As the summer flies by, returning to school suddenly seems all too close and for many children, that means the stress of keeping up with homework and school responsibilities. As children get older, the expectations of them at school increase exponentially and often this is when symptoms of ADHD tend to emerge. Consider helping your child by reviewing the typical symptoms and having your child assessed by a trained professional if your child seems to be struggling to keep up. It is important not only for school performance but also for your child’s overall self esteem.

ADHD can manifest as inattention and/or hyperactive-impulsive behavior. Although some children who have ADHD tend more toward one category than the other, most children have some combination of inattention and hyperactive-impulsive behavior. Signs and symptoms of ADHD become more obvious when the child is engaged in activities that require focused mental effort.

According to the Mayo Clinic the important Signs and symptoms of inattention include:

• Often fails to pay close attention to details or makes careless mistakes in schoolwork or other activities
• Often has trouble sustaining attention during tasks or play
• Seems not to listen even when spoken to directly
• Has difficulty following through on instructions and often fails to finish schoolwork, chores or other tasks
• Often has problems organizing tasks or activities
• Avoids or dislikes tasks that require sustained mental effort, such as schoolwork or homework
• Frequently loses needed items, such as books, pencils, toys or tools
• Can be easily distracted
• Often forgetful

Signs and symptoms of hyperactive and impulsive behavior may include:
• Fidgets or squirms frequently
• Often leaves his or her seat in the classroom or in other situations when remaining seated is expected
• Often runs or climbs excessively when it’s not appropriate or, if an adolescent, might constantly feel restless
• Frequently has difficulty playing quietly
• Always seems on the go
• Talks excessively
• Blurts out the answers before questions have been completely asked
• Frequently has difficulty waiting for his or her turn
• Often interrupts or intrudes on others’ conversations or games

CAUSES:
As a parent, we tend to blame ourselves for everything that disturbs our child. But according to the latest research, the vulnerability to ADHD is more likely to be inherited than due to parenting skills.
In fact, brain scans have revealed that there appears to be less activity in the areas of the brain that control activity and attention. Furthermore, ADHD tends to run in families since about 25% of children with ADHD have at least one relative with the disorder.
Toxic exposures have also been linked to ADHD. Pregnant women who smoke are apparently at increased risk of having children with ADHD. Exposure to lead, which is found mainly in paint and pipes in older buildings, has been linked to disruptive and even violent behavior and to a short attention span. Many environmental toxins including PCBs have also been linked to an increase risk of ADHD .Other risk factors include prematurity, hyperthyroidism, and behavioral disorders.
Unfortunately, children with ADHD are at risk for academic failure and low self-esteem. They are also more prone to accidents and injuries than other children, and, as they get older, are at an increased risk of alcohol and drug abuse, anxiety and/or depression and delinquent or oppositional behavior. Learning disabilities are also common in children with ADHD. Surprisingly, gifted learners also get ADHD more often than do other children.
Some parenting tips that can help alleviate the symptoms:

• Be affectionate and patient: Compliment your child on a daily basis and focus on the positive things they have accomplished in their day to help boost their self esteem as well as their confidence.try to be patient even when they are frustratingly hyperactive and inattentive- remember that they are struggling too.
• Be appreciative: Try to have realistic expectations and accept and appreciate your child by spending quality time doing something every day that you both can enjoy together.
• Be organized and structured: Use a big calendar to mark the week’s schedule so your child can visualize the plans for the week and start to feel more in control. Put stickers on days that mark a change in the usual routine. Make sure there is a quiet place to do homework without distraction.Try to keep your child on a routine, especially after school until bedtime. It is important for your child to get enough sleep because exhaustion makes ADHD symptoms worse..

EVALUATION:
The most important pieces of information to bring with you to the evaluations are:

• symptoms that you notice both at home or at school.
• any major stresses or recent life changes.
• Your child’s typical diet
• Your child’s typical schedule including sleep schedule
• all medications, as well as any vitamins or supplements, that your child is taking.
• Any other health conditions
• When did you first notice your child’s behavior issues or other symptoms?
• Are your child’s symptoms continuous, or intermittent?
• What seems to make your child’s symptoms worse or better

Unfortunately, there is not an absolute test to diagnose ADHD, but, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM published by the American Psychiatric Association, a child must have six or more signs and symptoms from one of the two categories below (or, six or more signs and symptoms from each of the two categories).

Inattention
1. Often fails to give close attention to details or makes careless mistakes in schoolwork other activities
2. Often has difficulty sustaining attention in tasks or play activities
3. Often does not seem to listen when spoken to directly
4. Often does not follow through on instructions and fails to finish schoolwork or chores (not due to oppositional behavior or failure to understand instructions)
5. Often has difficulty organizing tasks and activities
6. Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort(such as schoolwork or homework)
7. Often loses things necessary for tasks or activities (for example, toys, school assignments, pencils, books)
8. Is often easily distracted
9. Is often forgetful in daily activities

Hyperactivity and impulsivity
1. Often fidgets with hands or feet or squirms in seat
2. Often leaves seat in classroom or in other situations in which remaining seated is expected
3. Often runs about or climbs excessively in situations in which it is inappropriate
4. Often has difficulty playing or engaging in leisure activities quietly
5. Is often “on the go” or often acts as if “driven by a motor”
6. Often talks excessively
7. Often blurts out answers before questions have been completed
8. Often has difficulty awaiting turn
9. Often interrupts or intrudes on others (for example, butts into conversations or games)
10. In addition to having at least six symptoms from one of the two categories, a child with ADHD:
11. Has inattentive or hyperactive-impulsive signs and symptoms that caused impairment and were present before age 7
12. Has behaviors that aren’t normal for children the same age who don’t have ADHD
13. Has symptoms for at least six months
14. Has symptoms that impair school, home life or relationships in more than one setting (such as at home and at school)

MEDICATION: Currently, stimulant drugs (psychostimulants) and the nonstimulant medication atomoxetine (Strattera) are the most commonly prescribed medications for treating ADHD.

Stimulant medications for ADHD include:

• Methylphenidate (Ritalin, Concerta, Daytrana)
• Dextroamphetamine-amphetamine (Adderall)
• Dextroamphetamine (Dexedrine)

Although it seems counter-intuitive for a stimulant medication to help a hyperactive child, stimulants balance levels of the brain’s neurotransmitters. Unfortunately they also can cause a profound decrease in appetite and subsequent weight loss that can affect your child’s overall growth.

Nonstimulant medication?Atomoxetine (Strattera) is often a useful alternative to stimulant medications if they do not work or if they cause severe side effects atomoxetine may also reduce anxiety. However, Atomoxetine has been linked to rare side effects that include liver problems. In addition, some children and adolescents taking atomoxetine seem to have an increased risk of suicidal thinking.

In order to have your child properly evaluated, the first step is to consult with your pediatrician who can then refer you to the appropriate specialist, such as psychologist, psychiatrist or pediatric neurologist. Although it is never easy to think your child may be suffering from a disorder, the sooner it is addressed, evaluated and treated, the sooner you and your child will feel better.