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By Root 9952 0

doctors now think that abnormal brain development or an imbalance in brain chemicals causes an attention deficit disorder. This means that the inattention, impulsiveness, and hyperactivity that are characteristic of an attention deficit disorder have a physical cause in the brain. The common beliefs that ADD and, especially, hyperactivity result from such lifestyle habits as consuming too much sugar or watching too much TV, or from food allergies are not supported by scientific evidence. The disorder seems to run in families, which indicates a genetic component.

Symptoms

People with the inattentive form of ADHD most often have the following symptoms:

• Making careless mistakes and paying little attention to detail

• Not listening when spoken to directly

• Failing to follow instructions

• Trouble finishing tasks

• Being disorganized

• Absentmindedness and forgetfulness; losing or misplacing things

• Becoming distracted by noise

People with the hyperactive form of ADHD exhibit the following symptoms:

• Fidgeting or squirming

• Difficulty engaging in quiet activities, such as reading

• Constant, driven activity

• Excessive talking

• Difficulty waiting their turn

• Making blunt comments or blurting out answers

• Interrupting

If you think you or your child has an attention deficit disorder, see a doctor for a thorough evaluation. For effective treatment, it is essential to get an accurate diagnosis, which is not always easy.

Diagnosis

To make an accurate diagnosis of ADHD, a doctor will try to gather as much information as possible to rule out other possible causes of the problem behavior. He or she will evaluate the person’s health history and perform a physical and neurological examination. Laboratory tests also may be done to rule out other disorders that can mimic ADHD, such as hyperthyroidism (see page 901), pinworms (see page 444), a brain tumor (see page 682), or a sleep disorder such as restless legs syndrome (see page 705). In making a diagnosis for a child, the doctor probably will interview the parents, the child, and the child’s teachers and may want to examine school records to put together a profile of the child’s behavior. The doctor will then compare the child’s behavior to the classic symptoms of ADHD to reach a diagnosis.

Treatment

The most common treatment for an attention deficit disorder is the drug methylphenidate, a central nervous system stimulant. It may not seem logical to prescribe a stimulant for a disorder whose distinguishing feature is hyperactivity, but the drug is effective in calming agitated behavior in children who have an attention deficit disorder. The exact way the drug works is unknown, but the medication seems to affect the chemical dopamine in the brain, which helps in the regulation of attention and concentration. Appetite loss and insomnia are the two most prominent side effects of the medication. Methylphenidate is safe for children over age 6, but it can be addictive when taken in higher-than-prescribed doses.

Another commonly prescribed drug for ADHD is a combination of two different stimulant drugs—dextroamphetamine and amphetamine. This combined drug has a longer duration of action than methylphenidate. However, the drug has a high risk of abuse and addiction. Side effects are similar to those of methylphenidate.

Antidepressants such as bupropion and atomoxetine have also been found to be an effective treatment for some people with ADHD. It is not known exactly how these drugs work, but they seem to influence the absorption of chemical messengers in the brain (especially serotonin and norepinephrine) that help regulate attention, impulsivity, and activity. Because these medications are not stimulants and are not addictive, doctors can prescribe them for longer periods.

Drug therapy works best when combined with other types of treatment. Behavior modification teaches an affected person how to change his or her behavior to better control such tendencies as impulsiveness and disorganization. The person receives praise and