Several types of ADHD can be treated

By Dr. MARY BLAIR Health Columnist The Greenwood Commonwealth

Have you ever wondered, “Why does my child have difficulty attending to tasks and poor performance in school or appears to be hyperactive without candy or caffeine?”

If so, then your child may have a condition called Attention Deficit Hyperactivity Disorder. This disorder is described as someone having difficulty with attention, acting without thinking and excessive activity beyond what is normal for his or her age. This diagnosis can be made in children who are in school from age 4 to adults.

There are several different subtypes of the disorder — the predominately hyperactive type, inattentive type and combined type.

A child with predominately hyperactive type may have an inability to sit when at school or doing work, may blurt out answers, may tend to have difficulty with taking turns and is often constantly moving or squirming.

A child with predominately inattentive type may always seem to be daydreaming, may have complications with staying on task or remaining focused and tends to be forgetful or does not complete homework assignments or chores.

The combined type tends to have both hyperactive and inattentive behaviors that appear at different ages. Typically, the hyperactive symptoms start at age 4 and worsen by the age of 8. The inattentive behaviors do not appear until 9 or 10 years of age.

Before an evaluation, it is important to evaluate the child’s environment and behaviors.

Children should have a varied diet that includes fruits, vegetables, meats and starches.  They should have a limited amount of sugar and caffeine.  Children should have up to eight to 10 hours of sleep every night. They should have limited exposure — a  recommended two hours a day — to television, computer games, video games or cellphone videos and games. It is important that children are aware of the rules of home and school and the appropriate disciplinary actions are taken if they are not followed. If after the home and school environment are controlled and the child continues to have difficulty in school or home performance, the child should be seen by a pediatrician.

The pediatrician’s evaluation weighs heavily on the history of complications that the child has had. It is important to recall when the child first started to have complications, take note of what the child’s grades are like now and determine if the child has any other medical problems. The pediatrician will also have parents and teachers complete a questionnaire that will help with making a diagnosis. Once a diagnosis has been made, treatment can begin.

There are two main forms of treatment, behavioral therapy and medication therapy.

Behavioral therapy focuses on increasing a child’s success at home and in school by making changes to the child’s environment. Several aspects of the therapy include making a schedule for the child to follow, prompting during tasks and breaking tasks into simple steps. Behavioral methods do not work overnight. Consistency improves both the behavioral concerns and school performance. The second form of treatment is medication therapy. There are several different classes of medications, which includes stimulants and non-stimulants. It is important to discuss the side effects and benefits of the different medications prior to starting. Furthermore, once a diagnosis has been made and therapy has begun, a child should have monthly followups with their pediatrician until on an adequate dose for maximum performance with the least side effects. It is important to work closely with the school and your child’s doctor to have the most success with therapy.

Attention Deficit Hyperactivity Disorder is a treatable condition; however, all children that have moments where they are over active or daydream do not have ADHD. There must be increased frequency and severity of these behaviors that interfere with them having a normal life. If there is concern that your child has ADHD, please discuss this with your child’s doctor as soon as possible.

• Dr. Mary Blair is a pediatrician with the Greenwood Children’s Clinic. Email your questions to mblair@glh.org.