ADHD - Dr. Stombaugh’s cheat sheet
What is ADHD?
ADD or ADHD is a chronic disorder where there is an imbalance within the nervous system. This can interfere with a child’s development, functioning and relationships. It can occur in children or adults. It can be disruptive but is a manageable condition. There is nothing “ wrong” with your child. There is nothing that you did to cause ADHD in your child. Their brain just works differently. Individuals can struggle with the following:
Focusing
Impulse control
Hyperactivity
Inattention
Poor listening
Difficulty starting/completing tasks
Easily bored
Interrupting others
Fidgeting
Excessive talking
Easily distracted
Disorganization
(note: not every child has hyperactivity)
What ADHD is NOT.
It is not laziness, poor parenting or due to a high sugar diet. It is not contagious. There is no cure but many options for treatment.
First Steps?
The first step in evaluating a child is to discuss your concerns with your pediatrician. It is important to be sure that there are no hearing or vision problems. Also, your pediatrician will need to rule out anxiety which can look like ADD/ADHD. Is your child sleeping enough? Adequate sleep is crucial when helping children who are inattentive because an unrested child can exhibit multiple behavioral issues. Make sure that your child is getting daily physical activity and has a well-balanced diet. Your pediatrician will ask lots of questions and use a screening tool to document the challenges your child is having at home and at school. Your child may also be tested for a learning disability.
Treatment Options?
Not every child will need to be medicated for his/ her ADHD. Because it is a spectrum disorder with mild —>moderate —>severe symptoms, it will depend on your child, the family’s comfort level and the affect on his/ her functioning. All children should have a therapist to tackle behavioral issues and teach organizational skills. This can also help parents with coping skills and discipline at home. This is important for the optimal treatment of ADHD/ ADD and should be started early on once the diagnosis is made. School support is also crucial as ADD/ ADHD can affect academic performance (although not always very obvious) and relationships with peers. If medication is started, keep in mind that close follow up will be needed. Here are the various types of medications used to treat ADHD/ ADD.
STIMULANTS
Works 70-80% of the time
Works immediately
Increase levels of dopamine and norepinephrine (brain chemicals)
ex: Methylphenidate, Dextroamphetamine, Dexmethylphenidate
Brand names: Vyvanse, Concerta, Ritalin, Focalin, Adderall
NON-STIMULANTS
Works 20-30% of the time
Works within a few days
Various mechanisms
ex: Guanfacine, Clonidine, Atomoxetine
Brand names: Intuniv, Kapvay, Strattera
ALTERNATIVES
Limited data but some positive affects have been noted in certain age groups
Omega-3 Fatty Acids (fish oil) found on salmon, tuna and trout or supplements
(good sleep hygiene, well-balanced diet, daily physical activity should be part of any treatment plan)
Dr. Stombaugh’s Pearls for Parents:
Stay positive - kids with ADD/ ADHD have many great qualities. They are creative, persistent and bright.
Be realistic - Children still need to work hard. There are no quick fixes or magic pills. It is healthy to discuss personal expectations and goals with your child (yours and the child’s)
Be patient - It may take a few weeks to find the right treatment plan for your child
Set boundaries - ADHD is not an excuse for poor behavior, be kind and firm
Ask questions - the more you know, the more you can help your child
If your child’s treatment plan involves medications, this does not mean he/ she will be on them forever. As a child matures, learns coping skills and his/ her brain fully develops, often times they can be trialed off their medications and can do quite well. This of course is dependent on the child and life situations.