Parenting a Child With ADHD (cont.)
John Mersch, MD, FAAP
Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- Childhood ADHD facts
- What are the signs and symptoms of childhood ADHD?
- What should parents do if they suspect their child has ADHD?
- What are the causes of childhood ADHD?
- What should parents of children with ADHD expect from their child?
- What treatment options exist for a child with ADHD?
- What are the risks of the use of stimulant medication and other treatments?
- What are other therapeutic approaches for children with ADHD?
- Is childhood ADHD on the rise?
- What is the outlook for a child with ADHD?
- What can parents of children with ADHD do to help themselves?
- Find a local Psychiatrist in your town
Is childhood ADHD on the rise?
No one knows for sure whether the prevalence of ADHD (total number of patients) has risen, but it is very clear that the number of children newly identified annually (incidence) with the disorder and who obtain treatment has risen over the past decade. Some of this increased identification and increased treatment seeking is due in part to greater media interest, heightened consumer awareness, and the availability of effective treatments. Teachers are better trained to recognize the condition and suggest that the family seek help, especially in the more mild to moderate cases. The established DSM-IV ADHD criteria are concise and more exact than those diagnostic tools used previously. This may allow establishment of the diagnosis in children with more subtle or milder expression of the symptoms. The diagnosis of ADHD is also less of a social stigma than in the past. This more enlightened perspective reflects the understanding that ADHD is a biochemical disorder and not merely an "out of control child." As such, more parents are receptive to medical therapy for the condition rather than resorting to less effective home/school discipline techniques. Interestingly, the increase in prevalence of ADHD is not solely an American phenomenon but has been noted also in other countries. Whether the number of patients with ADHD has truly increased or rather our better recognition and acceptance of ADHD as a diagnosis has "increased," the number of patients remains to be further defined.
What is the outlook for a child with ADHD?
Literature supports the clinical observation that as many as 50% of children with ADHD will have symptoms persist into adulthood. One caveat needs to be mentioned -- many studies previously conducted focused on a patient population of males who were evaluated or treated by psychiatrists/psychologists or in clinics specially developed for such a patient population. The value of generalizing these results to the entire patient population with ADHD should be done with caution. Fortunately, new studies are being conducted to address this issue.
The following are current areas of concern:
- Education: Follow-up studies of children with ADHD growing into adolescence showed impairment of academic success. A few studies into adulthood have demonstrated persistence of these findings. Completion of expected schooling, lower achievement scores, and failure of courses are areas of concern.
- Employment: The rate of adult employment of those with and without a diagnosis of ADHD did not vary; however, those with ADHD did have occupations with a lower "job status."
- Socialization issues: A significant subset of children with ADHD has accompanying disruptive behavior disorders (oppositional defiant disorder or conduct disorder). In studies that followed children with ADHD into adulthood, between 12%-23% have socialization problems, versus 2%-3% of the general population.
- Substance abuse: Studies examining whether those with ADHD have a higher likelihood for such high-risk behaviors are controversial. The largest study to date supports other smaller studies that indicate ADHD patients who consistently take their medication have twice the likelihood of not using illicit drugs or excessive alcohol.
- Driving: A teen with ADHD is two to four times more likely to have a motor-vehicle accident or have his/her license suspended than a peer without such a diagnosis. Impulsivity and inattention again seem to be limited when at-risk teens consistently take their recommended medication.
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