Doctor-Recommended Advice for an ADHD Child Get the 411 on ADHD Medications, Learning Disabilities and More

Your child can’t sit still in the classroom, is always getting into trouble and can’t seem to remember simple tasks. Could it be ADHD? Read on for advice from adolescent psychiatrist Stephen Grcevich, M.D., on ADHD symptoms in children, medications and more. It’s natural for kids to be full of energy. But when a child can’t focus, constantly runs around, is overly mischievous and won’t sit still in the classroom, it could signal attention-deficit hyperactivity disorder (ADHD) — the most commonly diagnosed neurobehavioral disorder among kids. ADHD affects 1 in every 12 children in the U.S., according to the Centers for Disease Control and Prevention, with symptoms typically beginning as young as age 4 or 5. “An ADHD child has inappropriate levels of inattention and hyperactivity,” says child and adolescent psychiatrist Stephen Grcevich, M.D., assistant professor of psychiatry, Northeastern Ohio Universities College of Medicine, and president of Family Center by the Falls, Chagrin Falls, Ohio. “That means the child can’t function normally in school, family and social settings,” Grcevich says. Read on to learn how to manage your ADHD child with diet and medications, and what to expect as your child grows. How does a diagnosis of ADHD and ADD differ? Or are they the same? Some children are attention deficit, but they’re not impulsive or hyperactive. That is why some are diagnosed with attention deficit disorder (ADD). Do boys and girls exhibit symptoms of ADHD differently? Boys are more likely to demonstrate poor impulse control and hyperactivity. They’re more likely to fidget in class, be unable to sit still at dinner or be prone to injury because they act impulsively without thinking of consequences. Girls with ADHD are more likely to be daydreamers, “spacey” or disorganized. So while ADHD probably affects boys and girls equally, boys are diagnosed more often because they exhibit more outward symptoms. Can any foods help calm ADHD symptoms in children? Can sugary or processed foods cause ADHD or worsen ADHD symptoms? In my opinion, diet isn’t a significant factor in ADHD. No substantive evidence suggests that specific foods can calm ADHD symptoms in children. Two short-term studies have demonstrated modest improvements when children with ADHD ate a diet that restricted processed sugar, artificial dyes and preservatives. But no long-term data demonstrates the benefits of such diets. A small percentage of children with ADHD may have specific food allergies that exacerbate existing symptoms, but that’s not the norm. It’s also tough for children and families to adhere to strict dietary restrictions, so that might not be a practical treatment method. What medicines are most effective in treating an ADHD child? Stimulant medications are the prescription treatment of choice for most children with ADHD. They can dramatically improve their ADHD behavior. How do stimulants help an ADHD child? These medicines boost attention span and focus by increasing the levels of certain chemicals in the brain, such as epinephrine and norepinephrine, which help transmit signals between nerves. Seventy-five years of research with more than 2,000 published studies demonstrate benefits of stimulant medication for ADHD. The most commonly prescribed stimulants include Adderall XR (mixed amphetamine salts), Concerta (OROS methylphenidate), Vyvanse (lisdexamfetamine) and Focalin XR (d-methylphenidate). Sometimes it’s necessary to try different types and dosages to find the one that works best for an ADHD child. Are stimulants the only drug option? Nonstimulant medicines are also used, particularly if the ADHD child isn’t responding to stimulants, has a heart condition (stimulants can speed up pulse) or can’t tolerate the side effects of stimulants. The most commonly prescribed nonstimulants are Strattera (atomoxetine) and Intuniv (guanfacine ER). Tics are a side effect of stimulants. Why do some children develop them? It’s not clear. Increased dopamine activity, decreased sleep or increased anxiety are some theories. Tics caused or worsened by stimulant medications typically resolve within a day or two of discontinuing the medication. Are medicines that treat ADHD addictive? Taken orally, the medications are rarely addictive because the dose isn’t concentrated enough for the brain to get a high. People who become addicted typically have to get the medication into a form they can smoke, snort or inject. Is there a link between taking stimulants for ADHD and drug abuse? Substance-abuse rates among teens and young adults who take medication for ADHD aren't significantly different from peers without the disorder. The bigger risk is not treating ADHD. Teens and young adults with ADHD who don’t take medication have roughly twice the rates of substance use as peers who don’t have ADHD. That’s why treatment with ADHD medication during adolescence and young adulthood is important in reducing the risk of substance abuse. What is an auditory processing disorder and how is it different from ADHD? An auditory processing disorder (APD) is a learning disability in which children have difficulty processing language-related tasks, like listening in class or trying to understand verbal instructions — especially in noisy settings like a classroom or when siblings are talking in the room. ”Auditory processing” describes what happens when your brain recognizes sounds that travel through the ear and changes those sounds into information. With auditory processing disorder, the brain jumbles up the information. Children with APD often have trouble recognizing subtle differences between sounds in words, even if the sounds are loud and clear. For example, “Tell me how a chair and a couch are alike” may sound to a child with auditory processing disorder like “Tell me how a cow and a hair are alike.” ADP children may not have trouble interpreting or remembering non-language related tasks like playing with toys, building with blocks. Can children have an auditory processing disorder and ADHD? Absolutely. Specific learning disabilities are far more common among kids with ADHD. Do ADHD children typically earn bad grades in school? Not always. Some children develop strategies to compensate for their inattention and disorganization. The more intelligent the child, the more strategies, like covering for their symptoms or justifying them, they're likely to use to compensate for their ADHD symptoms. This is why some highly intelligent children with ADHD aren't diagnosed until late in high school, college or in some instances, adulthood. Will an ADHD child have to take medicine throughout life? About 50% of children with ADHD will continue to experience significant functional impairment as adults. But many patients stop taking medication when they go to college and choose classes within a major they find interesting, and they do well in their studies. Can an ADHD child outgrow the disorder? Children appear to outgrow certain symptoms of ADHD as areas of their brain mature. Hyperactive symptoms are most likely to resolve first. Impulse control improves next. The symptoms least likely to resolve over time include inattention, disorganization, procrastination, poor time management and difficulties with task completion. So an ADHD child might outgrow the ‘hyperactivity’ aspect but probably not the other difficulties.