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Caring for a Child with ADHD What is ADHD and is it common? Attention-deficit/hyperactivity disorder (ADHD) is a brain condition that makes it hard for children to focus on tasks and control their behavior. ADHD is one of the most common chronic conditions in children. ADHD is different from the usual behavior problems that children deal with at times. Children with ADHD tend to have persistent symptoms of inattention, impulsivity, and hyperactivity that interfere with their ability to carry on normal lives. Between 4 and 12 percent of school-aged children have ADHD. Boys are diagnosed about three times more often than girls. About 40 percent of children with ADHD will continue to have symptoms of ADHD as adults. What You Need to Know About ADHD The causes of ADHD still aren’t clear. However, ADHD is one of the most studied childhood conditions, and much has been learned about it. ADHD is a biological disorder, not just “bad behavior.” The parts of the brain that control attention and activity level may show lower activity in children with ADHD. There is a family connection with ADHD. Sometimes parents are diagnosed at the same time as their children. Environmental toxins can play a role in the development of ADHD, but that is extremely rare. Severe head injuries can cause ADHD in some cases. There is no evidence that ADHD is caused by eating too much sugar, food additives, allergies, or immunizations. Symptoms A child with ADHD may have one or more of the following symptoms: Inattention: The child has a hard time paying attention. She daydreams, is easily distracted and disorganized, and tends to lose a lot of things. Hyperactivity: The child seems to be in constant motion and has difficulty staying seated. He frequently squirms and talks too much. Impulsivity: The child frequently acts and speaks without thinking, interrupting others. She is unable to wait for things. A child with ADHD may have a very hard time getting along with siblings, friends, and classmates. Learning can be very difficult for a child with untreated ADHD, and their impulsiveness can lead to physical danger. Diagnosis The only way to determine if your child has ADHD is to be evaluated by a medical professional, who can accurately diagnose and treat ADHD. There is no simple test to diagnose ADHD and it will take some time to make the diagnosis. Your doctor or healthcare professional will follow a process that takes several steps to gather information from you, your child’s school, and any other caregivers who spend time with your child. Some children have ADHD along with other behavior conditions. Your child’s doctor or healthcare professional will look for signs of common “coexisting conditions” such as oppositional defiant disorder, anxiety disorders, depression, and learning disabilities. This handout may be freely downloaded from The Vermont Academic Detailing Program website www.vtad.org Updated: March 2013 Caring for a Child with ADHD ADHD Treatment Plan There is no specific cure for ADHD, but there are many treatment options for your child. A typical long-term management plan will include: Education about ADHD A team approach to treatment that includes doctors, parents, teachers, caregivers, other health care professionals, and your child Medication and Behavior therapy Parent training Individual and family counseling Medication Therapy Stimulant medications are the most effective, most commonly prescribed medications for ADHD. Examples of stimulant medications are methylphenidate (Ritalin, Concerta), mixed amphetamines (Adderall), or lisdexamfetamine (Vyvanse). Stimulant medications help children focus their thoughts better and ignore distractions, which helps them pay attention and control their behavior more effectively. All stimulants have the risk of abuse by adolescents or adults and are at risk for being stolen. Long-acting stimulants, such as Vyvanse and Concerta, are less likely to be abused or stolen, although the risk still exists. It is important to balance the risk of abuse and theft with the fact that stimulants are the most effective medications to treat ADHD. Talk to your child’s doctor or healthcare professional if you have concerns about stimulant abuse or theft. Never have your child stop taking prescribed medications without talking to your child’s doctor or healthcare professional first. There are medications to treat ADHD that are sometimes prescribed and are not stimulants. The most common medications include atomoxetine (Strattera) or guanfacine (Intuniv). They are not as effective as stimulants but may be a good choice for some children and adolescents. Common side effects of atomoxetine include upset stomach, decreased appetite, nausea, dizziness, tiredness, and mood swings. Common side effects of guanfacine are dry mouth, sedation, and headache. Your doctor or healthcare professional will work with you to find the right medication, dosage, and schedule for your child. Some children respond to one type of stimulant, but not others and it may take time to find the right combination. Doses may need to be adjusted over time, depending on weight and other factors (including side effects). For more information Not all children experience side effects, but those who do most commonly report decreased appetite or weight loss, sleep problems, and social withdrawal. Insomnia or sleep problems may be due to the time of day your child takes his or her stimulant medication. This side effect can usually be lessened or relieved completely by adjusting the timing of the medication. Other side effects can be lessened or relieved completely by changing dosage, adjusting the medication schedule, or choosing a different stimulant. Also, most side effects decrease over time with continued use of the medication. Your doctor or healthcare professional will guide you through this process. American Academy of Pediatrics (AAP): http://www.healthychildren.org Click on “Health Issues” and then “ADHD” American Academy of Family Physicians: http://familydoctor.org Click on “Diseases and Conditions” then “A” under “Browse by Name.” Scroll to the bottom and click ADHD Vermont Department of Health http://healthvermont.gov/family/ADHD/ADHD.a spx ADHD: What Every Parent Needs to Know by the American Academy of Pediatrics. This book is available in paperback and costs around $12. Source: Most of the information in this handout came from www.Healthychildren.org from the AAP. This handout may be freely downloaded from The Vermont Academic Detailing Program website www.vtad.org Updated: March 2013