ADHD Assessment and Treatment
Before starting any treatment, it is important to complete a full evaluation of ADHD. This includes an interview with the clinician, information from independent sources such as spouses or other family members, DSM-5 ADD symptom checklists and rating scales, as well as standardized testing.
Experts may also review your child's school record and speak with teachers and scout or religious coaches or leaders. ADHD symptoms must be evident from the beginning of childhood to be recognized at an adult age.
Symptoms of ADHD
The symptoms of ADHD vary by age, but children with the condition often have trouble staying focused on their work or paying attention to others. They might fidget, blurt out answers to questions or interrupt others. They might also struggle with organizational skills, get easily bored and find it difficult to wait their turn. The signs of impulsive behavior include jumping into activities without permission, running around or climbing places they aren't supposed to go. They might also be prone to using explosive excitement or anger as a source of stimulation and may even make others angry or playing pranks with them.
A doctor might utilize questionnaires or clinical interviews to determine if a child is ADHD. They may also ask teachers to complete ratings scales. They can also conduct a neurodevelopmental or physical exam to determine if there are any medical conditions that may trigger symptoms of ADHD. These include thyroid conditions and mood disorders.
The evaluator may also ask whether your child has any other mental disorders, such as conduct disorder as well as oppositional defiant syndrome and anxiety disorders. They will also inquire about your family history, such as if anyone else has ADHD or any other psychiatric issues.
Adults who suffer from ADHD often have difficulty managing their daily life, which includes the demands of work and home. They may also have issues being a good friend to family members or colleagues. They may be late for appointments or not show up for social occasions due to their symptoms. The academic challenges they face can result in failure at school and poor job performance.
For an adult to be diagnosed with ADHD, they must have six or more established symptoms of inattention or hyperactivity-impulsivity for at least six months. Doctors will interview the patient and someone who knows them well -- such as a spouse or parent for adults or a teacher coach, nanny or coach for children. The information will help the doctor decide which tests, if required, will identify other conditions that cause ADHD symptoms. They can also employ a checklist to determine the symptoms in adults.
Diagnosis
The method of diagnosing ADHD involves a number of appointments with doctors and therapists. The diagnosis is made based on symptoms and how they impact the person's life. It is crucial to obtain the correct diagnosis to manage symptoms that could hinder the family life and work. A doctor who is an expert in ADHD, like a psychiatrist or a psychologist can diagnose the condition.
The doctor will discuss the patient's medical history and symptoms, as well as when they first appeared. They might request the patient to keep a journal of their symptoms and the impact on their lives. This can be very helpful to have a clearer picture of the problem and to decide which tests or evaluations will be required to determine if ADHD is the cause.
In addition to observing how the person is functioning in various settings, the doctor will employ questionnaires to determine the symptoms. This could include questionnaires to parents and teachers to evaluate children for the disorder, and a patient interview to identify the symptoms they are experiencing. The questions are often similar to those in the NIMH ADHD diagnostic criteria, which help doctors identify whether a person is exhibiting hyperactive/impulsive or inattentive symptoms.
Some doctors will also do an exam to ensure there's no physical condition that could cause thyroid problems or seizures, which could be the root of the problem. Other tests can be done to determine if there are other issues such as anxiety or depression.
Sometimes, the doctor may request brain scans to rule out possible causes of the symptoms. These tests, which aren't commonly used to diagnose ADHD however, are a helpful instrument when other tests for diagnosing the condition have been ruled out.
If you are an adult who suspects that you or their child may have ADHD the best place to begin is to speak with a primary doctor. If the person doesn't have a primary care physician, they should contact their insurance company for a list of health specialists in their area who are qualified to perform an ADHD evaluation.
Treatment options
The first step in treatment is an evaluation by a doctor who can determine whether the symptoms are related to ADHD or another mental health condition. An extensive evaluation could include an interview with a child and parent as well as rating scales that evaluate the child's behavior with those of people who do not have ADHD.
There are many medical conditions that can trigger symptoms similar to those of ADHD. These include thyroid issues, head injuries, and seizures. It may be necessary to perform a physical exam in order to rule out any of these ailments. A psychological exam will be necessary to determine if symptoms are caused by ADHD or a different mental health condition such as anxiety.
ADHD symptoms can have a major impact on work, school and relationships. The person being evaluated should be able to discuss the issues they're experiencing candidly and honestly with the examiner and not be hesitant from fear of embarrassment or shame of being judged. They should describe symptoms as accurately as possible, including the way they affect them both at home and in school. Parents should be included in evaluations, but not in the decision-making process.
The type of medication prescribed is based on the condition that is causing it as well as the symptoms and age of the child. For example, stimulants are often prescribed to teens and children with ADHD. They work by increasing brain activity in areas that control the behavior and attention. These medications may come in the form of tablets that release immediately or modified-release tablets that release the medication slowly throughout the day. Methylphenidate is one of the most commonly prescribed medication for ADHD.
Other options for treating ADHD include marital and family therapy or cognitive behavioral therapy, which teaches specific techniques to change negative behavior into positive behaviors. These therapies may be beneficial for some adults suffering from ADHD and also educational and occupational accommodations.
The most crucial aspect of treatment is the follow-up phase, with frequent meetings to review progress and decide on the next steps. Parents should encourage teachers and other professionals to participate in the process, for example religious or scout leaders. These professionals can provide valuable information about how the child behaves in different environments and provide a more complete picture of the child's behavior.
Medication
ADHD is treated with various medications. The most popular are stimulants, which work by increasing activity in certain brain areas that control attention and behavior. Methylphenidate, the most commonly used stimulant among adults, teens and children who are older than five years old, is the most popular. It is available in tablet form and is typically taken between 2 and 3 times a day. It is available in immediate release (short-acting) or extended-release (taken at least once per day in the morning and released throughout the day).
Many people claim to feel better after taking medication. These effects can be observed in educational, social and home settings. The impact on performance in these environments is measured by using one or more standard rating scales, which compare behaviors of the individual with those of others. These ratings are not diagnostic by themselves, but provide valuable objective information for the evaluation process.
In addition to medications in addition to medication, there are other non-medical treatments for ADHD that include behavioral therapy and training for parents and teachers. assess adhd Iam Psychiatry of Pediatrics suggests that parents attend training in the area of behavior management prior to trying medication on their children. The guidelines also call for psychotherapy and intervention in the classroom to be a part of the treatment plan for teens and adolescents with ADHD.
The most common side effects of ADHD medication include stomach upset and changes in heart rate and blood pressure as well as sleep disturbances. Some children and teens who are taking stimulants could develop tics. They are repetitive movements or noises like eye-blinking or clearing the throat. Certain children and teens who take ADHD medication might experience a slight decrease in their growth, but this is typically minor and does not affect their final height.
The stimulant drugs do have the potential for abuse and addiction, but research shows that there is no significant risk at the dosages used to treat ADHD. Some kids and teens with ADHD are more prone for substance use problems however this is due to the disorder not the medication.
Another potential negative result of ADHD medication is the risk for developing cardiovascular disease (CVD). Recent research has found that those who take stimulant medications to treat ADHD have a higher chance of developing cardiovascular disease than those who don't. Researchers looked at data from 278 027 people, including 10 388 people with ADHD. They compared them with 51 672 people who were not diagnosed with ADHD. The participants were followed for 14 years.