Category Archives: ADHD

ADHD – Treatment and Management

Treatment for ADHD

Using medication alone is not usually the best treatment for ADHD. The first and foremost line of treatment is to address the child’s emotions (anxiety, panic, hyper-reactivity, impulsivity) and aim at making the child stable. If the child continues to have ADHD symptoms then medications may help.

Stimulant medications such as dexamphetamine and methylphenidate (Ritalin) are the two main medications used to treat ADHD. These stimulants act on neurotransmitters to release a chemical called dopamine. An increased amount of dopamine will help reduce hyperactivity and impulsive behaviours. Moreover, it is to note that the medications will work differently in different children so a particular child may benefit more from one of these medications than others. Some children may even benefit from taking a combination of the two.

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Caring for a child with ADHD

Caring for a child with ADHD can be very challenging as the patience of all family members is stretched. The aim in caring for a child that has been diagnosed with ADHD is to formulate the best way to help the child to learn and develop as well as reducing stress on all family members. Remember that a child with ADHD does not intend to be difficult.

Parents and caregivers needs to be consistent in their support routine, and it is very important to take breaks regularly, stepping back from problem to take a look at the situation when it is stressful.

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You can choose to:

* Develop consistent routines at home and school

* Keep instructions clear and simple

* Give reminders calmly

* Get physically close with the child and make the child’s full attention is given whilst talking

* Give one or two instructions at a time

* Praising is important, particularly if the child has done something good

* Ignore irritating behaviours and attitudes

* Discipline child for unacceptable behaviour for instance give timeout sessions

 

Other helpful tips to manage ADHD

Helping a child managing ADHD can be tailored to the individual child. Therapies such as counseling can help a child to develop concentration and social skills and can extend to controlling anger or treating impulsivity.

 

Therapies for ADHD can include:

* Behaviour modification

* Therapy aiming at rewarding child for good behaviour is more successful than punishment alone.

* Cognitive therapy

* Provides aids for a child to manage thinking skills such as problem solving and self control.

* Anger management

* This is for children with impulsive behaviour who are quickly frustrated and angered.

* Child learns to recognise the signs of growing frustration and learns coping skills which are designed to defuse the anger.

* Child also learns to relaxation and stress management skills

* Social training

* Suitable for a child with ADHD who do not get along with their peers due to aggressive and lack of social skills.

* Training teaches child to interact with peers.

* Family counseling

* Family counseling is for all members within the family and helps with formulating coping techniques for raising a child with ADHD.

 

Where to get further help

* Your regular GP

* Sydney Developmental Clinic * http://www.sydneydevelopmentalclinic.com.au/faq.htm

* Learning Discoveries Psychological Services * http://learningdiscoveries.com.au/adhd/?gclid=CP2nwN6blr4CFYaVvQodqT8AxA

* Support groups:

* Every day with ADHD and challenging behaviour  * http://www.everydaywithadhd.com.au/adhd-support-groups.html

* Raising children network *  http://raisingchildren.net.au/forum/Topic66203-17-1.aspx

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ADHD – Causes and contributing factors

The exact cause of ADHD is unknown;

however the following contributing factors may play a role in a child developing ADHD:

* Differences of neurophysiology of the brain anatomy, electrical activity and metabolism

* Genetics

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* Drug use during pregnancy such as nicotine and cocaine

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* Chronic exposure to low levels of lead influencing behaviour and brain chemistry

* Lack of early attachment where the child does not have enough bonding time with parent or caregiver

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* Early traumatic experiences relating to attachment resulting in inattention and hyperactivity.

* Childhood posttraumatic stress disorder due traumatic event which has similar symptoms to that of ADHD but treatment options is different. 

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ADHD – Diagnosis

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How is ADHD assessed/ diagnosed?

Usually a paediatrician or child psychiatrist conducts an initial assessment or diagnosis of ADHD. A psychologist can focus on how the disorder affects behaviour and learning, and what can be done to improve this.

There are various ways to measure ADHD. Psychologists use rating scales, questionnaires and other tests for collecting information from the children themselves, their parents/caregivers and their teachers. Children are observed at home and school.

To assess whether a person has ADHD, we can consider several critical questions:

* Is the behaviour excessive, long-term?

* Do they occur more often than in people the same age?

* Is it a continuous problem and not just a response to a temporary situation?

* Do the behaviours occur in several settings or only in specific places like the playground?

 

The person’s pattern of behaviour is then compared against a set of criteria and characteristics of the disorder. The universal criteria referred to for diagnosing ADHD is DSM-IV (diagnostic and statistical manual of mental disorders version IV) where there are three sub-types of ADHD.

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Caution: As everyone shows some of the behaviours mentioned in the above table at times, the DSM-IV contains very specific guidelines for determining when a patient is indicated with ADHD. Such guidelines include:

* Behaviours appear early in life, before 7 years and continue for at least 6 months.

* Behaviours must be more frequent or severe than in others of the same age group

Above all the behaviour creates a real handicap in at least two areas of the person’s life such as school, home, work or social settings.

 

Behaviours that are not necessarily ADHD

The following conditions listed do not qualify for diagnosis of ADHD as some of these conditions are either temporary or chronic:

o Attention lapses during absence seizures.

o Underachievement at school due to a learning disability.

o A middle ear infection or grommets that may reduce hearing sensitivity.

o Central Auditory Processing Disorder

o Visual Processing Disorder

o Dyslexia

o Disruptive or unresponsive behaviors due to childhood depression or anxiety.

o Anxiety, chronic fears and childhood depression can make a child seem overactive, quarrelsome, impulsive, or inattentive.

o Overactive or under active thyroid.

o Undiagnosed diabetes.

o A child who becomes overactive and easily distracted after the death of a family member or friend or after some traumatic loss or fearful experience may be dealing with unresolved grief and/or emotional problems.

o A chronic middle ear infection or mild asthma, often the result of dairy intolerance, can also make a child seem distracted and uncooperative and lead to Learning Difficulties.

o A child who is emotionally unstable and therefore cannot focus due to living with a family member who is physically or emotionally abusive or neglectful.

 

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Myths about ADHD

1. Children with ADHD are hyperactive

FACT: Some children with ADHD are hyperactive but many others with attention problems are not. Children who are inattentive with ADHD may appear spacey and unmotivated.Sticking out tongue

 

2. Children with ADHD never pays attention

FACT: Children with ADHD are able to concentrate on enjoyable activities, however they have trouble maintaining focus on boring and repetitive tasks.

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3. Children with ADHD could behave better if they wanted to

FACT: Children with ADHD will try to do their best to be good, but still they are unable to sit still and pay attention, however it does not mean they are being disobedient on purpose.

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4. Children will eventually grow out of ADHD

FACT: Symptoms of ADHD will continue until adulthood. Treatment aims at helping child to cope and manage symptoms.

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5. Medication is the best treatment for ADHD

FACT: Medication is not the first line of treatment for ADHD as it is not the best option. Effective treatment should look at your child’s behaviour and formulating techniques on how to make a child with ADHD stable.

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6. Certain foods can make ADHD worse

FACT: There is little evidence that ADHD is caused or made worse by certain foods (such as food additives). Some studies had suggests that a small number of children with ADHD may benefit slightly from dietary changes, but this is not always the case.

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ADHD: Attention deficit hyperactivity disorder

 

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Attention deficit hyperactivity disorder (ADHD) diagnosed in children can have a detrimental impact on their developmental stages, subsequently affecting their behaviour, particularly the ability to learn. Children with ADHD do not understand why they feel out of control or very lonely. The disorder impairs social and academic functioning and is noticed in children who are failing to learn at school.

 

In most cases, ADHD is noticed in school-aged children who have behavioural and learning problems and showing signs of hyperactivity and inattention. If the problems become severe enough undergoes assessments for ADHD.

 

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