes, impairments, and treatments.

A child with ADHD faces a difficult but not insurmountable task ahead. In order to achieve his or her full potential, he or she should receive help, guidance, and understanding from parents, guidance counselors, and the public education system. This document offers information on ADHD and its management, including research on medications and behavioral interventions, as well as helpful resources on educational options.

Because ADHD often continues into adulthood, this document contains a section on the diagnosis and treatment of ADHD in adults.


Symptoms


The principal characteristics of ADHD are inattention, hyperactivity, and impulsivity. These symptoms appear early in a child’s life. Because many normal children may have these symptoms, but at a low level, or the symptoms may be caused by another disorder, it is important that the child receive a thorough examination and appropriate diagnosis by a well-qualified professional.

Symptoms of ADHD will appear over the course of many months, often with the symptoms of impulsiveness and hyperactivity preceding those of inattention, which may not emerge for a year or more. Different symptoms may appear in different settings, depending on the demands the situation may pose for the child’s self-control. A child who “can’t sit still” or is otherwise disruptive will be noticeable in school, but the inattentive daydreamer may be overlooked. The impulsive child who acts before thinking may be considered just a “discipline problem,” while the child who is passive or sluggish may be viewed as merely unmotivated. Yet both may have different types of ADHD. All children are sometimes restless, sometimes act without thinking, sometimes daydream the time away. When the child’s hyperactivity, distractibility, poor concentration, or impulsivity begin to affect performance in school, social relationships with other children, or behavior at home, ADHD may be suspected. But because the symptoms vary so much across settings, ADHD is not easy to diagnose. This is especially true when inattentiveness is the primary symptom.

According to the most recent version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), there are three patterns of behavior that indicate ADHD. People with ADHD may show several signs of being consistently inattentive. They may have a pattern of being hyperactive and impulsive far more than others of their age. Or they may show all three types of behavior. This means that there are three subtypes of ADHD recognized by professionals. These are the predominantly hyperactive-impulsive type (that does not show significant inattention); the predominantly inattentive type (that does not show significant hyperactive-impulsive behavior) sometimes called ADD – an outdated term for this entire disorder; and the combined type (that displays both inattentive and hyperactive-impulsive symptoms).


Do you have any personal or professional experience with ADHD? Share your experiences with other nurse.



      

      

      
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  • S3010450_max50

    Jill34

    about 5 years ago

    2 comments

    I am an adult who has always had ADHD and I still struggle with it. Now I am in nursing school, and the demands for concentration, focus and attention to detail are making me so much more aware of my ADD. To you parents, I will say what worked best for me as a kid was one on one tutoring with a retired teacher. I think this was because I did not have the distractions of the class room. I remember not being able to get any thing done during class in second grade. My teacher would make me stay in from recess and finish my work. It seemed to be the only time I could get it done. I know now that my best work was done during recess, due to the quite empty room and
    lack of distractors. Also my mother didn't believe in medication, I know life would have been easier for me had I been taking the right medication. Having your child repeat a grade in school will not help your child. My mother did that with me and it just made be feel stupid and want to give up. Children with ADD redily want to give up on any thing difficult but repeating a grade in school is not the answer. Most kids with ADD are very smart they just need the right conditions to learn. One of the things that helped me as a kid was going to the special education class for part of the day because it was a smaller class with fewer distractors and more one on one attention. Kids with ADD need support in developing a skill or talent that they can excel at. Because as ADD kids our behavior is so often inappropriate we are constantly in trouble, and being corrected.
    This constant negative reinforcement is really hard on a kids self esteem. Your child may begin to feel worthless and see acting out as the most effective way to get attention. Medication and spending one on one time with your child will make a big difference. ADD kids are very creative and animated, nurture the positive aspects of the ADD in your child and his confidence will bloom.
    Again I would say don't deny your child medication, try a different one until you get it right, it really does make a night and day difference. It's like being almost blind and putting on glasses for the first time. Another thing that makes a difference is the amount of sleep your child gets at night, and
    the amount of exercise he or she gets during the day.

  • 3ofus_max50

    looking4info

    over 5 years ago

    2 comments

    My daughter just got diagnosed with ADHD and they want to put her on the Datrona Patch i have been looking for more info about the patch could someone out there please help she is 8 years old

  • Mom_and_daddys_little_turds_160_max50

    daddyofsadn

    over 6 years ago

    68 comments

    MY YOUNGEST SON HAS BEEN DIAGNOSED WITH ADHD HE HAS BEEN ON SEVERAL DIFFERENT MEDS NONE SEEM TO WORK VERY WELL HE BECOMES QUITE ANGRY AT TIMES HIS DOCTOR DOESNT SEEM TO KNOW HOW TOL GET A GRIP ON HIS PROBLEMS NO MATTER WHAT WE TELL HIM CAN ANYONE GIVE ME ANY ADVISE AS WHAT MY NEXT STEP SHOULD BE

  • Demetrice_029

    cuttie

    almost 7 years ago

    1042 comments

    When my daughter was 5 years old, she was recommended to repeat kindergarden, because her teacher thought, that she was not mature enough for kndergarden. My daughter went to preschool, and plus I read to my daughter, everyday, she memorized a children's book at athe age of 4, to make a long story short. My daughter was diagnosed having ADD at the age of 10. My daughter was figitty, and she had a short attention span. I didn't think she needed, the drug Ritlan, but I tried it anyway, the drug made my daughter feel drowsy at school, so I discontinued giving her the medication, and I just offered her more my time. My daughter was in special education from grade 5-10, her brain started maturing at the age of 16, so all her classes were modified to two resource classes, and four regular high school classes. In 2005, my daughter went to see a pschologist, he said, my daughter doesn't have ADD anymore. So the brain evenually keeps on maturing, and the ADD or ADHD ceases to assist.

  • Nana_and_grandkids_minus_noah_max50

    charlita

    almost 7 years ago

    2976 comments

    chellbeam: How old was your child when diagnosed with ADHD? I suspect my 6 yr. old grandson suffers from this. His mother(my daughter) was and still is borderline hyperactive. We started noticing problems with him in pre-school (last year) but they are rapidly escalating. He cannot sit still. Although he is quite smart, he cannot focus long enough to get his home work done and ends up in a crying jag every day. When doing his homework, he is over it before he has begun and he will blurt out answers before even thinking. He has always had the attention span of a gnat but now it's worse. He is easily distracted by any little thing. He is becoming so frustrated, as we are with him. I feel so bad for him. He has always been the sunshine in our lives but now (at age 6!) he is becoming angry at the world and hostile. As I am writing all this I feel sure he has ADHD. His mother is at wits end. I have heard so many stories about children on medication for this who become, like becki24's brother , a zombi. Or it entirely changes their personality, makes them submissive and takes the "life" out of them. It scares me. He is our first grandchild and all this is breaking my heart. I guess i need more information. We asked his MD, last year, about this and he said he was too young to diagnose. How old do they have to be? How are they diagnosed? And what happens to him in the meantime? Sign me Worried Grandmother

  • 100_0147_max50

    chellbeam

    almost 7 years ago

    1118 comments

    My daughter has ADHD. I know that dealing with somenone elses child for a little while is daunting, but it does not give people the insight to what a parent goes through. If there is anyone else out there that has a chlid like this and wants a sounding board or knows of a support group please let me know. I know I could use a sound board a lot of times. The medication that she takes is the Datrona patch and it works beautifully for her. It took me three years of trial and error to find the right med and doseage that works for her. We actually did a dose reduction over the summer also. I am very excited about that. She is gaining more weight now and I also think that it helps her to learn to control herself.

  • Williamsburg_max50

    becki24

    almost 8 years ago

    2 comments

    Not any professional experenise but my little brother had ADHD and the medicine he recieved made him not himself but like a walking zompie...He lost all communacation with everyone lost interest on everything...all kids have a hyper side to them what makes it right to say they have ADHD and just write it off as that...Its bad enough anymore that kids can't be themselves without people saying something is wrong with them when there is not...Yeah there is a lot of kids that don't pay a good amount of attention to anything..that is why they are kids....

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