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ADHD: The Facts About its Cause and Treatment
There has been so much confusion and misinformation about children who are hyperactive and distractible. Parents have heard that there’s no such thing as Attention Deficit Hyperactivity Disorder—that the diagnosis has been made up by doctors to make money—or that ADHD is caused by allergies, food colouring, too much sugar or a vitamin deficiency.

To make things more confusing, the media have connected the medication Ritalin with school shooters and teen suicide. Of course this has terrified parents. In addition, some groups buy ads in the media that spread false information about psychiatry, attempting to discredit the profession.

It’s no wonder parents are confused, scared and suspicious about ADHD.

During my many years as a child psychologist, I have treated thousands of youngsters with the disorder. Many of these children were as young as 4, 5 and 6. I have seen cases where teens with ADHD drop out of school, become delinquent and eventually end up in jail. And I have seen children with ADHD who are properly treated and leading successful lives.

Treatment really can make a difference. But in order to make an informed decision about treating a child, it’s imperative that parents have accurate information about ADHD.

According to the best research we have today, ADHD is a neurological disorder. It is not caused by allergies, food colouring, vitamin deficiencies or sugar. It is largely inherited: That is, ADHD runs in families. Also, some children have accidents and become neurologically impaired, resulting in ADHD. And some mothers run into problems during their pregnancy or delivery that result in ADHD.

There is no cure for ADHD. For kids diagnosed with it, the goal is to manage the disorder so that they don’t develop emotional and personality problems.

Medications that help children with ADHD are mostly stimulants. Dexedrine and Ritalin have been the two main stimulants doctors have relied on over the years. Research has resulted in medications like Concerta and Adderall, which are seen as being more effective and having fewer side effects. Since every child is different, these medications don’t always work, so doctors try other kinds.

When stimulants work, the results are often dramatic. The following is a letter from a teacher to parents regarding their severely hyperactive 8-year-old son, who had been on Adderall for one week: “This past week, your son has been very much in control of himself. He has been in his seat when he should have been, and on task nearly 100 percent of the time. He has not struggled with listening and focus. He has been pleasant and cooperative to work with. I am very pleased with the change. More learning is taking place.”

Parents often ask, “When should medication be considered an option?” My answer is that it should be tried when the best efforts have failed in helping a youngster succeed in school, enjoy good friendships and have healthy relationships with teachers and family. The typical child with ADHD who needs medication is a child who is failing in just about every aspect of his life. Peers do not want to be his friends. Teachers find him irritating and annoying. Parents find it hard to feel loving and supportive. No child can experience all this rejection day after day without becoming emotionally disturbed and developing personality problems. That’s why parents may need to explore whether medication can help their child.

If your child’s doctor recommends medication, try it for a month under medical and psychological supervision. Keep in mind that stimulants work like aspirin. They become effective in a matter of an hour. They are not like antidepressants, which need to build up in a person’s system for 30 to 60 days. In fact, stimulants do not build up in a child’s system. They are urinated away each day.

Since each child is different, your pediatrician or child psychiatrist will start your child with the smallest possible dose. Then your doctor will determine, with your help, if there are any benefits or side effects. As determining the right prescription is a process of trial and error, your doctor may have to alter the dose.

While this is taking place, try to be patient. Don’t take your child off medication before the doctor has had a chance to adjust the prescription, or at the first sign of a side effect. Give treatment a chance to work, and talk with the doctor about the appearance of any side effects.

How will you know if the medication is working?
Your child’s teacher is one of your best sources. In school a child has to sit quietly, follow rules, cooperate with an authority figure, stay on task, work rather than play, meet time limits and deal with occasional criticism from the teacher and distractions from other children. Talk to your child’s teacher about how well he or she is managing each of these tasks.

Over the last few years, there has been an increasing resistance on the part of parents to accept the recommendation of medication for a child with ADHD. I’m not a big fan of having to rely on medication for treating young children. But just as insulin is necessary for diabetic kids, medication can help prevent a child with ADHD develop emotional, personality and serious relationship problems.

If you want to read more on this subject, I suggest you read Dr. Thomas Phelan’s book, All About Attention Deficit Disorder.

Kenneth N. Condrell Ph.D Child Psychologist