Attention Deficit Hyperactivity Disorder in Children (ADHD in Children or Childhood ADHD)

  • Medical Author:
    Roxanne Dryden-Edwards, MD

    Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    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.

ADHD Symptoms in Children

Quick GuideADHD Symptoms in Children

ADHD Symptoms in Children

What are the treatments for ADHD in children? What are possible side effects of ADHD medications?

What are non-medication treatments for ADHD in children?

While medications are often prominent in the treatment of ADHD, there are a number of treatments without drugs. Psycho-education for the ADHD sufferer and his or her loved ones can be invaluable in improving understanding about the challenges of this condition and ways to cope. Behavioral treatments that address the interactions that the child with ADHD has with his or her parents, peers, and in school are also important in improving the child's ability to function. One such approach to behavioral treatment is Applied Behavioral Analysis (ABA). ABA uses a number of strategies for encouraging positive observable (as opposed to reported) behaviors and discouraging the continuation of negative observable behaviors by holding the individual accountable, establishing achievable goals, empowering the person's strengths, and maintaining an optimistic stance throughout the treatment process.

Mental-health professionals often work with parents through specialized parenting skills trainings and/or through family therapy to enhance family structure and support, develop ways to manage a child's behaviors and to cope with any distress that the symptoms of ADHD causes within the family. Children with ADHD, their parents, or other family members may also benefit from being part of a support group, in that such groups have the unique perspective of people who have similar experiences and can therefore give first hand advice on ways to cope.

ADHD treatment specialists may assist teachers in developing ways to provide academic accommodations, thereby encouraging and reinforcing the child's strengths, decreasing the child's counterproductive behaviors, and maximizing the child's academic success. Research shows that ADHD sufferers can also significantly improve their study skills, self-regulation, and feelings of well-being as the result of receiving ADHD coaching. This intervention is often designed to include weekly sessions, either in person, by telephone, or email over several months, often the length of the school year. The ADHD coach tends to focus on issues like scheduling homework, extracurricular and leisure activities, setting goals, organizing, confidence building, setting priorities, and persisting in getting things done. The coach will further provide emotional support, teach and encourage healthy social skills, self-discipline, and how to advocate for themselves. In order to encourage optimal investment of the child or adolescent in the ADHD coaching relationship, the goals and strategies are guided by the person with ADHD rather than the coach.

Mental-health practitioners may enlist the child with ADHD in an anger management or social-skills training group of their peers to improve the child's ability to manage his or her emotions, as well as their success at making and keeping friends.

Individual psychotherapy that uses a cognitive behavioral approach has been found to be an effective part of comprehensively treating ADHD. This method teaches time management, organization, and planning in an attempt to decrease the negative impact that distractibility, restlessness, and impulsivity can have on the life of the ADHD sufferer. It also seeks to alleviate ways of thinking that encourage depression and anxiety.

What are medications for ADHD in children?

Children with ADHD often benefit from being prescribed medication. The most common medications used to treat this disorder are the stimulant medications. Perhaps the oldest prescribed stimulant for the treatment of ADHD is Ritalin. However, given the longer days that older children and teens have compared to young children, stimulants that last longer are usually prescribed for those age groups. Examples of these prescribed drugs include long-acting preparations of methylphenidate, like Daytrana patches, Quillivant-XR liquid, Ritalin-LA, Concerta, and dexmethylphenidate (Focalin-XR), as well as the long-acting amphetamine salt Adderall-XR. Long-acting stimulants also include lisdexamfetamine (Vyvanse). However, shorter-acting stimulants like amphetamine salt (Adderall), amphetamine sulfate (Evekeo), dextroamphetamine sulfate (Dexedrine or Zenzedi), and methylphenidate preparations, like Focalin and Metadate, may be more suitable for younger children so they are less likely to have trouble sleeping at night. Daytrana and a liquid form of methylphenidate called Quillivant XR can be useful in younger children because these two medications do not present trouble swallowing for children. Vyvanse and Focalin-XR can also be useful in that regard since its capsules can be opened and put in liquid or on food. Also, the effect of the Daytrana patch comes out of the child's system soon after the patch is removed, allowing parents to have more control over how long they would like the medication effect to last each day.

Some children and adolescents may need to take a nonstimulant medication for treatment of ADHD. For those whose symptoms early in the morning or late in the evening are an issue, stimulants may not be the optimal medication treatment. For others, side effects like low appetite, stomach upset, insomnia, tremors, depression, loss of exuberance, irritability, less frequently tics, and rarely hallucinations may make it unwise for the child to take a stimulant medication. While stimulant treatment of people with ADHD who have no history of drug abuse tends to contribute to a decreased likelihood of developing a substance-abuse problem later on, those who have a recent history of alcohol or other drug abuse may make the small but real addiction potential of stimulants a reason not to prescribe a medication from that group. For children who either experience suboptimal effects, side effects, or significant stimulant medication side effects, non-stimulant medications like guanfacine (Tenex or Intuniv), clonidine (Catapres or Kapvay), or atomoxetine (Strattera) may be considered. The prescription dietary supplement Vayarin has also been found to be effective in treating childhood ADHD.

Children who suffer from ADHD are at higher risk for developing mood problems during adulthood. They may therefore benefit from medications that have been found to be helpful for people who have both ADHD and depression or anxiety, like bupropion (Wellbutrin) or venlafaxine (Effexor).

While further research is needed to determine the potential effectiveness of home or natural remedies for treatment of ADHD, a number of parents use such treatments without drugs in an attempt to help their children. Such alternative treatments include vitamin supplements and restrictions to the child's diet. A significant limitation of these remedies includes the difficulty in implementing them. The Feingold diet (developed in the 1970s) involves omitting food additives in an attempt to alleviate ADHD symptoms. While the Feingold diet may help some individual children, it has long ago been deemed ineffective for most.

Lifestyle improvements have been found to help reduce some symptoms in some children. Such improvements include regular exercise and ensuring the person receives adequate sleep every night. In fact, there is research that indicates that regular physical activity can measurably decrease ADHD symptoms, particularly in young children. Children who have trouble sleeping may benefit from over-the-counter medications that are not habit forming, such as melatonin.

Medically Reviewed by a Doctor on 5/2/2016

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