ADHD (Attention Deficit Hyperactivity Disorder) is a neurobehavioral disorder that affects 3-5 percent of all American children.
According to the National Resource Center on ADHD, about 7%, or 705,000, of African American children have attention deficit hyperactivity disorder (ADHD). These numbers come from a 2007 report by the Centers for Disease Control and Prevention. However, these numbers may not accurately reflect the numbers of African American children who have ADHD.
In addition, a 2005 study published in The Journal of the National Medical Association shows that many African American parents were unfamiliar with ADHD. Although the study indicated that 69 percent of African American parents have heard of ADHD, only 36 percent of African American parents actually knew some information about ADHD.
Research has demonstrated that ADHD has a very strong neurobiological basis. Although precise causes have not yet been identified, there is little question that heredity makes the largest contribution to the expression of the disorder in the population.
In instances where heredity does not seem to be a factor, difficulties during pregnancy, prenatal exposure to alcohol and tobacco, premature delivery, significantly low birth weight, excessively high body lead levels, and postnatal injury to the prefrontal regions of the brain have all been found to contribute to the risk for ADHD to varying degrees.
There are three primary subtypes of ADHD, each associated with different symptoms:
ADHD (Primarily Inattentive Type):
- Fails to give close attention to details or makes careless mistakes
- Has difficulty sustaining attention
- Does not appear to listen
- Struggles to follow through on instructions
- Has difficulty with organization
- Avoids or dislikes tasks requiring sustained mental effort
- Is easily distracted
- Is forgetful in daily activities
ADHD (Primarily Hyperactive/Impulsive Type):
- Fidgets with hands or feet or squirms in chair
- Has difficulty remaining seated
- Runs around or climbs excessively
- Has difficulty engaging in activities quietly
- Acts as if driven by a motor
- Talks excessively
- Blurts out answers before questions have been completed
- Has difficulty waiting or taking turns
- Interrupts or intrudes upon others
ADHD (Combined Type):
- Meets both inattentive and hyperactive/impulsive criteria
Exams and Tests
As there is no single test to diagnose ADHD, determining whether a child has the disorder takes many steps. A comprehensive evaluation is necessary to establish the diagnosis, rule out other causes, and determine the presence or absence of coexisting conditions. Such an evaluation requires time and effort. It should include a clinical assessment of the child’s school, social, and emotional functioning, as well as his or her developmental level. A careful history should be taken from parents, teachers, and the child when appropriate.
Teens with ADHD present a special challenge, as the academic and organizational demands upon them increase. In addition, they face typical adolescent issues: discovering their identity, establishing independence, and dealing with peer pressure.
Several types of professionals can diagnose ADHD, including pediatricians, psychologists, social workers, nurse practitioners, psychiatrists, and other medical doctors. A thorough medical examination by a physician is important. Only medical doctors can prescribe medication if it is indicated.
Regardless of who does the evaluation, use of the most current diagnostic criteria according to established professional standards of diagnosis is essential. During the evaluation process, the evaluating professional will request that the child’s parents and teachers complete various forms, checklists, and behavior questionnaires in order to gather comprehensive information.
Effective treatment of ADHD in children and teens requires a comprehensive approach that professionals call multimodal. This means that the best outcomes are achieved when multiple interventions work together as part of a comprehensive treatment plan. The elements of a multimodal treatment approach include:
- Parent training
- Behavioral intervention strategies
- An appropriate educational program
- Education regarding ADHD
- Medication, when necessary
Positive behavior intervention can be critical. The most important techniques are consistency and positive reinforcement, in which the child is rewarded for desired behavior. Classroom success may require a range of interventions, from making minor adjustments in the regular classroom to requiring special education programs. For many children with ADHD, medication may be an integral part of treatment. Both stimulant and nonstimulant medications are now available to physicians and parents.
Around two-thirds of children with ADHD have at least one other coexisting disorder. Disruptive behavior disorders, mood disorders, anxiety disorders, tics and Tourette syndrome, and learning disabilities are among the most common conditions that co-occur in children with ADHD.
When to Contact a Medical Professional
Currently, ADHD assessments are not recommended for children under 6 years of age. Research on preschoolers is being done to learn more about early screening for children at risk of ADHD. If your preschooler displays signs of ADHD, talk to your healthcare provider. Your doctor may advise you to observe and track your child’s symptoms over time.
There is no “cure” for ADHD. Children with the disorder seldom outgrow it; however, some may find adaptive ways to accommodate the ADHD as they mature.
When a child is more than rambunctious, it is important to know the facts. According to research or other evidence, the following steps may be helpful:
- Supplement with essential fatty acids
Getting approximately 186 mg of EPA (eicosapentaenoic acid), 480 mg of DHA (docosahexaenoic acid), 96 mg of GLA (gamma-linolenic acid), 864 mg of linoleic acid, and 42 mg of arachidonic acid supplies fatty acids important for brain function.
- Check out L-carnitine
To improve behavior, take 100 mg of this supplement for each 2.2 pounds of body weight a day, with a maximum of 4 grams a day.
- Give magnesium a go
200 mg a day can address possible deficiency of this mineral that may influence ADHD
- Try the Feingold diet
Work with the Feingold Association or a diet specialist to reduce or eliminate food additives and other food issues that may affect ADHD
These recommendations are not comprehensive and are not intended to replace the advice of your doctor or pharmacist.