Attention Deficit Hyperactivity Disorder
Attention deficit hyperactivity disorder (ADHD) is the most commonly diagnosed psychiatric disorder of childhood, estimated to affect 3 to 5 percent of school-aged children. Two to three times as many boys as girls are affected by ADHD. Research shows that ADHD tends to run in families.
The core symptoms of ADHD include developmentally inappropriate levels of attention, concentration, activity, distractibility, and impulsivity. Children with ADHD usually have impaired functioning in peer relationships and multiple settings including home and school. ADHD has also been shown to have long-term adverse effects on academic performance, vocational success, and social-emotional development.
What Treatments Are Available for ADHD?
Psychostimulant medications, including methylphenidate, amphetamine, and pemoline, are by far the most widely researched and commonly prescribed treatments for ADHD. Numerous short term studies have established the safety and efficacy of stimulants and psychosocial treatments for alleviating the symptoms of ADHD.
A multisite study of children with ADHD recently concluded that the two most effective treatment modalities for elementary school children with ADHD are a closely monitored medication treatment and a treatment that combines medication with intensive behavioral therapy. The combination of medication and behavioral therapy was necessary to produce improvements in some outcomes such as academic performance and family relations.
Another study has shown that boys with ADHD who are treated with stimulants are significantly less likely to abuse drugs and alcohol when they get older. In previous studies, these same researchers found that nearly twice as many adults with ADHD (that was generally not diagnosed or treated until much later in life) also abused drugs and/or alcohol at some point in their lives, compared to adults without ADHD. More studies are needed to examine the long-term use of stimulant medications in children and adolescents.
Problems Faced by Families
ADHD can be reliably diagnosed when appropriate guidelines are used. Ideally, a health care practitioner making a diagnosis should include input from parents and teachers. But some health practitioners make a diagnosis without all this information and tend to either overdiagnose the disorder or underdiagnose it. Despite data showing that stimulant medication is safe, there are widespread misunderstandings about the safety and use of these drugs, and some health care practitioners are reluctant to prescribe them. Like all drugs, the medications used to treat ADHD do have side effects and need to be closely monitored.
Parents need to carefully evaluate treatment choices when their child receives a diagnosis of ADHD. When they pursue treatment for their children, families face high out-of-pocket expenses because treatment of ADHD and other mental illnesses is often not covered by insurance policies. In schools, treatment plans are often poorly integrated. In addition, there are few special education funds directed specifically for ADHD. All this leads to children who do not receive proper and adequate treatment. To overcome these barriers, parents may want to look for school-based programs that have a team approach involving parents, teachers, school psychologists, other mental health specialists, and physicians.
A two-day consensus conference on ADHD, held at the National Institutes of Health in November 1998, brought together national and international ADHD experts as well as representatives from the public.
For More Information
Mental Health: A Report of the Surgeon General can be viewed at www.surgeongeneral.gov
National Institute of Mental Health
Office of Communications and Public Liaison
Information Resources and Inquiries Branch
6001 Executive Blvd., Room 8184, MSC 9663
Bethesda, MD 20892-9663
Phone: 301-443-4513
TTY: 301-443-8431
FAX: 301-443-4279
Mental Health FAX 4U: 301-443-5158
E-mail: nimhinfo@nih.gov
NIMH home page address: www.nimh.nih.gov
Substance Abuse and Mental Health Services Administration
Center for Mental Health Services
Office of External Liaison
Room 15C-05, Parklawn Building
5600 Fishers Lane
Rockville, MD 20857
Phone: 301-443-2792
FAX: 301-443-5163
SAMHSA home page address: www.samhsa.gov
CMHS Knowledge Exchange Network (KEN)
P.O. Box 42490
Washington, DC 20015
Phone: 1-800-789-2647
FAX: 301-984-8796
KEN home page address: www.mentalhealth.org
U.S. Department of Health and Human Services
Mental Health: The Cornerstone of Health
Home page address: www.mentalhealth.org/cornerstone
