Recognize ADHD early for the best treatment outcomes
Does your child--or do you--have trouble staying focused, sitting still, or organizing tasks for school or work? If so, then you might want to consult a mental health specialist about attention-deficit/hyperactivity disorder, or ADHD.
ADHD is one of the most common neurodevelopmental鈥痙isorders in children and also affects many adults, according to psychiatric nurse practitioner Matthew James Tirelli, MSN. 鈥淎DHD affects about 11% of school-age children and is more commonly diagnosed in biologically male than biologically female children,鈥 Tirelli says. 鈥淭he current U.S. prevalence for adults with ADHD is between 2.5% and 4.4%, depending on the study.鈥
Because many ADHD symptoms--difficulty staying still for long periods of time, short attention span, and disruptiveness in the classroom--are common in young children, and because the term 鈥楢DHD鈥 is casually used to describe anyone who has some inattention or hyperactivity, many people assume that the condition is over- or inappropriately diagnosed, Tirelli says. 鈥淭o meet a diagnosis of ADHD, a person must have impairment in two or more domains of their life, such as school, home or community setting,鈥 he explains. 鈥淩ecently, a lot of adults have found videos describing symptoms of ADHD on Tiktok and have used this to inquire about a possible diagnosis in themselves,鈥 he adds. 鈥淲hile Tiktok has increased both valuable information and misinformation, I always encourage my patients to bring their concerns to me for verification or validation.鈥
Symptoms of ADHD may include:
- Frequent daydreaming
- Forgetting or losing things often
- Squirming or fidgeting
- Talking too much
- Making careless mistakes
- Taking unnecessary risks
- Inability to resist temptation
- Trouble taking turns
- Difficulty getting along with others
Although ADHD in children can develop into a lifelong condition, research suggests that adequately treating it with psychiatric medication can decrease the likelihood that it will persist into adulthood, Tirelli says. 鈥淚n general, we see that about 50% of people 鈥榞row out鈥 of ADHD, while another 25% might have symptoms but don鈥檛 necessarily need treatment into adulthood,鈥 he says.
Categories of ADHD
ADHD falls into three categories: inattentive, hyperactive-impulsive, and combined. Individuals with inattentive ADHD have trouble organizing or finishing tasks, paying attention to details, or following instructions or conversations. They are easily distracted or forget details of daily routines.
Those with hyperactive-impulsive ADHD fidget with or tap their hands or feet, squirm in their seat, and talk a lot, often out of turn. They can鈥檛 sit still for meals or homework. Smaller children may constantly run, jump, or climb. People with hyperactive-impulsive ADHD feel restless and behave impulsively, sometimes interrupting or grabbing things from others. They have trouble waiting their turn or listening to directions. Not surprisingly, they are more prone than others to accidents and injuries. People with combined ADHD have equal amounts of both types of symptoms, whose presentation may change over time.
Because other disorders 鈥 including anxiety disorder, depression, oppositional defiant disorder, and learning disorders 鈥 can mimic ADHD, recognizing and treating the condition early are key to positive outcomes.
Causes of ADHD
Studies have yet to identify the specific causes of ADHD. There is no evidence that eating too much sugar, watching too much television, poor parenting, or social and environmental factors such as poverty or family chaos cause it, although they might make it worse.
Genetics may play a role, however. 鈥淎DHD is one of the most heritable psychiatric conditions and often runs in families,鈥 Tirelli says. 鈥淪iblings have twice the risk of having ADHD than the general population, (e.g., if one sibling has ADHD, then chances are good that another sibling will have it too).
Indeed, without identification and treatment, ADHD may lead to substance abuse, delinquency, anxiety, depression, and academic and job-related problems. 鈥淎DHD symptoms can be exacerbated by not taking care of oneself (good sleep, appetite, not exercising, substance use),鈥 Tirelli says. 鈥淪ymptoms can also be more impactful when people are in environments that are not well-suited for their individual needs.鈥
Treatments for ADHD
The best treatments include a combination of behavior therapy and medication. 鈥淏ehavioral modification techniques can include organizational and time management skills,鈥 Tirelli says. Extra time on tests and assignments, working in a quiet and distraction-free location, and using mindfulness skills in moments of distraction can also help, he adds. 鈥淧sychostimulant medication can be extremely helpful for individuals with ADHD, and studies show that adequately treating it decreases teenager impulsivity (not wearing seatbelts or reckless driving for example) and substance use.鈥
The Weill Cornell Psychiatry Specialty Center has faculty who specialize in the diagnosis and evidence-based treatment of ADHD. Its clinicians tailor treatment to the unique needs of each individual child and family following a comprehensive evaluation, which contains a careful history and clinical assessment of an individual鈥檚 academic, social, and emotional functioning, and developmental level. Treatments may include pharmacotherapy, behavioral therapy, and parent education and support. Says Tirelli, 鈥淎s providers, we work with our clients to figure out a treatment plan that aligns best with their individual values and needs.鈥