ADHD Assessment and Treatment
It is crucial to remember that a complete assessment of ADHD is required prior to beginning any treatment. This includes an interview with a clinician, information from independent sources such as spouses or other family members, DSM-5 ADD symptom checklists and rating scales, as well as tests that are standardized.
Experts may also see your child's school records and speak to teachers as well as religious leaders, scout leaders or coaches. ADHD symptoms must be evident from childhood to be diagnosed at an adult age.
ADHD symptoms
The symptoms of ADHD vary by age, but children suffering from ADHD are often having trouble staying focused on their work or paying attention to others. They might fidget or mutter answers to questions, or interrupt others. They might also have issues organizing, become easily bored and have a hard waiting to be the next. Symptoms of impulsive behavior can include a tendency to engage in activities without permission, or running around or climbing places they shouldn't. They might also be at risk of using extreme excitement or anger to stimulate themselves and may even make others angry or playing pranks on them.
In an evaluation, a physician may use clinical interviews or questionnaires to determine whether the child has ADHD. Teachers may also be asked to complete ratings scales. They can also conduct a neurodevelopmental or physical exam to identify any medical conditions that could cause symptoms of ADHD. These include mood disorders and thyroid issues.
The evaluator will also want to be aware of if your child has any other mental health problems such as oppositional defiant disorder or anxiety disorders or conduct disorder. They will also inquire about your family history, such as whether any other family members have ADHD or other psychiatric disorders.
Adults who suffer from ADHD typically have difficulty managing their life, including home and work responsibilities. They may also have issues being a good coworker or family members. The symptoms of these people can result in them being late for appointments or to not show up at social engagements. Their struggles at school can cause academic failure and poor performance.
For an adult to be diagnosed with ADHD, they must have six or more established symptoms of inattention or hyperactivity-impulsivity for at least six months. Doctors will interview the patient as well as someone who is familiar with them such as a spouse or parent for adults, or a teacher, coach or nanny for children. The information collected will allow the doctor to determine which, if any, tests might determine if other conditions cause symptoms of ADHD. They may also utilize a checklist to detect these signs in adults.
Diagnosis
The process of determining ADHD involves a number of appointments with therapists and doctors. The diagnosis is determined by the presence of symptoms and their impact on a person's life. A correct diagnosis is crucial to gain control over the symptoms, which can affect work and family life. A doctor who is an expert in ADHD, like a psychologist or psychiatrist will be able to determine the cause of the disorder.
The doctor will go over the patient's medical history and symptoms, which includes a discussion of when they first appeared. They might ask the patient to keep a record of their symptoms and the impact on their lives. This can be very helpful in getting an accurate picture of the issue and assisting in determining which tests or evaluations are needed to determine if ADHD is the reason behind the symptoms.
The doctor may also utilize questionnaires to determine the symptoms. This may include questionnaires for parents and teachers to evaluate children for the disorder, as well as an interview with a patient to determine the symptoms they are experiencing. The questions are often similar to those in the NIMH ADHD diagnostic criteria, which help doctors identify whether a person is exhibiting hyperactive/impulsive or inattentive symptoms.
Some doctors will also do an exam to ensure there isn't a physical condition like thyroid issues or seizures, that could be the root of the issue. Other tests are also available to screen other conditions such as depression or anxiety.
Occasionally, the doctor will request brain scans to determine the cause of the symptoms. These tests, which aren't typically used to diagnose ADHD however, can be a useful tool when other tests for diagnosing the condition have been ruled out.
For adults who suspect they or their child has ADHD the best place to begin is to speak with an primary care physician. If the person doesn't have a primary care doctor, they should inquire with their insurance company for a list of health specialists in their area who are certified to conduct an ADHD evaluation.
Treatment options
The first step in treatment is an evaluation by a doctor who will determine if the symptoms are due to ADHD or another mental health issue. An extensive evaluation could include an interview with the child and a parent and rating scales that measure behavior to that of people without ADHD.
A variety of medical conditions can cause symptoms that are similar to the symptoms of ADHD which include thyroid problems, seizures and head injuries. It might be necessary to undergo an exam for physical symptoms to rule out these illnesses. A psychological examination will also be required to determine if the symptoms are due to ADHD or a different mental health condition, like anxiety.
The signs of ADHD can lead to significant impairment in school, work and relationships. The person being evaluated should be honest and open with the examiner about the issues they're having. They shouldn't hide their feelings for fear of criticism or shame. They should describe symptoms as accurately as possible and include the ways they affect them both at home and in school. Parents should be involved in evaluating their children, but not in the decision-making process.
The dosage of the medication will depend on the child's age, the condition that is creating the symptoms, and the kind of medication. Stimulants, for example, are typically prescribed to teens and children with ADHD. They stimulate brain activity in areas that regulate attention and behaviour. They are available in tablets with immediate release and modified-release, which release the medicine slowly throughout the day. Methylphenidate is one of the most commonly prescribed medication for ADHD.
Other treatments for ADHD include family and marital therapy or cognitive behavioral treatment that teaches specific strategies to change negative behavior into positive behavior. These treatments can be beneficial to adults with ADHD as well as educational and occupational accommodations.
The most important part is the follow-up. It is essential to hold regular meetings to evaluate progress and decide the next steps. Parents should be encouraged to include teachers and other professionals, including Scout and religious leaders in the process. These people can provide valuable information on how the child behaves in different environments and provide a more complete picture of the child's functioning.
Medication
ADHD is treated with a variety of medications. Most often, stimulants increase brain activity in certain brain regions that control attention and behavior. Methylphenidate is the most widely used stimulant among teenagers, adults and children older than 5 years old. It comes in tablet form and is usually taken 2 to 3 times per day. It comes in immediate-release (short acting) or extended-release versions (taken one time a day, but released throughout the day).
Many people report that their symptoms and impairment significantly improve after a period of medication. These effects are typically observed in school, home and social situations. Learn Even more of these influences on performance is evaluated by using one or more standardized ratings scales, which compare the performance of a person to others. The scores of these forms aren't considered diagnostic by themselves however they serve as important sources of information that can be used in the evaluation process.
There are non-medical treatment options for ADHD, including behavior therapy and training for parents and teachers. The American Academy of Pediatrics recommends that parents attend training on behavior management before trying medication for their children. The guidelines also recommend psychotherapy and intervention in the classroom to be part of the treatment plan for teens and adolescents with ADHD.
Most commonly, ADHD medication can cause nausea, sleep disturbances, and changes in blood pressure or heart rate. Children and teens who are taking stimulants might develop tics. They are repetitive movements or noises, such as eye-blinking or throat clearing. ADHD medication can cause a slight slowdown in growth for certain teenagers and children, but it's usually not significant and doesn't affect their height.
The stimulant medications have the potential to cause addiction and abuse, however studies have shown that this is not the case with the dosages prescribed for ADHD. ADHD can increase the risk of addiction to substances in some teens and children however this isn't due to the medication.
Another potential negative result of ADHD medication is the risk for developing cardiovascular disease (CVD). A recent study found that those who took stimulant drugs for ADHD had a higher risk of developing CVD than others who didn't take the medications. Researchers analyzed data from 278 027 individuals which included 10 388 individuals who suffer from ADHD. They compared them with 51 672 people who were not diagnosed with ADHD. The participants were monitored for 14 years.