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Attention deficit hyperactivity disorder

Attention deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders in children. It is usually first diagnosed in childhood and often continues into adulthood. Children with ADHD may have trouble paying attention, controlling impulsive behaviors (may act without thinking about what the result will be), or tend to be overactive. In addition to genetics, other possible causes and risk factors for ADHD are brain injury, exposure to environmental risks (e.g., lead) during pregnancy or at a young age, alcohol and tobacco use during pregnancy, premature delivery, and low birth weight.

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Symptoms

Symptoms of ADHD children include inattention, hyperactivity, and impulsivity. Many children with ADHD:

  • Are in constant motion

  • Squirm and fidget

  • Make careless mistakes

  • Often lose things (e.g., school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile phones).

  • Do not seem to listen

  • Are easily distracted

  • Do not finish tasks

  • Often leave their seat in situations when remaining seated is expected.

  • Often run about or climb in situations where it is not appropriate (adolescents or adults may be limited to feeling restless).

  • Cannot play or take part in leisure activities quietly.

  • Talk excessively

  • Blurt out an answer before a question has been completed.

  • Have trouble waiting for their turn

  • Interrupt or intrude on others (e.g., butting into conversations or games)

  • Have trouble organizing tasks and activities

  • Forget daily activities

Diagnosis

The diagnosis of ADHD can be made by a team of specialists treating the child which include children's physicians, psychiatrists, and child psychologists. The standard guidelines have been mentioned for ADHD diagnosis by the American Academy of Pediatrics or the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM).

The following components will likely be considered in making the diagnosis of ADHD:

  • The physical examination will help rule out other possible causes for the symptoms.

  • Gathering information about any present medical conditions, personal or family medical history, and the history of the symptoms.

  • ADHD rating scales or psychological tests to help collect and evaluate information about the symptoms.

Treatment

ADHD can be treated by medications or lifestyle modification therapy, but a combination of both is often preferred.

The various therapies which are beneficial for the treatment of ADHD are physical exercise and yoga.

  • Behavioral management interventions such as parent training, classroom intervention, and peer-based intervention.

  • Training interventions: Cognitive behavioral therapy (CBT), neurofeedback, virtual- and augmented reality-based training, educational games/programs, organizational & skills training.

  • Integrative medicine: mindfulness, Tai Chi, hypnosis, dietary intervention, and meditation. 

 

Currently, several clinical trials on the development of new therapeutics for ADHD are evolving. Stand-alone emerging drugs for treating ADHD include Viloxazine and Dasotraline. Some emerging drugs that have the potential to treat specific symptoms of ADHD, when used in conjunction with the standard pharmacotherapy in children include amantadine. Amantadine has proved to enhance cognitive functions in ADHD, and tipepidine is effective in improving hyperactivity/impulsivity symptoms in ADHD.

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