Change the Course with ADHD Diagnosis and Treatment

She hasn’t consumed too much sugar or food additives. He hasn’t played too many video games. Your child is not lazy, and she isn’t trying to push your buttons. If he had a choice, he wouldn’t want to be this way.

Often genetic, ADHD (attention deficit hyperactivity disorder) is a brain chemistry issue that impedes brain signaling and causes behaviors that interfere with how a person functions socially, at school, at home or in a job.   

Early diagnosis and treatment can improve self-esteem and help children reach their full potential.

Understanding ADHD and Its Types

Subtypes further define ADHD – inattentive, hyperactive/impulsive and combined type. 

A child with ADHD might have chronic behaviors such as difficulty staying focused (inattentive) or trouble being still/controlling impulses (hyperactive/impulsive) or both. Other behaviors may be present as well.

Prior to the early 1990s, professionals commonly used ADD (attention deficit disorder) to describe what we now call ADHD, which is more comprehensive. Some may still use ADD to describe the “inattentive” subtype.

Research has shown ADHD to be more common in males than females. About two-thirds or more of children with ADHD continue to have symptoms and challenges into adulthood, according to the Attention Deficit Disorder Association. Particularly, inattention, restlessness and impulsivity can persist.

The earlier you identify and treat ADHD, the better, Dr. Casdorph says, before children start developing bad thoughts about themselves or a sense of negativity.

ADHD Causes and Risk Factors

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Research points to genetic causes of ADHD. In fact, 40 to 60 percent of children of adults with ADHD will also have the condition, says the Association.

People with ADHD have abnormal levels of certain brain chemicals (neurotransmitters). These chemicals – dopamine and norepinephrine – help the brain send and receive messages, and they play essential roles in thinking and attention.

“It’s a brain chemistry issue,” explains Mark Casdorph, DO, Upper Valley Outpatient Behavioral Health. “Dopamine helps us filter out things that aren't important and to focus and organize our thoughts and behaviors.”

Varied risk factors can contribute to ADHD, including:

  • Genes
  • Cigarette smoking, alcohol use or drug use during pregnancy
  • Exposure to environmental toxins during pregnancy
  • Exposure to environmental toxins, such as high levels of lead, at a young age
  • Low birth weight
  • Brain injuries

ADHD Diagnosis

The earlier you identify and treat ADHD, the better, Dr. Casdorph says, before children start developing bad thoughts about themselves or a sense of negativity. Symptoms can appear as early as between the ages of 3 and 6, can continue through adolescence and adulthood, and can change over time. 

“ADHD is not something that just simply goes away,” he says. “When not diagnosed, it can have a profound effect on a child. It can set them on a life path that is not good. If they struggle with grades, for example, they can develop a sense that they're not smart, whether that’s true or not.”

In addition, learning disabilities, anxiety disorder, conduct disorder, depression and substance abuse are common in people with ADHD.

Diagnosis of ADHD  requires a comprehensive evaluation by a licensed clinician, such as a pediatrician, psychologist or psychiatrist with expertise in ADHD.

Dr. Casdorph says historical information from parents and teachers, along with personal observation and interaction with a child, all combine in developing a diagnosis. Clinical tests also help determine or confirm diagnosis.

ADHD Treatment

While there is no cure for ADHD, treatment can help reduce symptoms and improve functioning. Research has shown that the most effective treatment is a combination of medication and therapy. Education and training can support treatment as well.

Medication. Professionals primarily prescribe stimulant medications, such as Ritalin and Adderall, which treat symptoms by increasing the brain chemicals dopamine and norepinephrine. Medications should be carefully prescribed and monitored since they can negatively interact with certain health problems. Non-stimulants are an alternative but take longer to start working.

Many medications and dosages may need to be tried before finding the right one for each patient.

Although not approved by the U.S. Food and Drug Administration (FDA) specifically for the treatment of ADHD, antidepressants are sometimes used alone or in combination with a stimulant to treat ADHD.

Psychotherapy. Behavioral therapy and family therapy can help patients and their families better manage ADHD behavior and cope with its effects on their lives and relationships. Therapy also can help patients work through feelings of shame, guilt, failure and chronic stress.

Education and training. Mental health professionals can educate parents about ADHD and how it affects a family, offering them skills training, stress management techniques and support groups. They also can help children and parents develop new skills, attitudes and ways of relating to each other.

Small Steps: Hydrate Ahead of Time
Drink plenty of water before practices or exercising in the heat.