Health professionals keeping watch on ADHD

This is the first of four articles in a series about Attention Deficit Hyperactivity Disorder.
By Cortney L. Hill, Salisbury Post

Imagine living in a fast-moving kaleidoscope where images, sounds and thoughts are constantly shifting.

Or being so wrapped up in thoughts that you don't notice when someone speaks to you.

According to the National Institute of Mental Health, this is what it's like to have Attention Deficit Hyperactivity Disorder, or ADHD.

ADHD appears to be a hereditary, biochemical disorder in the area of the brain that controls concentration, information retrieval and organization.

"It mostly causes inattention, hyperactivity and impulsivity," said Dr. Jill Aiken, physician at the Salisbury Pediatric Associates.

Diagnosis of ADHD is complex and requires information from multiple sources such as parents, physicians, and teachers.

ADHD affects as many as 2 million American children, and is three times more common in boys than girls. In Rowan County, close to 1,000 children have been diagnosed with being ADHD.

"Over half of all children that have ADD or ADHD also have other chemical imbalances," said Denise Waller-Overcash, ADHD parent with 9-and 7-year-old ADHD children. "These are known as comorbids."

Waller is on the board of Healthy Children of Rowan County, which offers a support group for parents who have ADHD children.

" ... ADHD is simply a chemical imbalance -- much like diabetes -- except it occurs in the brain," said Waller-Overcash. "While I am mildly ADD (Attention Deficit Disorder), my children are on the severe end of the spectrum of ADHD."

Waller-Overcash said that ADD is not as easily detected as ADHD because it isn't accompanied by hyperactivity.

"It's the same chemical imbalance," Waller-Overcash said. "But those with ADD are often called the 'daydreamers' where as those with ADHD are often times bouncing off the walls."

To best understand ADHD, it's important to understand what it is not.

According to the Healthy Living magazine:

n ADHDis not a disease or illness.

n It is not a learning disability, although many children with ADHD also may have learning disabilities.

n It is not the result of laziness, excess sugar, poor schools, bad parenting or a character flaw.

"Parents really light up when you tell them this is not their fault," Aiken stated within the article.

Waller-Overcash said that children with ADHDare "extremely creative, bright and are exceptionally smart,"she said.

"But it sometimes doesn't come out as well because they are easily frustrated, stressed, or tired. That's where the medicines help."

Signs of ADHD

Many parents can see signs of ADHD in their toddlers long before they enter school.

"Like if the child has a hard time staying focused during games or other activities," said Dr. Thomas Carlton, pediatrician with Salisbury Pediatric Associates. "But once the child enters school, often times the teachers are the ones to detect it first."

Three common signs of ADHDare as follows:

n Inattentiveness

When children have a hard time keeping their mind on one thing.

"They may get bored with a task after a few minutes and move on to one thing, then another thing ..." said Beatrice Hair, director of the Salisbury Tutoring Academy.

n Hyperactive

People who are hyperactive always seem to be in motion.

"Often times they can not sit still, whether they are wiggling their legs, touching everything, roaming around the room or wiggling in their seat," Hair said.

According to the National Institute of Mental Health, teens and adults with ADHD may feel intensely fidgety or find themselves bouncing from one task to another.

n Impulsive

People who are unable to curb their immediate reactions or think before they act, according to the National Institute of Mental Health.

The Institute gave such examples as children running out into the street without looking, blurting out answers in class before called on, or grabbing toys from other children and hitting when getting upset.

Diagnoses/ treatment

ADHD can not be diagnosed by a blood test, brain scan or other physical tests, Carlton said.

"A physician or mental health professional must conduct a complete evaluation to screen for ADHD," Carlton said. "Interviews and questionnaires are used to obtain information from the patient, the patient's family, and his teachers."

If ADHD is diagnosed, the physician must then determine whether there are any other comorbids, which are other psychiatric disorders affecting the patient.

"Other comorbid disorders include disruptive behaviors, depression, bipolar, anxiety, tics and obsessive-compulsive disorders," said Waller-Overcash. "My children also have other disorders as well, including depression, and Lizzie has a nervous disorder."

Lizzie is Waller-Overcash's 9-year-old daughter.

There are two ways to treat ADHD. One way is through medicine, and the other is behavior management. Medications do not cure ADHD and parents can opt not to use medications.

"They can go over it with their doctor as far as other alternative treatments," Carlton said.

But health officials suggest incorporating both medication and behavior management to have more of an impact.

"Many parents worry or feel guilty about medicating a child," said Waller-Overcash. "But it's important to know that these medications have been successfully and safely used for over 25 years."

Untreated ADHD can have a serious impact on the children's lives.

Recent research indicates that children treated for ADHD show no higher rates of substance abuse in adulthood than the general population.

In contrast, adults with ADHDwho are untreated in childhood show higher-than-normal rates of substance abuse.

If ADHDgoes untreated, health officials say that:

n As many as 30 percent of adolescents will drop out from school or fail to complete high school, compared with 10 percent of those without ADHD.

n On average, in their first two years of driving, adolescents with ADHD are involved in more automobile accidents; they are more likely to be at fault and incur bodily injuries.

n 38 percent of young adults with ADHD are likely to have been pregnant or to have caused a pregnancy, compared with 4 percent of those without ADHD.

n More than 40 percent of children indulge in early tobacco and alcohol abuse, compared with 30 percent or less of those without ADHD.

"ADHD can be successfully and safely treated," Hair said. "With stimulant medication treatment, classroom behavior and grades improve, aggressive behavior becomes less severe, and children begin to feel better about themselves."

Hair is in her second year of working on a 20-year study of the long-term effectiveness of medication in treating ADHD.

"Istrongly believe that people will refer to the Hair Study to prove that medicating an ADHDchild will pay off in their adult lives,"Hair said.

Waller-Overcash said it is common to change medications from time to time.

"Don't be afraid to change. Their bodies can get used to that medicine and it won't be effective," she said.

"However the parent decides to treat their children, it's very important to have a team approach," Carlton said. "The parent should be involved, the doctor, as well as the teachers. That's the only way the child can be successful."

For more information about getting your child evaluated for ADHD, call Salisbury Pediatric Associates at 704-636-5576; for information about the Salisbury Tutoring Academy, call 704-633-8207.

Contact Cortney L. Hill at 704-797-4249 or chill@salisburypost.com

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Coming Sunday: Denise Waller-Overcash lets us in on what life is like as an ADD mom raising two ADHDchildren.

Coming Monday:A teacher and area pediatricians share their perspectives on Attention Deficit Hyperactivity Disorder.

Coming Tuesday: Take a look at the first day of a special camp for children with ADHD.