Return to Specialty Areas Main page

Attention Deficit Hyperactivity Disorder

Attention Deficit Hyperactivity Disorder (ADHD) is the most prevalent mental health condition among school-age children, affecting about 4 percent of the child population in this country. It is typically accompanied by symptoms such as inattention, over-activity, and impulsiveness, which must be very persistent over time as a way to distinguish the disorder from the way young children, or highly intelligent children, behave on a periodic or situation-specific basis.

The American Psychiatric Association divides ADHD 3 ways:

• Primarily Inattentive
• Primarily Hyperactive/Impulsive
• Combined (i.e., a mix of impulsive behavior with inattention).

It is important to note that ADHD is quite often accompanied by other problems such as depression, anxiety, learning disabilities, and oppositional defiant disorder. (Please see our description of oppositional defiant disorder below. This disorder is the most frequent accompaniment to ADHD and can lead to more serious conditions if not treated correctly.)

Because some normally active or inattentive children may be misdiagnosed with ADHD, it is very important to seek assessment from a specialist in the condition. Similarly, the diagnosis of ADHD is often missed, causing unnecessary suffering and again underlining the need for expert evaluation. Unidentified ADHD will typically result in intensifying behavior problems, school problems, and parental frustration. As untreated children with ADHD get older, they tend to dominate other children or lapse into a chronic state of low self-esteem.

The effective therapies for this disorder include cognitive-behavior therapy, behavior therapy, behavior modification, school intervention, family therapy, parent management training, and – when the problem is more severe – medication management.

Medications for ADHD tend to be stimulants (e.g., Adderall, Dexedrine, Ritalin, Concerta, Focalin), although Strattera is now available as a non-stimulant option as are antidepressants such as Tofranil or Wellbutrin. Stimulants tend to work more quickly but have abuse potential and on occasion have very serious side effects such as seizures, tics, liver failure, or coma.

If at all possible, school children with ADHD should be taught in smaller classrooms with one-to-one teacher availability and specialized methods. Under federal law, ADHD is a health impairment, and schools with ADHD students may qualify for special education funding. Physically and mentally challenging activities can draw upon the natural inclinations of those with ADHD, who tend to be talented in the arts, sports, and jobs requiring physical labor.

Here are some recommendations for parents of ADHD children:

1) Make simple rules and provide consistent, appropriate consequences for misbehavior.
2) Make a schedule for everyday activities such as waking up, meals, homework, TV, and going to bed.
3) Reward good behavior.
4) Identify and emphasize your child’s strengths.
5) Focus on work, not so much on performance factors such as getting top grades.
6) Set aside TLC time to be alone with your child.