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What you need to know about ADHD

Tuesday, August 07, 2012

 

GoLocalWorcester spoke with Dr. JoAnn Carson, MD, specialist in development and behavioral pediatrics at UMass Memorial’s Children’s Medical Center and professor at the University of Massachusetts School of Medicine, who evaluates young children with developmental delays and behavioral problems, about Attention Deficit Hyperactivity Disorder (ADHD).

What is ADHD? Is it hereditary?

ADHD is a behavioral disorder with multiple possible causes, including genetic, central nervous system insults (such as fetal exposures to alcohol and nicotine, or lead) and psychosocial factors. There is frequently, but not always, a history in the family of ADHD.

How early can it be diagnosed?

Diagnosis can be made as early as 4 years of age. In adolescents and adults, symptoms of inattention and distractibility are likely not ADHD if these symptoms were no present prior to puberty (or around age 12).

Diagnosis of ADHD is made when a history from both parents and teachers indicates a significant level of inattentive and/or hyperactive/impulsive symptoms, developing prior to age 12 that negatively affect at least one area of function (i.e., academic, peer relationships, behavior).

Does ADHD appear in conjunction with other conditions?

It is important at all ages to ensure that the inattentive or hyperactive symptoms are not primarily due to another medical problem (e.g., obstructive sleep apnea), a learning disability, or another mental health problem (e.g., depression, anxiety, Autism Spectrum Disorder). Sometimes, these disorders account for the symptoms entirely. Frequently, however, these other disorders come hand in hand with ADHD.

Does early diagnosis improve outcomes? What has been the best treatment?

In October of 2011, the American Academy of Pediatrics published newly revised guidelines regarding ADHD diagnosis and management. One of the changes is expanding the age range for diagnosis to include 4 and 5 year olds. It is difficult to accurately diagnose ADHD in preschoolers due to the fact that the symptoms of ADHD may be developmentally normal for this age group.

Nonetheless, children of this age whose inattentive, hyperactive and impulsive symptoms are interfering with peer relationship and behavior at home or at school may benefit from ADHD management. Treatment in preschoolers, the AAP advises, entails behavioral interventions (mainly behavior management training for parents) prior to consideration of medication management. In contrast, there is good evidence that ADHD medication is an important component of ADHD treatment, and should be recommended in conjunction with behavioral interventions and classroom modifications. Early multimodal treatment can prevent some of the related outcomes associated with ADHD, e.g., school failure, declining self-esteem, depression, school drop-out and substance abuse.

Can it be outgrown?

Most individuals with ADHD diagnosed in childhood have persistent symptoms into their adult years. Individuals can learn to compensate for their ADHD symptoms, for example, by making lists, thus limiting the functional impact of their symptoms.

Dr. Carson graduated in 1977 from Yale College (Bachelors of Science), in 1981 from Columbia University College of Physicians and Surgeons (M.D. degree), and trained at Jacobi Medical Center in the Bronx. I was an attending physician at Jacobi for several years prior to moving to the University of Connecticut in 1991. In 2001, she completed a fellowship in General Academic Pediatrics, specializing in Developmental-Behavioral Pediatrics, and a Masters of Public Health at University of Connecticut School of Medicine in 2001. In 2009, she joined the faculty at University of Massachusetts School of Medicine, where she evaluates young children with developmental delays and behavioral problems at UMMHC.

 

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Comments:

Jean Nystrom

I have done a lot of homework on this topic. I found no quantitative statistics that convinced me that medication is the way to go. I feel that parents with children and persons suffering from ADHD/ADD should seek alternatives to the current medications available. I have a child with ADHD. I tried the Ritalin with little to no success. I found the drug made my child lethargic and once it wore off she would either crash or become even more hyper-active. Believe me, I tried it for a period of time to see if it would build up in her system and alleviate not only the behavior but the side effects. It did not. After doing much research I found a program that is working for my child and my family. I use Play Attention. Play Attention is a program that builds behavioral shaping. Since investing my child's mental health into this platform I have now learned that they are using this program at nuclear power plants, nascar mechanics use it. Personally, I just want my child to live a normal, loving life and enjoy life to the maximum. Jnystrom

Alexander Nestoiter

I agree that in some cases medication is warranted. But for the majority standing on a balance beam and pretending you are on tightrope set, will train the brain to focus and to work faster. Although doctors cannot prescribe such a "pill", it remains a viable alternative to the pills.
There are local environmental factors to blame, sure. I still cannot believe all this can be solved by meds alone. The following articles show a different perspective on the origins and treatments of ADD/ADHD
http://blog.myownwaterpipe.com/2012/03/21/vestibular-stim.aspx
http://blog.myownwaterpipe.com/2012/03/09/balance-training.aspx




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