Does your child have ADHD?
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Updated January 05, 2015.
Children with attention deficit-hyperactivity disorder (ADHD) may have predominantly hyperactive-impulsive, predominantly inattentive, or combined subtypes. Complaints about ADHD generally arise from parents, teachers, or other caregivers rather than the child.
Symptoms of hyperactivity and impulsivity include excessive fidgeting, restlessness, difficulty playing quietly, always being on the go, talking excessively, not waiting turns or blurting out answers.
After 7 to 8 years of age, hyperactivity tends to decline and by adolescence, symptoms may be barely observable to others, though feelings of restlessness may continue. Impulsivity, on the other hand may continue through life. Adolescents with untreated ADHD are at a greater risk of engaging in drug use or experimentation than those without ADHD.
Inattentiveness just means a reduced ability to focus attention. Cognitive processing speed may also be reduced. Children may appear to be daydreaming. Inattentive traits may only become apparent at age 9 or so, as the child makes careless mistakes, seems not to listen, avoids tasks requiring consistent effort, and is easily distracted.
As a result of either hyperactivity or inattention, children with ADHD may have fewer opportunities to develop social skills or have difficulty forming friendships. Poor self-esteem and increased risk of depression or anxiety may result.
Additional Tests:
As if often the case, a physician’s job is largely to exclude other potential causes such as hearing or vision problems, nervous system infections, medication side effects, or head trauma.
The doctor will want to know about recent emotional or medical events, as well as developmental milestones such as when the child first began speaking. It can be difficult to distinguish problems with learning, language, or auditory processing from ADHD. Gifted children may also be misdiagnosed due to boredom in a regular classroom. A brief list of alternative conditions to consider includes:
It’s also important to investigate for coexisting disorders such as oppositional defiant disorder, conduct disorders, depression, anxiety, or learning disabilities, which are all more common in children with ADHD.
When other causes are excluded, different rating scales and criteria may be used to diagnose ADHD. It is often useful to obtain information from professionals in school or after-school programs.
Quantitative EEG analyzes the electrical activity of the brain in ways that may provide diagnostic information. While the FDA has licensed the use of EEG for assessment of children with ADHD, and studies have shown differences between children with ADHD and normal children, most medical professionals believe the studies were of limited quality. A subsequent meta-analysis has suggested the EEG results are unreliable. Furthermore, there is no evidence suggesting that EEG is superior to better-established clinical diagnosis. However, few would argue against use of an EEG if a seizure disorder is suspected. A polysomnogram may be used to investigate for sleep disorders.
Other clinical evaluations may include a language evaluation to rule out language or communication disorders, an evaluation of motor coordination, or a mental health evaluation. Laboratory tests may include lead levels, thyroid hormones, or genetic tests.
Criteria:
The DSM-5 criteria for ADHD insist that at least 6 symptoms of hyperactivity and impulsivity or inattention are needed in children. This number drops to 5 in people aged 17 or older. Symptoms must occur often, be present in more than one setting, last at least six months, be present before the age of 12, impair function, and exceed what is expected for the child’s age. The criteria cannot be applied to children less than four years of age. Response to stimulant medication cannot confirm or refute an ADHD diagnosis, as this improves behavior in children with other problems as well as normal kids.
Source:
KR Krull, Attention deficit hyperactivity disorder in children and adolescents: Clinical features and evaluation. UpTo Date, updated Sep 111, 2014, accessed December 28, 2014.
Updated January 05, 2015.
Children with attention deficit-hyperactivity disorder (ADHD) may have predominantly hyperactive-impulsive, predominantly inattentive, or combined subtypes. Complaints about ADHD generally arise from parents, teachers, or other caregivers rather than the child.
Symptoms of hyperactivity and impulsivity include excessive fidgeting, restlessness, difficulty playing quietly, always being on the go, talking excessively, not waiting turns or blurting out answers.
After 7 to 8 years of age, hyperactivity tends to decline and by adolescence, symptoms may be barely observable to others, though feelings of restlessness may continue. Impulsivity, on the other hand may continue through life. Adolescents with untreated ADHD are at a greater risk of engaging in drug use or experimentation than those without ADHD.
Inattentiveness just means a reduced ability to focus attention. Cognitive processing speed may also be reduced. Children may appear to be daydreaming. Inattentive traits may only become apparent at age 9 or so, as the child makes careless mistakes, seems not to listen, avoids tasks requiring consistent effort, and is easily distracted.
As a result of either hyperactivity or inattention, children with ADHD may have fewer opportunities to develop social skills or have difficulty forming friendships. Poor self-esteem and increased risk of depression or anxiety may result.
Additional Tests:
As if often the case, a physician’s job is largely to exclude other potential causes such as hearing or vision problems, nervous system infections, medication side effects, or head trauma.
The doctor will want to know about recent emotional or medical events, as well as developmental milestones such as when the child first began speaking. It can be difficult to distinguish problems with learning, language, or auditory processing from ADHD. Gifted children may also be misdiagnosed due to boredom in a regular classroom. A brief list of alternative conditions to consider includes:
- Autism spectrum disorders
- Neurodevelopmental syndromes like fragile X, Klinefelter or fetal alcohol syndrome
- Seizure disorder
- CNS infection or trauma
- Metabolic disorders
- Motor coordination problems
- Emotional and behavior disorders
- Psychosocial and environmental factors:
- Sleep disorders
- Substance abuse or medication side effects
It’s also important to investigate for coexisting disorders such as oppositional defiant disorder, conduct disorders, depression, anxiety, or learning disabilities, which are all more common in children with ADHD.
When other causes are excluded, different rating scales and criteria may be used to diagnose ADHD. It is often useful to obtain information from professionals in school or after-school programs.
Quantitative EEG analyzes the electrical activity of the brain in ways that may provide diagnostic information. While the FDA has licensed the use of EEG for assessment of children with ADHD, and studies have shown differences between children with ADHD and normal children, most medical professionals believe the studies were of limited quality. A subsequent meta-analysis has suggested the EEG results are unreliable. Furthermore, there is no evidence suggesting that EEG is superior to better-established clinical diagnosis. However, few would argue against use of an EEG if a seizure disorder is suspected. A polysomnogram may be used to investigate for sleep disorders.
Other clinical evaluations may include a language evaluation to rule out language or communication disorders, an evaluation of motor coordination, or a mental health evaluation. Laboratory tests may include lead levels, thyroid hormones, or genetic tests.
Criteria:
The DSM-5 criteria for ADHD insist that at least 6 symptoms of hyperactivity and impulsivity or inattention are needed in children. This number drops to 5 in people aged 17 or older. Symptoms must occur often, be present in more than one setting, last at least six months, be present before the age of 12, impair function, and exceed what is expected for the child’s age. The criteria cannot be applied to children less than four years of age. Response to stimulant medication cannot confirm or refute an ADHD diagnosis, as this improves behavior in children with other problems as well as normal kids.
Source:
KR Krull, Attention deficit hyperactivity disorder in children and adolescents: Clinical features and evaluation. UpTo Date, updated Sep 111, 2014, accessed December 28, 2014.
Source...