Michael, a twelve year old, was prone to getting into fights with his peers. He had some friends but had trouble making new ones. His parents were especially concerned about his minor accidents – he was always bumping into objects and people. Many of these accidents were serious enough to require a trip to the emergency room where doctors stitched him up dozens of times.
Life at school was not much better. He was an excellent student until third grade when things began to fall apart — he was now failing math and social studies. While he was able to do very well in competitive video games, he could not focus in the classroom or at home. His grades fell.
Michael loved to play football and was considered a good athlete. Eventually, however, his lack of friends and failing grades took a toll on his self-esteem. He would often sulk and lash out irritably. He had difficulty playing quietly alone. He could not follow multi-step directions and would often interrupt people. He was impatient and fidgety and could not watch television show in one sitting. Michael had difficulty completing household chores and keeping his room organized. He would often misplace his mittens, assignment books, pencil sharpener, etc.
Thinking back, Michael’s parents realized he had shown signs of hyperactivity as early as age five. His parents had hoped he would ‘outgrow’ this phase of ‘absent-mindedness’ but now at age twelve, he was still hyperactive. They first tried to change his diet by limiting sugary foods. When his symptoms continued, Michael’s parents gave him an herbal supplement claimed to have beneficial effects on a child’s attention span. But nothing seemed to work. The last straw came when they found a marijuana pipe in his room. It was then that his parents brought him to me for psychiatric evaluation and treatment.
Does your child have Michael’s symptoms?
Michael had classic signs of Attention Deficit Hyperactivity Disorder (ADHD), one of the most common psychiatric illnesses in children. In the past, it has been known as Attention Deficit Disorder (ADD). Now, ADHD is considered to have these subtypes: predominantly inattentive type (significant problem with attention with minimal or no hyperactivity), predominantly hyperactive type (significant hyperactivity with minimal problems with attention) and combined type (significant problems with attention and significant hyperactivity). Parents should realize ADHD is a biological illness which could be treated very successfully with medications and counseling.
How common is ADHD?
Depending on the source of information, 3%-8% of school age children suffer from ADHD. It seems to be about three times more common in boys than girls. Some believe girls tend to suffer mostly from predominantly inattentive type of ADHD which does not cause the more visible problems caused by hyperactivity and therefore diagnosis may be delayed in girls. Primarily English speaking, non-Hispanic white boys are at greatest risk. There is significant geographical (state-to-state) variation in incidence of ADHD.
How early the symptoms of ADHD could be recognized?
Although the typical age of onset is in preschool in early elementary clinical age the symptoms of ADHD, in my experience, can often be recognized in children as young as two or three.
ADHD and often psychiatric illnesses
Children with ADHD seem to have a high incidence of major depression, bipolar disorder, obsessive compulsive disorder, Tourette’s disorder, learning disabilities and substance abuse.
ADHD and peer problems
Children with ADHD, as compared to children with ADHD, are three times more likely to have peer problems and ten times more likely to have difficulties maintaining friendships.
ADHD and physical injuries
Once a year, children with ADHD, as opposed to those without ADHD are more likely to have non-fatal and major physical injuries; hospital and ER admissions; motor vehicle accidents; drinking and driving; traffic violations, etc.
ADHD and stimulant medications
Stimulant medications such as Ritalin (methylphenidate) and Adderall (amphetamines) are among the most effective treatments of ADHD but there are significant misconceptions about these drugs. Even though these drugs are potentially addictive and should be used with caution ‘drug holidays’ during weekends or school breaks are no longer recommended. Additionally latest scientific evidence does not indicate that chemicals of these drugs have any adverse effects on a adult stature.
Next Week: Bringing ADHD Into Focus: Adults