TREATMENT FOR CHILDHOOD ADHD
What is ADHD?
Attention-Deficit/Hyperactivity Disorder, more commonly known as ADHD, is one of the most common mental health issues for kids and teens (Froehlich, Lanphear, Epstein, Barbaresi, Katusic, & Kahn, 2007; DSM-5).
We first notice signs of ADHD when children begin school, although the symptoms tend to be present as early as two or three years of age (DSM-5).
ADHD starts with differences in functioning in the brain. Research has identified possible neurological explanations for symptoms of ADHD (see Rubia, Smith, Brammer, Toone, & Taylor, 2005; Yu-Feng, 2007), but the field is continuing to learn more each year.
ADHD includes consistent inattention and/or hyperactivity-impulsivity that prevents children from everyday functioning, such as academic performance, making friends, etc. Although people commonly refer to ADHD as one disorder, three subtypes of ADHD have been identified.
The three main subtypes of ADHD include:
Predominantly inattentive presentation
- Difficulty maintaining attention or focus to one task
- Often makes careless mistakes
- Difficulty organizing or keeping track of schedule
- Frequently loses things
- Easily distracted
Predominantly hyperactive/impulsive presentation
- Constant squirming, fidgeting, bouncing
- Difficulty being quiet or waiting
- Interrupts others frequently
- Agitated, unable to sit still
- A combination of inattentive and hyperactive/impulsive symptoms
- Typically the most severe type
ADHD is one of the most common mental health problems in children
Many of these symptoms are common in normal children. The term “disorder” is used very intentionally, as it represents the effects of these symptoms on the child’s development. In determining a diagnosis, the severity and duration of the symptoms must be assessed. Additionally, these symptoms must be present in multiple settings – not just at school.
ADHD has been found to be associated with increased risk of antisocial behavior (fighting, stealing, etc), substance abuse, dropping out of school or expulsion, suicidality, and teen pregnancy (Harpin, 2005).
These risks make early intervention a necessity for children with ADHD (McGoey, Eckert, & Dupaul, 2002).
So, how can we help?
Treatment for ADHD
The first step in treating ADHD involves accurate assessment of symptoms and diagnosis. Many other disorders can manifest in similar ways, and the treatment is different for each disorder.
Here are a few examples of other issues that look like ADHD:
- Inability to focus or concentrate
- Irritability and aggression
- Difficulty staying on task
- Fidgeting and squirming
- Inability to follow instruction
- Difficulty staying on task
Conduct Disorder / Oppositional Defiant Disorder
- Refusal to comply with instruction
- Agitation / irritability
Left untreated, ADHD can significantly impact the life trajectory of a child
Of course, ADHD can also be present with other disorders such as depression and anxiety. Difficulty focusing or sitting still would make most of us feel depressed, angry or anxious.
Accurate diagnosis might also include specific testing for ADHD using neuropsychological tests. If you would like to learn more about testing for ADHD, check out the page on Diagnostic Assessment under ADHD.
Once we have a clear diagnosis, I design a treatment plan to help manage symptoms and improve functioning in the affected areas (e.g. school).
Treatment objectives for ADHD might include:
- Improving organizational skills
- Down-regulating or calming the body
- Developing insight regarding attention difficulties
- Increased awareness for instruction from adults
- Learning to express frustrations or needs in a healthy way
Part of the treatment plan may also involve having your child meet with your primary care provider (PCP), psychiatrist, or other prescribers to consult regarding the use of medication.
Although medication can be an effective way to moderate hyperactive behaviors (Nair, Ehimare, Beitman, Nair, & Lavin, 2006), precautions must be taken before a giving children stimulant medication long-term (Greenhill, Pliszka, & Dulcan, 2002). Stimulants also tend to be overprescribed in the United States (Jensen, Kettle, Roper, Sloan, Dulcan, Hoven, & Payne, 1999). We will work as a team to determine the most effective strategy for treatment before moving forward with medication.
Interested? Let’s connect!
If you are interested in therapy services, please contact me as soon as possible. I would love to hear from you and answer any questions you may have about my practice.
Read about Dr. Montgomery
Dr. Montgomery holds dual certifications in Clinical Psychology (California Board of Psychology PSY28475) and Family Therapy (California Board of Behavioral Sciences MFT49608). He has dedicated his professional and academic activities to understanding and addressing psychological, behavioral and interpersonal health in children, adolescents, and families.
- Psy.D. Clinical Psychology
- M.A. Clinical Psychology
- M.S. Counseling Psychology
- B.A. Psychology
Want to learn more about me?
Click on the About tab to find out more about my credentials and get a better sense for who I am.
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Want to learn more about therapy, assessment, and mental illness?
Check out the tabs above, or click on the links below:
- Therapy with Children
- Therapy with Teens
- Therapy with Adults
- Testing for Academic and Professional Exam Accommodation Eligibility (California Bar Exam, LSAT, GRE, MCAT and more)
- Testing for School Performance (Psychoeducational Evaluations, Learning Disabilities, IQ, ADHD, and more)
- Testing for Diagnosis (Depression, Anxiety, Bipolar, ADHD and more)
Froehlich, T. E., Lanphear, B. P., Epstein, J. N., Barbaresi, W. J., Katusic, S. K., & Kahn, R. S. (2007). Prevalence, recognition, and treatment of attention-deficit/hyperactivity disorder in a national sample of US children. Archives of pediatrics & adolescent medicine, 161(9), 857-864.
Greenhill, L. L., Pliszka, S., & Dulcan, M. K. (2002). Practice parameter for the use of stimulant medications in the treatment of children, adolescents, and adults. Journal of the American Academy of Child & Adolescent Psychiatry, 41(2), 26S-49S.
Harpin, V. A. (2005). The effect of ADHD on the life of an individual, their family, and community from preschool to adult life. Archives of disease in childhood, 90(1), i2-i7.
Jensen, P. S., Kettle, L., Roper, M. T., Sloan, M. T., Dulcan, M. K., Hoven, C., ... & Payne, J. D. (1999). Are stimulants overprescribed? Treatment of ADHD in four US communities. Journal of the American Academy of Child & Adolescent Psychiatry, 38(7), 797-804.
McGoey, K. E., Eckert, T. L., & Dupaul, G. J. (2002). Early intervention for preschool-age children with ADHD: A literature review. Journal of Emotional and Behavioral Disorders, 10(1), 14-28.
Nair, J., Ehimare, U., Beitman, B. D., Nair, S. S., & Lavin, A. (2006). Clinical review: evidence-based diagnosis and treatment of ADHD in children. Missouri medicine, 103(6), 617-621.
Rubia, K., Smith, A. B., Brammer, M. J., Toone, B., & Taylor, E. (2005). Abnormal brain activation during inhibition and error detection in medication-naive adolescents with ADHD. American Journal of Psychiatry, 162(6), 1067-1075.
Yu-Feng, Z., Yong, H., Chao-Zhe, Z., Qing-Jiu, C., Man-Qiu, S., Meng, L., ... & Yu-Feng, W. (2007). Altered baseline brain activity in children with ADHD revealed by resting-state functional MRI. Brain and Development, 29(2), 83-91.