Monday, August 20, 2012

ADHD in young children: One of the most common difficulties of childhood

Working as a licensed clinical psychologist I am often faced with parents coming to me for help with their young child. These families may seek help with managing a number of concerns such as anger, excessive worrying, or attention problems. Now that summer vacation for children has ended and the school year is here, many parents and teachers will be confronted with over-active children. Some of these concerns may be due to limited opportunities to go outside and play, while others may have difficulties resulting from a more complex issue such as a diagnosable disruptive behavior disorder.

During early childhood children often have difficulty sitting still, paying attention, or controlling their impulses. This is part of the normal developmental process. However, for a small number of these children the problem is more persistent and impacts their daily lives at home and at school. Children with pervasive over-activity levels and inattention may have Attention-Deficit Hyperactivity Disorder also known as ADHD.  ADHD is a neurobiological disorder characterized by developmentally inappropriate impulsivity, inattention, and in some cases, hyperactivity. There are several types of ADHD that can be diagnosed and children may present with different symptoms. About 9.5 percent of children ages 4 to 17 in the United States have been diagnosed with ADHD, according to the Centers for Disease Control and Prevention. People with ADHD can be very successful in life. But without appropriate identification and treatment, ADHD can have serious consequences such as difficulties with school work, poor social skills, and conduct problems. Early identification and treatment are extremely important so if you notice concerns please consult with a psychologist.

The best outcomes for children with ADHD are associated with the use behavior therapy and medication management. According to Pediatrics, it is recommended that young children with ADHD receive behavioral interventions first, such as parent training in behavior management techniques. These treatments can be followed-up with medication if behavioral interventions are not successful.  In my practice, I typically recommend that parents attempt to implement behavior treatments. If the difficulties associated with ADHD are moderate or severe I will recommend consultation with a pediatrician or psychiatrist for medication management considerations. There is some evidence showing benefits of medication for treating ADHD in young children, however it is unclear how medication affects the child’s brain.

Below are a few suggestions for managing difficulties associated with ADHD:
  • Provide positive attention to the child
  • Target performance goals and monitoring behavior by tracking progress
  • Implement individualized home and school reinforcement programs
  • Utilize non-physical punishment procedures such as time-out or response cost systems

It should be noted that some of these recommendations may be implemented at home without a professional. However, if the child’s difficulties are persistent and long-standing you will benefit from contacting a psychologist in your area who can help tailor treatment to you and your child. Additionally, teachers and parents may consult with a school psychologist at their local school who can assist with interventions in the classroom settings and developing appropriate educational accommodations.

Additional suggestions for parents:

Driven To Distraction: Recognizing and Coping with Attention Deficit Disorder from Childhood Through Adulthood By: Edward M. Hallowell and John J. Ratey

Taking Charge of ADHD: The Complete, Authoritative Guide for Parents  By: Russell A. Barkley PhD

© Copyright 2012 Erlanger A. Turner