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 Attention Deficit and Hyperactivity Disorder (ADHD)

From WebMD, the most well-known consumer health information resource

  • Symptoms in children, include “easily distracted,” “loses things,” and “daydreams”

  • Causes of ADHD aren’t known, however, “several things may lead to it” like “heredity” and “toxins” but not “sugar” or “poor home life”

  • ADHD treatment:

    • Medication: Lists 8 medications with amphetamines listed as the first option… dietary supplements for essential fatty acids (omega 3) are also suggested.

    • Therapy: Lists several options with special education listed as the first option. No references to any specific resources.

  • What to expect: “many people live successful, happy lives.”

  • Other resources provided:

    • Guess Who Has Dyslexia?

    • Easing ADHD Symptoms … how afterschool programs can help kids… “The researchers can't say for sure whether after-school programs ease symptoms”

    • Bipolar disorder or ADHD?

    • Scary Side Effects of ADHD Meds

The Health Hippo experience

Symptoms in children:  Inattentiveness, impulsivity, and hyperactivity occur to some extent in all children. It is the persistence, pervasiveness, and functional complications of the behavioral symptoms that lead to a diagnosis of ADHD.  6 or more symptoms of hyperactivity and impulsivity or 6 or more symptoms of impulsivity including “occur often” and “impair function in academic, social, or occupational activities”. [Citation:  American Psychological Association’s Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5)]

  • Is ADHD the accurate diagnosis?  The symptoms of ADHD overlap with over 33 individually described medical conditions, including visual processing, auditory processing, developmental variations such as giftedness or coordination disorders, and sleep problems.  Further, as many as one-third of children with ADHD have an additional related health issue.  A thorough set of testing is necessary to confirm a diagnosis of ADHD and potentially related issues, as summarized here (link to chart).  [Citation]

  • Can an ADHD diagnosis be confirmed if ADHD medications prove beneficial?  No.  Studies have shown that stimulant medications improve behavior in children with ADHD, children with conditions other than ADHD (eg, learning disabilities, depression), and normal control children.  Worse, the non-specific improvement in behavior that occurs with stimulant medication can mask other problems and/or delay the use of more appropriate interventions.  [Citation]

Causes of ADHD:  Genetics appears to be a primary factor based on studies of twins, family-based and case-control studies, and population-based genetic testing.   Various environmental factors may play a secondary role.  Dietary factors, such as food additives, are being investigated along with prenatal medications and conditions (such as alcohol and tobacco smoke) and head trauma in young children.

ADHD treatment.

  • Behavior therapy including … (provide link to resources)

  • Medication (note potential need for cardiac evaluation), for age 6 or above

  • Medication (note potential need for cardiac evaluation), for ages 4 and 5; amphetamines are not recommended

  • Combination therapy

  • School-based interventions including… (provide link to resources)

  • Psychotherapy interventions (if there are other related health issues)

  • Physical activity

  • Mindfulness

  • Dietary diets

    • Elimination diets

    • Essential fatty acid supplementation

  • Trigeminal nerve stimulation

  • Other alternative therapies including vision training, megavitamins, herbal and mineral supplements, neurofeedback / biofeedback, chelation, and applied kinesiology.

What to expect. 

Prognosis depends on severity of symptoms at onset, whether other related health issues also exist, intellect, social advantage, and whether the condition responded to treatment.   Issues to be concerned about include a potential higher rate of injury and self-injury, driving issues, academic functioning, and substance abuse.

Other resources provided: 

  • National Initiative for Children’s Healthcare Quality toolkit.

  • US Agency for Healthcare Research and Quality’s comparative effectiveness review of interventions for preschoolers at risk for attention-deficit/hyperactivity disorder (ADHD).

Myth-busting

  • How prevalent is ADHD among children?  Because ADHD is not a reportable disease, estimates vary widely, ranging from 2 to 18%, and rely on parent-reporting and information derived from medical records, billing or pharmacy records.

  • Poll:  what do you feel people should know, but don’t, about ADHD?  (access to poll leads to paywall)