Attention+Deficit+Hyperactivity+Disorder+(ADHD)

__ ADHD __

**Term:** Attention Deficit Disorder (ADHD)

**Decription: ** ADHD is one of the most common neurobehavioral disorders of childhood. It is usually first diagnosed in childhood and often lasts into adulthood. ADHD is a problem with inattentiveness, over-activity, impulsivity, or a combination. For these problems to be diagnosed as ADHD, they must be out of the normal range for the child's age and development. Research shows that between 30% and 70% of children with ADHD continue to have symptoms of the disorder when they become adults.

** Causes: ** Scientists are not sure what causes ADHD, although many studies suggest that genes play a large role. Like many other illnesses, ADHD probably results from a combination of factors. In addition to genetics, researchers are looking at possible environmental factors, and are studying how brain injuries, nutrition, and the social environment might contribute to ADHD. However, here are some factors that may play a role in developing ADHD:
 * __ Genes: __Researchers are looking at several genes that may make people more likely to develop the disorder. Children with ADHD who carry a particular version of a certain gene have thinner brain tissue in the areas of the brain associated with attention. This National Institute of Mental Health research showed that the difference was not permanent, however, and as children with this gene grew up, the brain developed to a normal level of thickness.
 * __Environemental Factors:__ Studies suggest a potential link between cigarette smoking and alcohol use during pregnancy and ADHD in children.5,6 In addition, preschoolers who are exposed to high levels of lead, which can sometimes be found in plumbing fixtures or paint in old buildings, may have a higher risk of developing ADHD.
 * __Brain Injuries:__ Children who have suffered a brain injury may show some behaviors similar to those of ADHD. However, only a small percentage of children with ADHD have suffered a traumatic brain injury.
 * __Sugar:__ The idea that refined sugar causes ADHD or makes symptoms worse is popular, but more research discounts this theory than supports it. In studies that gave children either sugar or sugar subsitutes showed no difference in brain behavior.
 * __Food Additives:__ Recent British research indicates a possible link between consumption of certain food additives like artificial colors or preservatives, and an increase in activity. Research is under way to confirm the findings and to learn more about how food additives may affect hyperactivity.

**Symptoms:** Deciding if a child has ADHD is a several step process. There is no single test to diagnose ADHD, and many other problems, like anxiety, depression, and certain types of learning disabilities, can have similar symptoms. The American Psychiatric Association's Diagnostic and Statistical Manual-IV, Text Revision (DSM-IV-TR) is used by mental health professionals to help diagnose ADHD. This diagnostic standard helps ensure that people are appropriately diagnosed and treated for ADHD. To be diagnosed with the disorder, a child must have symptoms for 6 or more months and to a degree that is greater than other children of the same age. __DSM-IV Criteria for ADHD __

I. Either A or B:
 * Six or more of the following symptoms of inattention have been present for at least 6 months to a point that is inappropriate for developmental level: __Inattention__
 * 1) Often does not give close attention to details or makes careless mistakes in schoolwork, work, or other activities.
 * 2) <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Often has trouble keeping attention on tasks or play activities.
 * 3) <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Often does not seem to listen when spoken to directly.
 * 4) <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions).
 * 5) <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Often has trouble organizing activities.
 * 6) <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Often avoids, dislikes, or doesn't want to do things that take a lot of mental effort for a long period of time (such as schoolwork or homework).
 * 7) <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Often loses things needed for tasks and activities (e.g. toys, school assignments, pencils, books, or tools).
 * 8) <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Is often easily distracted.
 * 9) <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Is often forgetful in daily activities.


 * <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Six or more of the following symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for developmental level: __Hyperactivity__
 * 1) <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Often fidgets with hands or feet or squirms in seat when sitting still is expected.
 * 2) <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Often gets up from seat when remaining in seat is expected.
 * 3) <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Often excessively runs about or climbs when and where it is not appropriate (adolescents or adults may feel very restless).
 * 4) <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Often has trouble playing or doing leisure activities quietly.
 * 5) <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Is often "on the go" or often acts as if "driven by a motor".
 * 6) <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Often talks excessively.

__<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Impulsivity __
 * 1) <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Often blurts out answers before questions have been finished.
 * 2) <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Often has trouble waiting one's turn.
 * 3) <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Often interrupts or intrudes on others (e.g., butts into conversations or games).

<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">II. Some symptoms that cause impairment were present before age 7 years.

<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">III. Some impairment from the symptoms is present in two or more settings (e.g. at school/work and at home).

<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">IV. There must be clear evidence of clinically significant impairment in social, school, or work functioning.

<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">V. The symptoms do not happen only during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder. The symptoms are not better accounted for by another mental disorder (e.g. Mood Disorder, Anxiety Disorder, Dissociative Disorder, or a Personality Disorder).

<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">**ADHD Subtypes:**

<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Based on the critera established by the DSM-IV, three types of ADHD have been identified.
 * 1) __<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Predominantly hyperactive-impulsive __
 * 2) <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Most symptoms (six or more) are in the hyperactivity-impulsivity categories.
 * 3) <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Fewer than six symptoms of inattention are present, although inattention may still be present to some degree.
 * 4) __<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Predominantly inattentive __
 * 5) <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">The majority of symptoms (six or more) are in the inattention category and fewer than six symptoms of hyperactivity-impulsivity are present, although hyperactivity-impulsivity may still be present to some degree.
 * 6) <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Children with this subtype are less likely to act out or have difficulties getting along with other children. They may sit quietly, but they are not paying attention to what they are doing. Therefore, the child may be overlooked, and parents and teachers may not notice that he or she has ADHD.
 * 7) __<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Combined hyperactive-impulsive and inattentive __
 * 8) <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Six or more symptoms of inattention and six or more symptoms of hyperactivity-impulsivity are present.
 * 9) <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Most children have the combined type of ADHD.

<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">**Treatment:** <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">In most cases, ADHD is best treated with a combination of medication and behavior therapy. Good treatment plans will include close monitoring, follow-ups and any changes needed along the way. Currently available treatments focus on reducing the symptoms of ADHD and improving functioning. Treatments include medication(stimulant, non-stimulant) various types of psychotherapy, education or training, or a combination of treatments, as well as Clinical Trails.

<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">**Medications:** <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Currently, there are no medications that will cure ADHD, but helps control the symptoms as long as the medication is taken. The most common type of medication used for treating ADHD is called a "stimulant." It has a calming effect on children with ADHD. Stimulants are the best-known and most widely used treatments. Between 70-80 percent of children with ADHD respond positively to these medications. Many types of stimulant medications are available. A few other ADHD medications are non-stimulants and work differently than stimulants. Non-stimulants were approved for treating ADHD in 2003. This medication seems to have fewer side effects than stimulants and can last up to 24 hours. For many children, ADHD medications reduce hyperactivity and impulsivity and improve their ability to focus, work, and learn. Medication also may improve physical coordination. However, a one-size-fits-all approach does not apply for all children with ADHD. What works for one child might not work for another. Stimulant medications come in different forms, such as a pill, capsule, liquid, or skin patch. Some medications also come in short-acting, long-acting, or extended release varieties. In each of these varieties, the active ingredient is the same, but it is released differently in the body. In 2007, the FDA required that all makers of ADHD medications develop Patient Medication Guides that contain information about the risks associated with the medications. The guides must alert patients that the medications may lead to possible cardiovascular(heart and blood) or psychiatric problems. Most of theses medications like Adderall XR, Concerta, Vyvanse, Quilivant XR and Focalin XR are FDA approved for use in adults.

<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;"> Below is a table that lists the medications available and each approved age limit.


 * ~ Trade Name ||~ Generic Name ||~ Approved Age ||
 * = Adderall ||= amphetamine ||= 3 and older ||
 * = Adderall XR ||= amphetamine (extended release) ||= 6 and older ||
 * = Concerta ||= methylphenidate (long acting) ||= 6 and older ||
 * = Daytrana ||= methylphenidate patch ||= 6 and older ||
 * = Desoxyn ||= methamphetamine hydrochloride ||= 6 and older ||
 * = Dexedrine ||= dextroamphetamine ||= 3 and older ||
 * = Dextrostat ||= dextroamphetamine ||= 3 and older ||
 * = Focalin ||= dexmethylphenidate ||= 6 and older ||
 * = Focalin XR ||= dexmethylphenidate (extended release) ||= 6 and older ||
 * = Metadate ER ||= methylphenidate (extended release) ||= 6 and older ||
 * = Metadate CD ||= methylphenidate (extended release) ||= 6 and older ||
 * = Methylin ||= methylphenidate (oral solution and chewable tablets) ||= 6 and older ||
 * = Ritalin ||= methylphenidate ||= 6 and older ||
 * = Ritalin SR ||= methylphenidate (extended release) ||= 6 and older ||
 * = Ritalin LA ||= methylphenidate (long acting) ||= 6 and older ||
 * = Strattera ||= atomoxetine ||= 6 and older ||
 * = Vyvanse ||= lisdexamfetamine dimesylate ||= 6 and older ||
 * Quillivant XR || methylphenidate (extended release) || 6 and older ||

<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">**Psychotherapy:** <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Different types of psychotherapy are used for ADHD. Behavioral therapy aims to help a child change his or her behavior. It might involve practical assistance, such as help organizing tasks or completing schoolwork, or working through emotionally difficult events. Behavioral therapy also teaches a child how to monitor his or her own behavior. Learning to give oneself praise or rewards for acting in a desired way, such as controlling anger or thinking before acting, is another goal of behavioral therapy. Parents and teachers also can give positive or negative feedback for certain behaviors. In addition, clear rules, chore lists, and other structured routines can help a child control his or her behavior.

<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Clinical Trails:
<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">is a research program that tests the effectiveness and safety of various interventions for people with a certain conditions and find new and improved methods of evaluating/treating a condition. There are trails that have been conducted for diagnosis and treatment of ADHD in children. These trails included measuring drug treatment, behavioral treatment and/or combined treatment for children. Some of these trails involving children have tested the potential roles that lead exposure, exposure to other neurotoxins and psychosocial(social and psychological behavior) situations might play in causing ADHD. <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Clinical Trails are divided in four phases: <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">__Phase I__- involves giving new treatment to a small number of participants. researchers determine the best way to give the new treatment and how much can be given safely. <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">__Phase II__- focus on learning whether the new treatment has an effect on a specific condition. Information of side-effects from the treatment is recorded. <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">__Phase III__-compares the new treatment with a placebo. researchers determine which study group has fewer side-effects and is shows the most improvement. <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">__Phase IV__-involves more people, are conducted after the treatment has been approved. provides opportunities to learn more details about the treatment and address questions from other phases of the trails that may have came up.

<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">**Technological Advances:** <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">__Neuro feedback:__ <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">This company is using video games in order to help children maintain focus and increase thier ablilty to concentrate at tasks at hand. media type="custom" key="11384988"

__<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Invisible Clock: __ <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">An Invisible Clock is a small device that looks a lot like a pager. It is designed to send vibrations or beep at specific intervals to help keep a person on task. <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Much like an Invisible Clock, a Motivator can also be programmed to sound when movement occurs. This can be helpful for an adult in the office who is on a deadline and needs to stay at his desk for long periods of time.

<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">__b-Calmsound:__

media type="youtube" key="3SAQy_6WGDo" height="315" width="420"

<span style="background-color: #ffffff; color: #000000; display: block; text-align: left; text-decoration: none;">**<span style="background-color: #ffffff; color: #000000; display: block; font-family: Arial,Helvetica,sans-serif; font-size: 110%; text-align: left;">Currently in ADHD News: ** >
 * According to an article from the Washington Times, Doctors are finding that too many children are being diagnosed with ADHD resulting in children taking powerful medication that they do not need. There was a study by Rae Thomas at the Centre for Research in Evidence-Based Practice at Australia's Bond University. About 87 percent of children diagnosed with ADHD in the U.S in 2010, received medication(a large number received medications that was unnecessary and possible harmful treatment). The side-effects from these powerful medications can be very dangerous such as suicidal thoughts. To read more the article is click on the "Washington Times Article," link under Links.
 * <span style="background-color: #ffffff; color: #000000; display: block; text-align: left; text-decoration: none;"><span style="background-color: #ffffff; color: #000000; display: block; font-family: Arial,Helvetica,sans-serif; font-size: 110%; text-align: left;">New research just released provides insight into one of neuroscience's most intriguing mysteries: how the human brain learns and remembers. These studies - involving topics as diverse as musical memory, "change blindness," and attention deficit hyperactivity disorder(ADHD) - illustrate the profound influence that specific changes in either the brain's structure, function, or both, can have on human behavior.The research findings were presented at Neuroscience 2011, the Society for Neuroscience's annual meeting and the world's largest source of emerging news about brain science and health.
 * <span style="background-color: #ffffff; color: #000000; display: block; text-align: left; text-decoration: none;"><span style="background-color: #ffffff; color: #000000; display: block; font-family: Arial,Helvetica,sans-serif; font-size: 110%; text-align: left;">Women need ADHD meds as well: ADHD is usually thought of as a predominantly male problem, but a new report from Medco Health Solutions shows the number of women taking medication for ADHD is rising rapidly. Researchers studied trends in the use of mental health medications among about 2.5 million insured Americans and found that the number of women aged 20 to 44 on ADHD medicines shot up 250% from 2001 to 2010. In general, amongst women aged 20 to 44 around one in 50 took medicine to control ADHD. One factor that might play a role is the approval for use of all five medicines since 2001.

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 * Webmd-Clinical Trails
 * NIMH- ADHD
 * Washington Times Article