ADHD
(ATTENTION DEFICIT HYPERACTIVITY DISORDER)
ADHD or Attention Deficit Hyperactivity Disorder is a clinical diagnosis requiring evaluation of behavior across multiple settings (family, school, and social groups). The usual patient is male (but it can also occur in females) and the diagnosis is usually made in elementary school with symptoms appearing by age 7.
The five criteria for ADHD are:
1. Some inattention or hyperactivity-impulsive symptoms present before age 7.
2. Some impairment from symptoms present in 2 or more settings (homework, school, social).
3. Clear evidence of clinically significant impairment in academic, social, or occupational functioning.
4. Symptoms do not occur exclusively during other mental illness.
5. Inattention, impulsivity, or hyperactivity.
The assessment includes a history and physical examination. A screening neurological exam is done with personal and classroom evaluation. Inventories of behavior are done by teachers, parents and if old enough, the patient himself or herself.
Patients should also be evaluated for learning disabilities and speech and language disorders.
Once a therapeutic alliance is established between student, parent and school, treatment can begin. The decision to treat with behavioral therapy will almost always include medication. The goals should be realistic, attainable, and measurable. A 504 or federal entitlement can be invoked in school to offer the student some assistance.
Medication should be monitored quarterly for student success and for evaluation of growth. Parents should be aware this is not a “quick fix” and may mean life long treatment, including during college and career. Some 37% of all children with ADHD have an additional condition such as oppositional defiant behavior, mood disorders, anxiety, or depression.
Much research and study is being done on ADHD and its variants with a promising future for these young people.