By Jannette Rivera, MD

All normal children have times when they may appear hyperactive, running around endlessly, yelling and seemingly out of control, and yet, at other times they may seem inattentive and “spaced out.” This may be normal childhood behavior for some, but for others, these behaviors may be so severe that it disrupts their lives.

Attention deficit/hyperactivity disorder (AD/HD) is a diagnosis given to children who consistently display behaviors associated with impulsivity, hyperactivity and distractibility. The diagnostic criteria requires that these behaviors be excessive, long term, appear before age seven, present for at least six months and disrupt at least two areas of a child’s life (i.e. home and school).

AD/HD is one of the most common conditions of childhood. It affects four to twelve percent of school aged children. According to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, the official clinical diagnosis is attention deficit hyperactivity disorder. This diagnosis in turn is divided into three categories: combined type, predominantly inattentive type, and predominately hyperactive/impulsive type. Many people use the term attention deficit hyperactivity disorder and attention deficit disorder interchangeably.

If you suspect your child may have AD/HD, observe your child closely during activities where he is expected to pay attention; children with AD/HD often have difficulty paying attention to detail or when spoken to and make careless mistakes. Observe your child when you expect him to sit for a while or think before acting; children with AD/HD often have difficulty staying on task, following instructions and tend to be restless, fidgety, loquacious or impulsive. Talk to your child’s teacher. Learn about your child’s behavior at school, their academic performance and learning abilities. If you suspect your child has AD/HD, talk to your child’s pediatrician, a clinical psychologist or a psychiatrist.

There is no single medical test for the diagnosis of AD/HD. However, reliable diagnostic criteria and tools have been developed. In order to make an accurate diagnosis, families, teachers and health care providers must work as a team. To evaluate your child, your child’s doctor may ask you and other informants to fill out rating scales about your child. These rating scales will help determine what type of AD/HD your child may have.

The exact cause of AD/HD is not known. Common myths regarding the cause of AD/HD are: poor parenting, lack of discipline, poor teachers, excessive TV viewing, food allergies and excessive sugar. One popular theory regarding the cause of AD/HD is that refined sugar and food additives cause hyperactive and inattentive behavior in children. The National Institutes of Health concluded that refined sugars and food additives may affect five percent of children with AD/HD. AD/HD is more likely caused by abnormal neurotransmitter activity in the brain. There is evidence that AD/HD may have a genetic component.

Clinical studies have shown that the most effective treatment for AD/HD involves both pharmacologic treatments and therapy. Medications are used to normalize neurotransmitter activity in the brain. Pharmacologic treatments include stimulants (Ritalin, Concerta, Adderall, etc.) and non stimulant (Strattera) medications. These can be prescribed by your child’s pediatrician or psychiatrist. Therapy includes behavior therapy and cognitive therapy. These services are aimed at helping the child with behavior modification and with the emotions that arise from having AD/HD. Therapy can be sought from a clinical psychologist or a psychiatrist.

Parents can help their child succeed by establishing routines for daily activities, limiting distractions, assisting their child with organizational and study skills, praising, complementing and providing positive feedback when they put forth their best effort. Identify what your child is good at doing and build on it. Help them with the use of agendas and keep “to-do” lists. Keep rules and instructions clear and brief. Give them a sense of responsibility; this will help boost their self esteem. Allow your child to have downtime and allow them to expel extra energy through physical activity. Remember to work closely with your child’s teacher and doctor. Most of all, tell your child that you love and support them unconditionally.