Ask the Doctor
Dr. Teresa Lemma, M.D.
Board Certified Pediatrician and
Program Director for the Pediatric Residency Program at
Richmond University Medical Center
Managing Behaviors in Children with ADHD
ADHD, also known as attention-deficit hyperactivity disorder, is a behavior disorder, usually first diagnosed in childhood that is characterized by inattention, impulsivity, and, in some cases, hyperactivity. Most families seek help when their child's symptoms begin to interfere with learning and adjustment to the expectations of school and age-appropriate activities.
The following are the three most common symptoms of ADHD:
1.Inattention. The child exhibits difficulty listening to others or attending to details, is easily distracted, forgetful, or shows poor organizational skills for their age. They may be caught day-dreaming in school or at home.
2.Impulsivity. The child has difficulty waiting for their turn in school or social games, often interrupts, blurts out answers before waiting to be called upon, or takes frequent risks without thinking of consequences.
3.Hyperactivity. The child seems to be in constant motion, as if driven by a motor. They have difficulty remaining in their seat when expected, talks or fidgets excessively, repeatedly forgets or loses things, or shifts from one task to another without any completion.
ADHD has three subtypes:
- Predominantly hyperactive-impulsive: usually boys.
- Predominantly inattentive: usually girls.
- Combined hyperactive-impulsive and inattentive: Most common subtype.
The symptoms of ADHD may resemble other medical conditions or behavior problems. Keep in mind that many of these symptoms may occur in children and teens that do not have ADHD. A key element in diagnosis is that the symptoms must significantly impair adaptive functioning in both home and school environments. Always consult your pediatrician for a diagnosis.
ADHD probably is caused by a combination of factors:
Genes: ADHD runs in families. Boys are at higher risk for developing ADHD. They are affected 4 times more than are girls.
Environment: There may be an increase incidence of ADHD in the children of women who smoke or drink during pregnancy or in preschool children who have had lead exposure
Increase intake of sugar is not a risk factor.
Treatment For Attention-Deficit/Hyperactivity Disorder
Specific treatment for ADHD will be determined by your child's pediatrician based on factors including your child's age, overall health, and medical history, the extent of your child's symptoms, and their tolerance for specific medications or therapies.
Major components of treatment for children with ADHD include parental support and education in behavioral training, appropriate school placement, and medication. Treatment with a psycho stimulant is highly effective in many children with ADHD.
Parenting children with ADHD may be difficult and can present challenges that create stress within the family. Classes in behavior management skills for parents can help reduce stress for all family members. Training in behavior management skills for parents usually occurs in a group setting which encourages parent-to-parent support.
Behavior management skills may include the following:
◦ Point systems. Reward systems designed specifically for your child may help to reinforce good behaviors, build structure and routine, and help them identify a way to complete attainable goals.
◦ Contingent attention. Respond to the child with positive attention when desired behaviors occur and withhold attention when undesired behaviors occur. Teachers may also be taught behavior management skills to use in the classroom setting. Training for teachers usually includes use of daily behavior reports that communicate in-school behaviors to parents.
Behavior management techniques tend to improve targeted behaviors (such as completing school work or keeping the child's hands to himself or herself), but are not usually helpful in reducing overall inattention, hyperactivity, or impulsivity. Treatment for impulse control may include psycho stimulant medications. These medications are used for their ability to balance chemicals in the brain that prohibit the child from maintaining attention and controlling impulses. They help "stimulate" or help the brain to focus and may be used to reduce the major characteristics of ADHD.
Prevention of ADHD
Preventive measures to reduce the incidence of ADHD in children are not known at this time. However, early detection and intervention can reduce the severity of symptoms, decrease the interference of behavioral symptoms on school functioning, enhance the child's normal growth and development, and improve the quality of life experienced by children or adolescents with ADHD.
Dr. Teresa Lemma is a Board Certified Pediatrician who practices at Pediatric Health Care PC in New Dorp along with Clifford Mevs, MD and Susan Daiuto, DO. She is the Program Director for the Pediatric Residency Program at Richmond University Medical Center.