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February 27, 2007
General Evidence-based Information on ADHD
Attention Deficit/Hyperactivity Disorder
Attention Deficit/Hyperactivity Disorder (ADHD) is the most commonly diagnosed behavioral disorder of childhood, estimated to affect between 3% and 5% of school-aged children, as well as 1% to 6% of Adults.
Diagnosis
Accurate diagnosis is difficult (usually requiring multiple tests and more than one visit to a healthcare professional) but essential, as early treatment can substantially affect the course of a child's educational and social development.
A person is considered to have ADHD if he or she demonstrates symptoms of inattention, hyperactivity, and impulsivity for at least 6 months in at least two settings (such as at home and in school). The symptoms must appear before age seven and cause significant functional problems at home, in school, and in various social settings. Although many children with ADHD have symptoms of both inattention and hyperactivity-impulsivity, some demonstrate symptoms from only one of the clusters below.
Symptoms of Inattention
•Fails to pay close attention to details or makes careless mistakes.
•Has difficulty sustaining attention in tasks or play activities.
•Does not seem to listen when spoken to directly.
•Does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace.
•Has difficulty organizing tasks and activities.
•Avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort.
•Loses things necessary for tasks or activities.
•Is easily distracted by extraneous stimuli.
•Is forgetful in daily activities.
Symptoms of Hyperactivity and Impulsivity
•Fidgets with hands or feet or squirms in seat.
•Leaves seat in situations where remaining seated is expected.
•Runs or climbs excessively in inappropriate situations (in adolescents or adults, may be limited to subjective feelings of restlessness).
•Has difficulty playing or engaging in leisure activities quietly.
•Acts as if "driven by a motor".
•Talks excessively.
•Blurts out answers before questions are completed.
•Has difficulty awaiting turn.
•Interrupts or intrudes on others.
Causes
ADHD tends to occur in families, and often overlaps with other brain-based disorders such as Depression, Learning Disorder, Tic Disorder, or Obsessive Compulsive Disorder. Genetic and environmental factors that affect brain development during prenatal and postnatal life are likely involved. Children and adults with ADHD often are found to have altered brain activity in the prefrontal cortex, a region thought to be the brain's command center. Researchers also find that hyperactive behavior in children may result from excessive slow-wave (or theta) activity in certain brain regions, although a number of ADHD subtypes with quite different brain features have been identified, contributing to the complexity of evaluation and treatment.
Treatment
Multiple strategies are most effective to manage ADHD over the long-term. A therapy called Neurofeedback, or EEG Biofeedback, is a non-drug alternative shown in a number of published studies to be beneficial in about 70% of cases. Psychostimulant medications are beneficial in 55% to 60% of cases. Behavioral treatments include individual and family education, behavioral therapy, school remediation, and social skills training. Nutritional management is a frequently explored alternative therapy. Although relatively few studies support various nutritional approaches as effective for ADHD, a growing number of studies do suggest an association between essential fatty acid (EFA) deficiencies and hyperactivity in children. A few studies have shown certain nutritional supplements such as Pycnogenol or DMAE may be similarly effective as Ritalin for ADHD. Preliminary evidence also indicates that homeopathy may significantly improve behavior among children with ADHD.
Research suggests that children who receive sustained comprehensive treatment (such as Neurofeedback, medication, or behavioral therapy) are less likely to have behavioral problems in adolescence. In most cases, ADHD can be effectively managed throughout life, particularly when multiple treatment strategies are combined.
(Adapted from information supplied by the Center for Integrative Medicine, University of Maryland Medical Center, 2004.)
Posted by jeffreywilson1 at February 27, 2007 03:13 PM