Parents are distressed when they receive a note from school saying that their child won't listen to the teacher or causes trouble in class. One possible reason for this kind of behavior is Attention Deficit/Hyperactivity Disorder (ADHD).

Even though the child with ADHD often wants to be a good student, the impulsive behavior and difficulty paying attention in class frequently interferes and causes problems. Teachers, parents, and friends know that the child is misbehaving or different but they may not be able to tell exactly what is wrong.

Any child may show inattention, distractibility, impulsivity, or hyperactivity at times, but the child with ADHD shows these symptoms and behaviors more frequently and severely than other children of the same age or developmental level. ADHD occurs in 3-5% of school age children. ADHD must begin before the age of seven and it can continue into adulthood. ADHD runs in families with about 25% of biological parents also having this medical condition.

A child with ADHD often shows some of the following:

• trouble paying attention

• inattention to details and makes careless mistakes

• easily distracted

• loses school supplies, forgets to turn in homework

• trouble finishing class work and homework

• trouble listening

• trouble following multiple adult commands

• blurts out answers

• impatience

• fidgets or squirms

• leaves seat and runs about or climbs excessively

• seems "on the go"

• talks too much and has difficulty playing quietly

• interrupts or intrudes on others

A child presenting with ADHD symptoms should have a comprehensive evaluation. Parents should ask their pediatrician or family physician to refer them to a child and adolescent psychiatrist, who can diagnose and treat this medical condition. A child with ADHD may also have other psychiatric disorders such as conduct disorder, anxiety disorder, depressive disorder, or bipolar disorder. These children may also have learning disabilities.

Without proper treatment, the child may fall behind in schoolwork, and friendships may suffer. The child experiences more failure than success and is criticized by teachers and family who do not recognize a health problem.

Research clearly demonstrates that medication can help improve attention, focus, goal directed behavior, and organizational skills. Medications most likely to be helpful include the stimulants (various methylphenidate and amphetamine preparations) and the non-stimulant, atomoxetine. Other medications such as guanfacine, clonidine, and some antidepressants may also be helpful.

Other treatment approaches may include cognitive-behavioral therapy, social skills training, parent education, and modifications to the child’s education program. Behavioral therapy can help a child control aggression, modulate social behavior, and be more productive. Cognitive therapy can help a child build self-esteem, reduce negative thoughts, and improve problem-solving skills. Parents can learn management skills such as issuing instructions one-step at a time rather than issuing multiple requests at once. Education modifications can address ADHD symptoms along with any coexisting learning disabilities.

A child who is diagnosed with ADHD and treated appropriately can have a productive and successful life.

Excerpts from Your Child on Attention Deficit/Hyperactivity Disorder

From time to time, in the normal course of their explorations and interactions in the world, most children bubble over with restlessness. On their feet, they dash from here to there. In a chair, they squirm, twist, churn, wriggle, and jiggle. With so much to do and so much going on around them, there's neither time nor reason to sit still,

While such activity is normal during early childhood, some children continue to operate as though they live within a high-speed kaleidoscopic world. For children who have attention deficit/hyperactivity disorder, images, sounds, and thoughts churn constantly, distracting them, making it impossible for them to stay fixed on any one task or activity. These children often start running almost as soon as they learn to walk.

Sometimes when people speak, hyperactive children are so distracted or so inattentive that they don't even notice. Such children have great difficulty sitting still, planning ahead, or attending to what's going on around them. They often find it impossible to consider and conform to expectations and requirements of the world around them. As a result, their difficulties often cause disruption, annoyance, and disappointment to others in their environment. In addition, these children are more accident prone and difficult to manage.

Excerpts from Your Adolescent on Attention Deficit/Hyperactivity Disorder

Once called hyperkinesis or minimal brain dysfunction, attention deficit/hyperactivity disorder (ADHD) affects between 3 to 5 percent of all children, perhaps as many as two million American youngsters. Two to three times more boys than girls are affected, though the disorder is being identified increasingly in girls. On the average, at least one or two teens in every classroom in the United States need help for the disorder. While it appears that some of the symptoms of ADHD disappear by adolescence, some teenagers continue to have difficulties in their social relationships and school performance. In some teens, attention deficit/hyperactivity disorder may coexist along with antisocial or delinquent behaviors.

Teens with ADHD are inattentive, overac­tive, impulsive, and disorganized. These behaviors may resemble normal teen behavior. They are, however, persistent, extreme, and truly outside the control of the teen with ADHD. Adolescents with attention deficit/hyperactivity disorder have a harder time keeping their minds focused on individual tasks for even short periods of time without becoming bored or distracted. And even more impulsive than their non ADHD peers, these teens seem incapable of curbing their automatic reactions, of thinking before they act. During stressful situations, these already exaggerated behaviors become more extreme. Because of these troublesome symptoms, the adolescent may have trouble developing a sense of mastery and positive self esteem.