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ADHD Assessment and Treatment
Before beginning any treatment, it is essential to complete a full evaluation of ADHD. This should include an interview with a clinician as well as information from outside sources such as spouse or other family members, DSM-5 ADD symptom checklists and rating scales and tests that are standardized.
Experts may also want to see your child's school records and speak to teachers and scout or religious coaches or leaders. ADHD symptoms must be evident from the beginning of childhood to be diagnosed at an adult age.
The symptoms of ADHD
ADHD symptoms can vary based on age, but many children suffering from this disorder have difficulty focusing or paying attention. They may fumble or blurt out answers to questions or interrupt other people. They may also have trouble with organization, get easily bored and have a hard time waiting for their turn. Impulsive behavior can be described as engaging in activities or rushing around in circles without permission. They may also be prone to using exuberant emotions or anger as a way to get their attention, such as making others angry or playing pranks on them.
A doctor can use questionnaires or clinical interviews to determine if a child has ADHD. Teachers may also be asked to complete ratings scales. They can also conduct an examination of the neurodevelopmental or physical to determine if there are medical issues that could trigger symptoms of ADHD like thyroid disorders or mood disorders.
The evaluation will also need to be aware of if your child has any other mental health issues like oppositional defiant disorder or conduct disorder or anxiety disorders. They will also ask you about your family history. For example if other family members suffer from ADHD or other psychiatric issues.
Adults who suffer from ADHD frequently have trouble managing their daily life, which includes the demands of work and home. They may also have trouble working with colleagues or family members. They might be late for appointments or not attend social events due to their symptoms. Their academic difficulties can lead to failure in 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 both the patient and a person who is familiar with them. This could be a parent, spouse, teacher or coach, nanny or a coach for children. The details will aid the doctor decide what tests, if any are required, will identify other conditions that cause ADHD symptoms. They may also use a checklist to identify these symptoms among adults.
Diagnosis
The method of diagnosing ADHD involves a series of appointments with therapists and doctors. The diagnosis is determined by the presence of symptoms and their impact on the individual's life. Getting a correct diagnosis is crucial to gain control over the symptoms, which can affect work and family life. A medical professional who is an expert in ADHD such as a psychologist or psychiatrist will be able to diagnose the condition.
The doctor will review the patient's medical history and symptoms, which includes the date they first began to show. They may request that the patient keep a diary of their symptoms and the impact on their lives. This can be extremely helpful to get a clear picture of the problem and to decide on the tests or evaluations will be required to determine if ADHD is the reason.
In addition to observing how a person functions in various environments, the doctor will employ questionnaires to determine the signs. This could include questionnaires to parents and teachers to evaluate children for the disorder, as well as an interview with the patient to determine 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.
Certain doctors may also conduct an examination to ensure there isn't a physical condition like thyroid issues or seizures, that could be the cause of the issue. Other tests may be conducted to check for other conditions such as anxiety or depression.
Sometimes, the doctor may conduct brain scans to determine the cause of the symptoms. These tests are not used to diagnose ADHD but can be useful when other tests for diagnosing the condition have failed.
For adults who suspect that they or their child may have ADHD the best place to begin is to talk to an primary care physician. If conversational tone does not have a primary care physician, they should contact their insurance provider for a list of health specialists in their area who are able to conduct an ADHD assessment.
Treatment options
A doctor can tell if symptoms are caused by ADHD or another mental condition. A thorough assessment could include an interview with a child and parent, as well as rating scales that assess the child's behavior with those of people who do not have ADHD.
There are a variety of medical conditions that could cause symptoms similar to those associated with ADHD. These include thyroid issues or head injuries, as well as seizures. A physical exam may also be required to determine these causes. A psychological examination will also be required to determine if the symptoms are caused by ADHD or another mental health issue, like anxiety.
ADHD symptoms can have a significant impact on school, work and relationships. The person who is being evaluated must discuss the issues they are having in a candid and honest manner with the examiner, and not be hesitant from fear of embarrassment or shame of criticism. They should describe their symptoms as in detail as they can, including the way they affect them at home as well as at school. Parents should be included in evaluations, but not in the decision-making process.
The kind of medication prescribed will depend on the child's age, the condition that is leading to the symptoms and the type of medication. Stimulants, for example, are often prescribed to adolescents and children with ADHD. They stimulate brain activity in areas that control the behavior and attention. These medications are available as immediate-release tablets and modified-release tablets that release the medication gradually throughout the day. Methylphenidate is the most commonly prescribed medication for ADHD.
Other types of treatment for ADHD may involve family and marital counseling or cognitive behavior therapy, which helps to teach specific skills to transform negative behaviors into positive ones. These treatments may be beneficial to adults suffering from ADHD, as well occupational and educational accommodations.
The most important aspect is the follow-up. It is essential to hold regular meetings to assess progress and decide the next steps. Parents should encourage teachers and other professionals to participate in the process, such as religious or scout leaders. These professionals can provide valuable information on how the child behaves and performs in various situations.
Medication
There are a variety of medications used to treat ADHD. The majority of stimulants increase the activity of certain brain regions that regulate attention and behaviour. Methylphenidate is the most frequently used stimulant among adults, teens and children who are older than five years old is the most popular. It is a tablet form, usually 2 to 3 times per day. It is available in immediate-release (short acting) or extended-release versions (taken once a day but released throughout the day).
Many people have reported that their symptoms and impairments significantly improve after a period of medication. These effects can be seen in educational, social and home settings. The effect on performance in these settings is measured with one or more standardized rating scales that compare the behaviors of the individual with those of others. The scores on these forms of rating are not considered diagnostic by themselves however they serve as important sources of information during the evaluation process.
There are a variety of non-medical treatment options for ADHD such as behavior therapy and training for parents and teachers. The American Academy of Pediatrics suggests that parents undergo training in the area of behavior management prior to using medications on their children. The guidelines also call for psychotherapy and a classroom-based intervention to be a part of the treatment plan for adolescents and teens with ADHD.
Most often, ADHD medication can cause nausea, sleep disturbances and changes in blood pressure or heart rate. Some kids and teens who take stimulants can develop tics which are repeated movements or sounds, such as eye blinking, or clearing the throat. Some teens and children who take ADHD medication may notice a slight slowdown in their growth, but it is usually minor and does not impact their final height.
Stimulant medications do have the potential for addiction and abuse, however studies show that this is not a significant risk with the doses prescribed to treat ADHD. ADHD can increase the risk of substance abuse in a few teens and kids, but this is not due to the medication.
Another potential adverse result of ADHD medication is the chance for developing cardiovascular disease (CVD). Recent research found that people who take stimulant medication to treat ADHD have a higher chance of developing cardiovascular disease than those who do not. Researchers analyzed data of 278 027 people, including 10 388 people with ADHD. They compared these individuals to 51 672 healthy controls without ADHD. These participants were followed for 14 years.