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Dear Melissa,
My daughter’s kindergarten teacher is concerned that she has ADHD. How do I know if she has ADHD or not? If she does have ADHD, what are the best treatment options?
Last week I tackled the first part of your question in my blog post, “ADHD or just being an active kid?” This week I’m addressing the second part of your question.
How is ADHD treated?
According to the CDC, in most cases ADHD is best treated with a multifaceted approach. This can include medication, behavior therapy, parent training, and school accommodations. Because roughly 10% of American children have a diagnosis of ADHD, there have been many, many, MANY books written about additional treatment options. Some of these options are sound and have research to support them; others are no better than snake oil. Unfortunately, inappropriate treatments can actually cause harm. It is very important to discuss all of your child’s ADHD interventions, both pharmaceutical and non-pharmaceutical, with your child’s pediatrician or mental health professional.
Behavioral Interventions
With so many treatment options, where do you start? According to the American Academy of Pediatrics, treatment for preschool-aged children should start with evidence-based behavior interventions BEFORE any medications are considered. This is where many pediatric Occupational Therapists can help. By working with the child, their families and teachers, strategies are used to:
- address impulsivity
- regulate emotional outbursts
- improve focus and attention
Also in my role as an OT, I help children with ADHD “catch up” on any splinter skills such as handwriting, making friends, and self-care. These are not developed properly due to difficulties attending to tasks.
Medication
Several different types of medications may be used to treat ADHD. Children can sometimes react differently to various ADHD medications. Because “trial and error” may be needed before the right combination is found, parents must work closely with the child’s prescribing physician. Any side effects need to be reported; you should not just stop a medication on your own.
Though it may seem counter-intuitive, stimulant drugs work well for many children with ADHD. Think of it this way. When the drug provides a child brain with sufficient stimulation, then the child is less likely to constantly seek out additional stimulation from his or her environment. Between 70-80% of children with ADHD respond positively to stimulant medications.
Currently, stimulants are the best-known and most widely-used treatments. A recent study published by the American Academy of Pediatrics found that treating ADHD with stimulants is NOT associated with reduced growth patterns in children as they reach adulthood. However, decreased appetite and difficulty sleeping have been observed as possible side-effects. Non-stimulant drugs were approved for treating ADHD in 2003 and appear to have fewer side effects.
Importance of Treatment
Regardless of the treatment approaches you choose, the bottom line is simple: get your child’s symptoms under control. Children with unmanaged ADHD are at a higher risk for substance abuse, smoking, job loss, divorce, and driving accidents. Therefore, it is imperative to work with your child’s treatment team in order to find what works for YOUR child.
What techniques have worked for you? Please share!
Please share! share@childrenstherapyteam.com
Resources:
What is ADHD, National Institutes of Health
ADHD or Not? Why a Diagnosis Matters, Web MD, Eric Metcalf (2012)
ADHD, Center for Disease Control & Prevention
ADHD: Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/ HyperactivityDisorder in Children and Adolescents, American Academy of Pediatrics, Pediatrics Volume 128, Number 5 (November 2011)
Diagnosing ADHD in Children: Guidelines & Information for Parents, American Academy of Pediatrics, (updated January 2015)
ADHD, Stimulant Treatment, and Growth: A Longitudinal Study, E. Hardstand, Weaver, Katusic, Colligan, Kumar, Chan, Voigt, Barbaresi, American Academy of Pediatrics, Pediatrics, Volume 134, (October 2014)
Stimulant Treatment of ADHD and Cigarette Smoking: A Meta-Analysis, E. Schoenfelder, Faraone, Kollins, American Academy of Pediatrics, Pediatrics Volume 133, Number 6 (June, 2014)
ADHD Resource Center, American Academy of Child & Adolescent Psychiatry (updated October, 2014)