What is ADHD? ADHD is a disorder of the brain that first appears in childhood and can continue through adulthood. It affects 2 million kids in the United States. ADHD is divided into two main behavior patterns: inattention and hyperactive-impulsive behavior, but it can also be a combination of the two. For inattention, it is hard for the child to focus on tasks for a sustained period of time. For hyperactive, the child often feels restless or cannot settle down. For impulsive behavior, the child has trouble controlling his or her urges or impulses. In this video, Dr. Preeti Parikh discusses the risk factors and ADHD causes. She discusses risk factors such as genetic factors, the size of one's brain, toxins like lead, as well as maternal smoking and/or drinking while pregnant.
ADHD in Children
Video 1: What is ADHD (Source 3)
• 2 million children in US - 6 million (Source 10)
• Disorder of the brain, first appears in childhood
• 2 patters: Inattention and Hyperactive/ Impulsive or combo
o Inattention- hard to focus on tasks
o Hyperactive/impulsive- restless, can’t control urges
• No known cause
• Possible risk factors- genetics, amount of neurotransmitters in the brain, environmental toxins (lead), smoking/drinking/drugs during pregnancy (Source 7) Dietary factors have not been shown to have any relation
• Problems with school, self-esteem, stress
• No single test to diagnose
Video 2: Signs of ADHD (Source 4)
• Parents should watch for 6 symptoms for 6 months
• Symptoms in 2 settings- home and school
• Usually appear before age 7 but hard to diagnose before that
o Inattention- failure to pay attention to details, trouble paying attention during play, inability to listen when spoken to, difficulty following instructions, trouble organizing, avoids activities that require mental effort, loses things they need, easily distracted
o Hyperactive- fidgeting, getting out of seat, running/climbing at inappropriate times, always on the go, excessive talking,
o Impulsive- Blurting out answers, having trouble waiting turn, butting in (Source 2)
Video 3: Treating AHDH (Sources 1, 5)
• No cure
• Treatment has some controversy
• Best action is therapy + medication + support system
• Behavioral therapy- rewards to reinforce positive actions and punishments to stop negative actions.
• Psychotherapy / family therapy- not shown to be beneficial unless co-existing condition
• Medications can be needed (Source 6)
o Stimulants- safe, help regulate neurotransmitters. Need to be given correctly. Concern about addiction but no reports of addiction in children. SE = weight loss, sleep problems, rarely growth and heart problems (Source 9)
• Anti-depressants- some benefit. Some kids suffer from depression too
• NRI- higher risk of side effects from simulants but has other SE- suicidal thinking and liver problems (Source 8)
1. ADHD: Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents. Pediatrics. October 2011.
2. American Psychiatric Association. Attention-deficit/hyperactivity disorder. In: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, American Psychiatric Association, Arlington, VA 2013
3. Krull K. Attention deficit hyperactivity disorder in children and adolescents: Epidemiology and pathogenesis. Uptodate. June 2014.
4. Krull K. Attention deficit hyperactivity disorder in children and adolescents: Clinical features and evaluation. Update. April 2014.
5. Krull K. Attention deficit hyperactivity disorder in children and adolescents: Overview of treatment and prognosis. Uptodate. June 2014.
6. Krull K. Attention deficit hyperactivity disorder in children and adolescents: Treatment with medications. Uptodate. July 2014.
7. Millichap JG. Etiologic classification of attention-deficit/hyperactivity disorder. Pediatrics. February 2008.
8. Park P, Caballero J, Omidian H. Use of Serotonin Norepinephrine Reuptake Inhibitors in the Treatment of Attention-Deficit Hyperactivity Disorder in Pediatrics. Ann Pharmacother. January 2014.
9. Riggs P. Systematic review with meta-analysis: Stimulant medication for ADHD not associated with subsequent substance use disorders. Evidence-Based Medicine. 2014.
10. Visser S, Danielson M, Bitsko R, Holbrook J, Kogan M, Ghandour R, Perou R, Blumberg Sp. Trends in the parent-report of health care provider-diagnosed and medicated attention-deficit/hyperactivity disorder: United States, 2003-2011. Journal of the American Academy of Child and Adolescent Psychiatry. November 2013.
Note: These are all the sources used for every video in this series, not every source listed was used in this specific video.
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