Attention-deficit/hyperactivity disorder (ADHD)

Attention deficit hyperactivity disorder (ADHD) is a common condition. A person who has ADHD has trouble paying attention and focusing on tasks, tends to act without thinking, and has trouble sitting still.

It may begin in early childhood and can continue into adulthood. ADHD can be treated with medicines, behavior therapy, and counseling. Treatment can improve your life.

In the past, ADHD was called attention deficit disorder (ADD).

The exact cause of ADHD is not clear. It tends to run in families, so genetics may be involved. Scientists are studying other possible causes, such as things in the environment and things that happen before or after birth.

A doctor uses a combination of exams, tests, and other information to check for ADHD. The doctor will look at guidelines created by the American Psychiatric Association. The diagnosis will be based on:

• A talk with your child.
• Your child's medical history. The doctor will ask about your child's social, emotional, educational, and behavioral history.
• A physical exam.
• Behavior rating scales or checklists for ADHD. These are used by parents and teachers to evaluate your child's symptoms.

Before meeting with your doctor, think about at what age your child's symptoms began. You and other caregivers can help by recording when the behavior occurs and how long it lasts. An important part of checking for ADHD is thinking about the kinds of problems caused by the behaviors. How much do they affect schooling and social behavior?

Treatment for ADHD will depend on the age of the person. It may include medicines and behavior therapy. For example:

• Children ages 4 to 5 years are treated first with behavior therapy. Your child's doctor will talk to you about medicine if your child's symptoms do not improve.
• Children ages 6 to 11 years are treated with medicine or behavior therapy or both.
• Children ages 12 to 18 years are treated with medicine and usually also with behavior therapy.
• Medicines can help, but they may have side effects and risks.

Medicines that may be used for ADHD include:

Stimulant medicines.

One example is amphetamine (for example, Adderall). Another is methylphenidate (for example, Concerta or Ritalin).

Nonstimulant medicines.

Examples are atomoxetine (Strattera), clonidine (Kapvay), or guanfacine (Intuniv). These medicines may be used if stimulant medicines aren't effective or have side effects that bother the person. They may be used alone. Or they may be used in combination with stimulant medicines.

With behavior therapy:

• Parents learn strategies, such as positive reinforcement, to improve a child's behaviors.
• Children learn skills for problem solving, communication, and self-advocacy.

Even though medicine can help improve your child's symptoms, it can't solve all of your child's behavior problems. Your child may also benefit from counseling, behavior therapy, or social skills training.

Behavior therapy helps train parents, teachers, and other adults who are caring for a child with ADHD. These programs focus on setting routines and rules for behavior and closely watching how a child responds.

Behavior programs most often used to help treat ADHD in a child include:

Behavior management.

Time-out and reward systems can help a child who has ADHD to learn appropriate behaviors for the classroom and home. Parents learn behavior management skills during a series of several counseling sessions. Each session may be 1 to 2 hours a week.

Social skills training.

These techniques help the child learn to be less aggressive and impulsive. Children learn to manage anger and behave in a more socially acceptable way.

Counseling.

This includes family therapy. All household members can benefit from learning how to deal effectively with ADHD behavior.

Behavior therapy for adults with ADHD

Behavioral intervention for adults focuses on help with organizational skills and healthy relationships.