Attention Deficit Hyperactivity Disorder (ADHD) is a disorder that occurs as a result of a brain chemical imbalance that affects only certain functions (concentration or behavior planning) but does not affect global intelligence.
Even though the exact cause of the disorder remains unknown, research indicates a strong genetic component related to the inheritance of a chemical imbalance of dopamine (up to 30% of all cases, one of the parents suffers the same problem.) There is also an indication that there may be a relation to perinatal complications (problems around time of delivery).
Children are immature beings and it is normal to have some degree of hyperactivity and impulsivity, and, of course, they can’t focus attention for as long as adults.
However, we also know that between 5 and 10% of school-age children suffer from this problem. These children exhibit certain characteristics or signs from a very young age: they are extremely active -they seem to have a “motor”-; they change from activity to activity quickly and do not complete tasks; they are absent-minded, often lose things, and have difficulty planning and organizing their time; they are often unable to predict the consequences of their actions, and seem to be very daring; they have difficulty waiting their turn and tolerating frustration, and might have problems with peer relationships. These are children have difficulty focusing in class or following instructions given to them at home, and they often make “stupid” mistakes for not adequately paying attention.
A “side effect” of particular concern to professionals is that of low motivation. We frequently find that our school-age patients have “given up” or are discouraged because they see the results of their efforts and continually face negative feedback.
Teachers are most commonly the first ones to alert parents to any difficulty that their child is having (15% teachers vs. 6% parents). This is normal because they work with the child in a noisy environment, full of stimuli and where paying attention, taking turns and inhibition of impulses, etc. are in the top 10 of “what to do.” Whenever the teacher is suspicious, it’s worth a visit to an expert for an evaluation.
Two professionals working together would ideally carry out the diagnostic process: a doctor (either a child psychiatrist or pediatric neurologist) and a psychologist.
The psychologist will administer tests in order to confirm that there is a problem with attention and measure its severity, as well as to rule out other causes of deterioration in academic performance (i.e. borderline intellectual functioning or learning disabilities). The evaluation process will include interviews with parents, the child and teachers. The doctor will corroborate the diagnosis after discarding other physical problems that can impair attention and evaluate whether medication is needed or not.
Medication only makes sense when the concentration problem reaches a critical intensity and interferes in several areas of the child’s life: school, social relationships, family life…
In case the inattention problems are mild, first step is parent training to help children learn skills that will promote attention or inhibition of impulses, and teaching parents how to give instructions, and to work with the child on study skills, self-instruction techniques, etc.
The most effective form of treatment in case of a moderate or severe attentional deficit is to combine cognitive-behavioral psychotherapy and medication.
Sinews is a center that offers all services in English and Spanish. The “Kids” division includes a full team of specialists: psychiatrists, psychologists, speech therapists & occupational therapist with tests available both in english and spanish. For more information, check the website.
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