How Is ADHD Diagnosed?

Though your child may have some symptoms that seem like ADHD, it might be something else. That's why you need a doctor to check it out.
There is no test for ADHD. Instead, diagnosing is a process that takes several steps and involves gathering a lot of information from multiple
sources. You, your child, your child's school, and other caregivers should be involved in assessing your child's behavior. They will also ask
what symptoms your child has, how long ago those symptoms started, and how the behavior affects your child and the rest of your family.
Doctors diagnose ADHD in children after a child has shown six or more specific symptoms of inattention or hyperactivity on a regular basis
for more than 6 months in more than two settings. The doctor will consider how a child's behavior compares with that of other children the
same age.

A doctor will give your child a physical exam, take a medical history, and may even give him a noninvasive brain scan.
Your child's primary care doctor can determine whether your child has ADHD using standard guidelines developed by the American Academy
of Pediatrics, which says the condition may be diagnosed in children ages 4 to 18.

It is very difficult to diagnose ADHD in children younger than 5. That's because many preschool children have some of the symptoms seen in
ADHD in various situations. Also, children change very rapidly during the preschool years.
In some cases, behavior that looks like ADHD might be caused instead by:

A sudden life change (such as divorce, a death in the family, or moving)

Undetected seizures

Medical disorders affecting brain function

Anxiety

Depression

3 Types of ADHD in Children

Doctors may classify symptoms as the following types of ADHD:

Combined type (inattentive/hyperactive/impulsive). Children with this type of ADHD show all three symptoms. This is the most
common form of ADHD.

Hyperactive/impulsive type. Children show both hyperactive and impulsive behavior, but for the most part, they are able to pay
attention.

Inattentive type. Formerly called attention deficit disorder (ADD). These children are not overly active. They do not disrupt the
classroom or other activities, so their symptoms might not be noticed.

ADHD Treatment Overview

Treatment plans may include special education programs, psychological intervention, and drug treatment. Learn as much as you can about
the options and talk them over with your child's health care provider so you can make the best plan for your child.

Studies show that long-term treatment with a combination of medications andbehavioral therapy is much better than just medication
treatment, or no specific treatments in managing hyperactivity, impulsivity, inattention, and symptoms of anxiety and depression. Those kids
treated with both ADHD drugs and therapy also had better social skills.

Understanding ADHD -- the Symptoms

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What Are the Symptoms of ADHD?

 The symptoms of attention deficit hyperactivity disorder -- or ADHD -- vary from person to person, but consist of some combination of
inattention, hyperactivity, and impulsivity.

Inattention. People who are inattentive have a hard time keeping their mind focused on one thing and may get bored with a task after only a
few minutes. Focusing conscious, deliberate attention to organizing and completing routine tasks may be difficult. You may notice
restlessness, procrastination, problems remembering obligations, trouble staying seated during meetings or activities, or starting multiple
projects at the same time but rarely finishing them.

Understanding ADHD

Hyperactivity. People who are hyperactive always seem to be in motion. They can't sit still and may dash around or talk incessantly.Children
with ADHD are unable to sit still and pay attention in class. They may roam around the room, squirm in their seats, wiggle theirfeet, touch
everything or noisily tap a pencil. Older adolescents and adults with ADHD may feel intensely restless.

Impulsivity. People who are overly impulsive seem unable to think before they act. As a result, they may blurt out answers to questions or
inappropriate comments, or run into the street without looking. Their impulsivity may make it difficult for them to wait for things they want or to
take their turn in games. They may grab a toy from another child or hit when they are upset. They often have difficulty making and keeping
friends.

ADHD often coexists with other conditions, such as depression, anxiety, conduct disorder, and oppositional defiant disorder. Some
symptoms may overlap with other medical conditions, as well.

Call Your Doctor About ADHD If:

You or your child shows symptoms of ADHD. Because the disorder is difficult to assess, be sure to see a doctor who is experienced with
diagnosing and treating ADHD and similar problems.

ADHD in Children Health Center

Tools & Resources

Alternative Treatments for ADHD

Getting Medication Right

ADHD Myths and Facts

How ADHD is Diagnosed

Types of ADHD

Quiz: Teen ADHD

ADHD in Children: When a Teacher Recognizes ADHD Symptoms

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Has your child's teacher let you know that they think your child has ADHD?

Teachers are often the first ones to recognize or suspect ADHD in children. That's because ADHD symptoms can affect school performance
-- and in some cases, disrupt the rest of the class -- and because teachers are with children day in and day out.
 Recommended Related to ADD-ADHD - Pediatric

ADHD Multimodal Treatment

ADHD (attention deficit hyperactivity disorder) is characterized by inattention, hyperactivity, and the inability to control impulses. It affects an estimated 5.2
million school-age children in the U.S. Everyone, especially younger children, may have symptoms of ADHD from time to time. But with ADHD, the ability to
function with daily activities is affected. A diagnosis of ADHD can be hard to make, and evaluation must be made by a specialist. There are several different
approaches to treating...

Read the ADHD Multimodal Treatment article > >

Since teachers work with many different children, they also come to know how students typically behave in classroom situations requiring
concentration and self-control. So when they notice something outside the norm, they may speak with the school psychologistor contact the
parents about their concerns.

But teachers can't diagnose ADHD. They can tell you what they've noticed, but after that, you would need to get a professional to evaluate
your child to see if they have ADHD or if something else is going on.

Because an ADHD diagnosis is based on observations of a child's behavior, the teacher -- and often past teachers -- will play a key role in
the process, though. The professional who makes the diagnosis -- usually a specially trained doctor, psychologist, psychiatrist, counselor, or
social worker -- will ask your child's teachers to rate their observations of your child's behavior on standardized evaluation scales to compare
it to that of other children the same age and gender.

ADHD Treatment: Coordinating With the School

If your child is diagnosed with ADHD, you'll need to work closely with your child's school.

The school nurse may play a role in dispensing ADHD medications. Your child's teacher will be important in carrying out the behavioral part
of a treatment plan.

As a parent, you'll need to keep open the lines of communication with the teacher to ensure a consistent system of incentives and discipline
between school and home.

For example, a younger child's teacher may make a checklist and reward the child with a star or smiley face each time he or she completes a
certain number of items on the list.

You may have a similar system at home or provide a bigger reward -- such as a special dinner, a family movie night, or an extra hour of TV or
computer time -- when your child gets a certain number of stars or smiley faces.

Getting Support for Yourself if Your Child Has ADHD

Your child's teacher can be a good supporter and resource, but you may want more help dealing with the challenges and emotions
of parenting a child with ADHD, or with concerns about medications or other issues.

Read and learn as much as you can about ADHD and its treatment. Other resources include your child's doctor or other professional who
diagnosed ADHD, and other parents of children with ADHD.

A national nonprofit organization called Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) also has resources,
including support groups for families. The organization's web site lists support groups in your area, and gives information on how to start a
group.

ADHD in Children Health Center

Tools & Resources

Alternative Treatments for ADHD

ADHD Myths and Facts

 Types of ADHD

How ADHD is Diagnosed

Getting Medication Right

Quiz: Teen ADHD

6 Parenting Tips for Raising Kids With ADHD

What to do, and not to do, if your child has ADHD.

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By Katherine Kam
WebMD Feature

Reviewed by Roy Benaroch, MD

When Hal Meyer learned that his son, 5, had ADHD, he couldnt believe it. When his child was at school, He was rambunctious, he couldnt
stay in his seat, he was going around, helping everybody, Meyer recalls. But to him and his wife, these were signs of brightness and
curiosity, not symptoms of inattention, impulsivity, and hyperactivity.

But experts told them, You dont understand. These are not typical of a 5-year-old.

Recommended Related to ADD-ADHD - Pediatric

Drug Combinations to Treat ADHD in Children

Ask 10 different parents how they treat their children's ADHD and you're likely to get 10 different answers. That's because treatment for ADHD is personalized.
Depending on the child, treatment can include: A single medicine Combination of medicines Medicine plus behavioral therapy Often, medicine treatment for
ADHD starts with a stimulant drug, such as: Adderall (amphetamine) Vyvanse (lisdexamfetamine) Concerta, Daytrana, or Metadate (methylphenidate) ...

Read the Drug Combinations to Treat ADHD in Children article > >

After they explained the disorder, the couple took a long time to accept the news. We went through a year or two of denial, Meyer says.

That was 20 years ago. Since then, Meyer has learned a lot about raising a child with ADHD. He shares those lessons with other parents
who are dealing with the power struggles, tantrums, low self-esteem, and school problems that often come with the disorder.

Shortly after his sons diagnosis, Meyer co-founded the New York City chapter of Children and Adults with Attention Deficit-Hyperactivity
Disorder (CHADD), a nonprofit education and advocacy group. He also founded the ADD Resource Center in New York City, which
provides parenting classes and support groups, among other services.

In New Jersey, Eva OMalley also knows the challenges first-hand. She has ADHD and so do her daughter, 22, and son, 17. OMalley
founded the Monmouth County CHADD chapter.

When OMalleys son was diagnosed at age 12, her husband worried about his son being labeled. Would people see the ADHD and not the
boy?

The children have grappled with school problems, forgetfulness and disorganization, OMalley says. Sometimes, ADHD makes both offspring
live only in the moment. You dont learn from your past, and you dont have a vision to the future, OMalley says. But there have been bright
spots, too, including her sons improved grades.

WebMD asked these parents, as well as a developmental pediatrician, to share insights on raising a child with ADHD.
 1. Be honest with your child about ADHD.

Meyer never thought about keeping the news from his son. I told him exactly what was going on, he says.

In contrast, some parents hide the disorder by telling their child, for example, that their ADHD drug is a magic vitamin, he says. But Meyer
has done ADHD coaching with kids who have confided that they arent fooled: they know that itsmedication.

ADHD isnt a childs fault. Its a brain disorder that causes youngsters to have trouble with concentration, ability to complete tasks, or plan for
the future. By being open, Meyer lessened the stigma for his son.

Once, he took his son, who was 7 or 8 at the time, to a restaurant where they spotted a youngster in perpetual motion -- so much, in fact,
that one parent had to hold him down. My mouth must have dropped, Meyer says. And my son said to me, Dont look at him as
hyperactive. Look at him as being in a hurry to see the world.

Impulse Control: Managing Behaviors of ADHD Kids

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It's hard for kids to hold back when they see something they really want. They need the ice cream cone NOW. They want their turn at the
new video game NOW.

Most kids learn self-control as they get older. Yet it can be harder for children with attention deficit hyperactivity disorder (ADHD) to gain
control over their impulses. As kids they might blurt out answers in class without raising their hand. Or they might jump into games without
waiting their turn.

In the teenage years, impulsivity can lead kids to drive while drunk, get into fights, have unprotected sex, or abuse drugs and alcohol.

Impulsive kids can seem out of control. But there are effective ways to get a handle on this behavior. Treatments that can help include:

Cognitive behavioral therapy

 Medicine

Teach New Behavior Skills

One way to help your child gain control over his or her impulses is with behavior skills therapy.

Cognitive behavioral therapy (CBT), and a form of CBT called social skills training, teach kids with ADHD how to:

Take charge of their behavior

Interact more positively with others

Learn the consequences of their actions

In CBT, children learn important skills, such as how to:

Wait their turn

Read social cues, like facial expressions and body language, and adjust their behavior based on these cues

Play by the same rules as other children

Understand the results of their actions

You can also control your child's impulsivity at home by using tools such as:

Distractions

Consequences

Rewards

Here are some tips:

Distraction. When your child acts impulsively, distract him or her by redirecting to another activity. For example, you can say: "I know you
want the video game. But why don't we play a game of catch until your friends are done playing with it?"

Consequences. Set clear and consistent consequences for bad behavior. For example, you can say: "You didn't stop interrupting so I'm
sending you to your room to quiet down."

Rewards. When your child stays in control and controls his impulses, reward him or her with praise.

Work With Teachers

Your child spends most of the day at school. That's why it's important to reinforce in school any behavior skills your child learns at the
therapist's office or at home.

To curb impulsivity during the day, make the teachers your allies. Try taking these steps:

Keep in close touch with all of your child's teachers.

Ask frequently how your child is behaving in school.

Work together with teachers to find solutions for any impulsivity issues that arise.
 Exercise

If you've ever sent your child outside to burn off some energy when he or she was misbehaving, you were on the right track. Studies are
finding that exercise can help control impulsivity and other behavior problems in kids with ADHD.

Consider signing your child up for a sports team, such as basketball, soccer, or baseball. Playing a sport not only gives kids exercise, but it
also teaches them important social skills, such as how to follow rules and take turns.

Tips to Reduce the Side Effects of ADHD Medications

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By Katherine Kam
WebMD Feature

Reviewed by Louise Chang, MD

WebMD Archive

For many children, ADHD medications curb restlessness, impulsivity, and inattention well enough for them to flourish at home, school, and on
the playground. But the drugs can also prompt common side effects, such as low appetite, stomach pain, or sleep problems. In rare and
serious cases, they can cause heart problems, such as chest pain, liver problems, or suicidal thoughts.

We do deal with both wonderful treatment response, but at the same time, medication-related side effects, says Murat Pakyurek, an
associate clinical professor at the University of California-Davis Medical Center department of psychiatry and the UC Davis M.I.N.D.
Institutes ADHD program. The majority of the medication-related side effects are mild and temporary in nature. But there are a few side
effects that are more severe and that need to be addressed immediately, he says.

Recommended Related to ADD-ADHD - Pediatric

What Is Adjunctive Therapy for ADHD in Children?

These days, parents have several options to improve their children's ADHD symptoms. Kids who are diagnosed with ADHD often start by taking a single
medicine, which is commonly from the stimulant class of medicines. If a stimulant drug doesn't work well, the doctor might recommend another type of medicine
added onto it. This is called adjunctive therapy.

Read the What Is Adjunctive Therapy for ADHD in Children? article > >

If your child takes ADHD medications, follow these tips to reduce common side effects. Be on the alert, too, for rare side effects.

Tips for Coping With ADHD Drug Side Effects

Decreased appetite: If your childs appetite wanes after taking ADHD medicine, give the dose after breakfast so that he or she will
eat better in the morning. Serve a large dinner in the evening, when the drug is beginning to wear off. Keep plenty of healthy snacks on hand;
a balanced diet with nutritious, higher-calorie foods and drinks will help to offset any weight loss from the ADHD drug. If your childs poor
appetite lasts for a long period, ask the doctor about reducing the dose or stopping the drug on weekends or summer breaks to allow
appetite to return to normal.

Stomach pain or upset: Dont give your child medicine on an empty stomach. For any GI discomfort, taking the medication with
or immediately after food will make a very big difference, Pakyurek says.

Sleep problems: Set up a regular bedtime routine that includes relaxing activities, such as bathing or reading. If a stimulant type of
ADHD medication prevents your child from sleeping well, ask the doctor about taking the drug earlier in the day or switching from a long-
acting to a shorter-acting form . Ask, too, about reducing the dose or stopping the drug in the afternoon to help your child sleep at bedtime.

Daytime drowsiness: If the ADHD drug atomoxetine (Strattera) is making your child sleepy during the day, ask about giving the
drug at bedtime instead of in the morning. You can also check with the doctor about lowering the dose or dividing the dose and giving it twice
a day.

Rebounding effects: When ADHD drugs wear off in the afternoon or evening, some children have more ADHD symptoms or
irritability. To prevent this rebounding, ask your childs doctor about using a longer-lasting medication or taking a small dose of fast-acting
stimulant later in the day.
 Mood changes: Keep an eye out for changes in your childs mood. If you see changes, such as lessened emotional expression or
suicidal thinking, alert your childs doctor right away.

Heart problems: Since there have been rare reports of serious heart problems in patients taking ADHD drugs, tell your childs
doctor about any heart problems in the family. If theres any history of significant heart problems, the physician may closely monitor,
particularly if theyre using stimulants. Or they may even decide to get an EKG to make sure that the child does not have any cardiac
problem, Pakyurek says.

Regular exams: While your child is on ADHD drugs, he or she will need regular visits with the doctor who prescribes the drugs, in part to
watch for side effects. The doctor will monitor vital signs, such as blood pressure and pulse, as well as height and weight. If theres a change
in your childs growth trajectory, treatment may need adjusting so that your child can catch up, says Ben Vitiello, a psychiatrist and chief of
the Child and Adolescent Treatment and Preventive Intervention Research Branch at the National Institute of Mental Health. Ask the doctor,
too, if your child needs tests, such as an EKG or periodic blood tests to check liver enzymes.