Q.What is ADD and ADHD?
A. Attention Deficit (Hyperactivity) Disorder is a condition in which the child has the following symptoms that may or not be accompanied by hyperactivity:
1. Difficulty in paying attention and focusing.
2. Difficulty with impulsivity.
3. A lack of organizational skills.
Q.How do we diagnose ADD?
A.This is a clinical diagnosis. It is usually diagnosed after a child enters school and because he/she is having difficulties there. A child should have a complete physical exam with a Pediatrician to confirm that there are no medical problems that could be causing these symptoms including testing a child's vision and hearing. There should be an evaluation by the child's' teachers and parents using guidelines to evaluate behavior. The child may be evaluated by a Neurologist, developmental Pediatrician, or a Psychiatrist to make certain the child fits the categories for ADD/ADHD and make sure there are no other concerns e.g. learning disabilities.
Q.How do we treat ADD/ADHD?
A.The medical therapies fall into three categories:
1. Stimulant medication e.g. Ritalin, Concerta, Focalin, Daytrana
2. Non stimulant medication e.g. Straterra
3. Anti-depressants e.g. Wellbutrin
Stimulant medications are the most commonly used medications. There are side effects to all three classes of medication. For example, stimulant medications can suppress appetite and growth and can cause difficulty with falling asleep. Therefore, they must be used with supervision by a medical professional to make sure they are well tolerated. The medical therapies will be managed by your pediatrician, neurologist, or psychologist so let us talks about behavioral therapies.
Behavioral therapies are multiple.
1. In managing behaviors there are technologies to improve memory and focus. For example, while riding in a car, tell the child you are going to play a game. You are going to name three things and you are going to ask the child to name them later. So, at the beginning of the ride, name three items, e.g. ice cream, bicycle, mountain and at the end of the ride, ask the child to list them. If the child can name three things consistently, then go to five things. There is also a board game called Memory which works on the same skills.
- When all the behavioral and psychological therapies are not working.
- When the child's school performance is below expectations due to his/her inability to concentrate on set skills.
- When the child is not able to control impulsive behaviors leading to relationship problems or when the child is disruptive to others in class.
- When there are concerns that poor academic performance is leading to low self esteem.
- The child is doing well academically in school.
- The child's behavior is not disruptive in class.
- The child's peer and family relationships are good.
- When the parents are concerned about long term use of medication.