Attention Deficit Hyperactivity Disorder (ADHD)

ATTENTION PARENTS ANDTEACHERS! LEARN TO DEAL WITH INATTENTIVE, HYPERACTIVE & IMPULSIVE KIDS

ADHD is a disorder of thebrain and behavior. It affects about 3 to 5% of children. The symptoms startbefore seven years of age. Global prevalence for children is approximately 5%,with wide variability dependent on research methodologies utilized in studies. AttentionDeficit Hyperactivity Disorder, ADHD, is one of the most common mentaldisorders that develop in children. Children with ADHD have impairedfunctioning in multiple settings, including home, school, and in relationshipswith peers. If untreated, the disorder can have long-term adverse effects intoadolescence and adulthood.

Symptoms:

The most common symptomsof ADHD are:

Impulsiveness:

acting before thinking ofconsequences, jumping from one activity to another, disorganization, tendencyto interrupt other peoples' conversations

Hyperactivity:

restlessness, oftencharacterized by an inability to sit still, fidgeting, squirminess, climbing onthings, restless sleep.

Inattention:

easily distracted,day-dreaming, not finishing work, difficulty listening.

Subtypes:

ADHD has three subtypes:

Predominantlyhyperactive-impulsive

Most symptoms (six ormore) are in the hyperactivity-impulsivity categories.

Fewer than six symptomsof inattention are present, although inattention may still be present to somedegree.

Predominantly inattentive

The majority of symptoms(six or more) are in the inattention category and fewer than six symptoms ofhyperactivity-impulsivity are present, although hyperactivity-impulsivity maystill be present to some degree.

Children with thissubtype are less likely to act out or have difficulties getting along withother children. They may sit quietly, but they are not paying attention to whatthey are doing. Therefore, the child may be overlooked, and parents andteachers may not notice that he or she has ADHD.

Combinedhyperactive-impulsive and inattentive

Six or more symptoms ofinattention and six or more symptoms of hyperactivity-impulsivity are present.

Most children have thecombined type of ADHD

Causes

A specific cause of ADHDis not known. There are, however, a number of factors that may contribute toADHD including genetics, diet and social and physical environments.

Genetic factors

Studies indicate that thedisorder is highly heritable and that genetics are a factor in about 75% ofADHD cases. Hyperactivity also seems to be primarily a genetic conditionhowever other causes do have an effect.

Researchers believe thata large majority of ADHD cases arise from a combination of various genes, manyof which affect dopamine ( a chemical in the brain) transporters. The broadselection of targets indicates that ADHD does not follow the traditional modelof a "genetic disease" and should therefore be viewed as a complexinteraction among genetic and environmental factors.

Environmental factors

Environmental factorsimplicated include alcohol and tobacco smoke exposure during pregnancy andenvironmental exposure to lead in very early life. Complications duringpregnancy and birth—including - premature birth—might also play a role.

Diet

Additives

Studies have found thatdietary elimination of artificial food coloring and preservatives provides astatistically significant benefit in children with

Sugarregulation

A number of studies havefound that sucrose (sugar) has no effect on behavior and in particular it doesnot exacerbate the symptoms of children diagnosed with ADHD

Omega-3supplement

Preliminary researchsuggests 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 compellingevidence that social factors alone can cause ADHD.[Many researchers believe that relationships with caregivers have a profoundeffect on attentional and self-regulatory abilities. A study of foster childrenfound that a high number of them had symptoms closely resembling ADHD, whileother researchers have found behavior typical of ADHD in children who havesuffered violence and emotional abuse.

Head injury

ADHD patients have beenobserved to have higher than average rates of head injuries, however currentevidence does not indicate that head injuries are the cause of ADHD in thepatients observed

Pathophysiology

One study states that adelay in development of certain brain structures like frontal cortex andtemporal lobe occurs by an average of three years of age. These structures areresponsible for the ability to control and focus thinking. On the other handthe motor cortex develops faster than normal. It indicates the slowerdevelopment of behavioral control and faster development for advanced motordevelopment may cause increased attention deficits and hyperactivity.

Another study states thatthere 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 thatthis region normalizes in thickness during the teen years showing improvementin clinical symptoms

Additionally, SPECT scansfound people with ADHD to have reduced blood circulation (indicating low neuralactivity), and a significantly higher concentration of dopamine transporters inthe striatum which is in charge of planning ahead. Medications focused ontreating ADHD (such as methylphenidate) work by reducing dopamine reuptake incertain areas of the brain, such as those that control and regulateconcentration. As dopamine is a stimulant, this increases neural activity andthus blood flow in these areas (blood flow is a marker for neural activity).

Treatment:

Treatments can relievemany of the disorder's symptoms, but there is no cure. With treatment, mostpeople with ADHD can be successful in school and lead productive lives.Researchers are developing more effective treatments and interventions, andusing new tools such as brain imaging, to better understand ADHD and to findmore effective ways to treat and prevent it. Methods of treatment usuallyinvolve some combination of medications, behavior modifications, life-stylechanges, and counseling.

Lifestyle

Aerobic fitness mayimprove cognitive functioning and neural organization related to executivecontrol during pre-adolescent development, though more studies are needed inthis area. One study suggests that athletic performance in boys with ADHD mayincrease peer acceptance when accompanied by fewer negative behaviors

Medications

The most common type ofmedication used for treating ADHD is called a "stimulant." Althoughit may seem unusual to treat ADHD with a medication considered a stimulant, itactually has a calming effect on children with ADHD. Many types of stimulantmedications are available. A few other ADHD medications are non-stimulants andwork differently than stimulants. For many children, ADHD medications reducehyperactivity and impulsivity and improve their ability to focus, work, andlearn. Medication also may improve physical coordination.

However, a one-size-fits-allapproach does not apply for all children with ADHD. What works for one childmight not work for another. One child might have side effects with a certainmedication, while another child may not. Sometimes several differentmedications or dosages must be tried before finding one that works for aparticular child. Any child taking medications must be monitored closely andcarefully by caregivers and doctors.

Stimulant medicationscome in different forms, such as a pill, capsule, liquid, or skin patch. Somemedications also come in short-acting, long-acting, or extended releasevarieties. In each of these varieties, the active ingredient is the same, butit is released differently in the body. Long-acting or extended release formsoften allow a child to take the medication just once a day before school, sothey 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 thechild and whether the child needs medication only for school hours or forevenings and weekends, too.

The side effects ofstimulant medications:

The most commonlyreported side effects are decreased appetite, sleep problems, anxiety, andirritability. Some children also report mild stomachaches or headaches. Mostside effects are minor and disappear over time or if the dosage level islowered.

Decreased appetite. Be sure your child eats healthymeals. If this side effect does not go away, talk to your child's doctor. Alsotalk to the doctor if you have concerns about your child's growth or weightgain while he or she is taking this medication.

Sleep problems. If achild cannot fall asleep, the doctor may prescribe a lower dose of themedication or a shorter-acting form. The doctor might also suggest giving themedication earlier in the day, or stopping the afternoon or evening dose.Adding a prescription for a low dose of an antidepressant or a blood pressuremedication called clonidine sometimes helps with sleep problems. A consistentsleep routine that includes relaxing elements like warm milk, soft music, orquiet activities in dim light, may also help.

Less common side effects.A few children develop sudden, repetitive movements or sounds called tics.These tics may or may not be noticeable. Changing the medication dosage maymake tics go away. Some children also may have a personality change, such asappearing "flat" or without emotion.

Psychotherapy:

Different types ofpsychotherapy are used for ADHD. Behavioral therapy aims to help a child changehis or her behavior. It might involve practical assistance, such as helporganizing tasks or completing schoolwork, or working through emotionallydifficult events. Behavioral therapy also teaches a child how to monitor his orher own behavior.

Learning to give oneselfpraise or rewards for acting in a desired way, such as controlling anger orthinking before acting, is another goal of behavioral therapy.

Parents and teachers alsocan give positive or negative feedback for certain behaviors. In addition, clearrules, chore lists, and other structured routines can help a child control hisor her behavior.

Therapists may teachchildren social skills, such as how to wait their turn, share toys, ask forhelp, or respond to teasing.

Learning to read facialexpressions and the tone of voice in others, and how to respond appropriatelycan also be part of social skills training.

Parenting skills traininghelps parents learn how to use a system of rewards and consequences to change achild's behavior. Parents are taught to give immediate and positive feedbackfor behaviors they want to encourage, and ignore or redirect behaviors theywant to discourage. In some cases, the use of "time-outs" may be usedwhen the child's behavior gets out of control. In a time-out, the child isremoved from the upsetting situation and sits alone for a short time to calmdown.

Parents are alsoencouraged to share a pleasant or relaxing activity with the child, to noticeand point out what the child does well, and to praise the child's strengths andabilities.

They may also learn tostructure situations in more positive ways. For example, they may restrict thenumber of playmates to one or two, so that their child does not become overstimulated.

Or, if the child hastrouble completing tasks, parents can help their child divide large tasks intosmaller, more manageable steps. Also, parents may benefit from learningstress-management techniques to increase their own ability to deal withfrustration, so that they can respond calmly to their child's behavior.

Sometimes, the wholefamily may need therapy. Therapists can help family members find better ways tohandle disruptive behaviors and to encourage behavior changes. Finally, supportgroups help parents and families connect with others who have similar problemsand concerns. Groups often meet regularly to share frustrations and successes,to exchange information about recommended specialists and strategies, and totalk with experts.

Attention-Deficit Hyperactivity Disorder (ADHD): Learn how to identify andprevent this disorder from making a foray into your family!

Your child may be suffering from ADHD and you might not even know it! ADHDaffects about 4 to 12% of school-age children in India and is more frequent in boysthan in girls. If the short attention span of your child poses problems forhim, at school or home, and his hyperactivity is a cause of concern, chancesare that he might be a victim of this neurobehavioral developmental disorderand needs serious medical attention. Don’t pass-off your child’s behavior asjust ‘difficult’. Learn to detect and eliminate the symptoms and stop thedisease before it strikes!

URL   :    http://onlineconsultancy.blogspot.com