| For children with ADHD there are many child | | | | on stopping the medication, These include slowing of |
| interventions to help these children and their families, | | | | growth, loss of appetite, poor weight gain, difficulty |
| the main ones being medication, behavior treatment i.e. | | | | sleeping, headaches, daydreams and tics, These are |
| working with the child at home and at school, parent | | | | usually minimal, and the medicine can always be |
| training in groups or alone, family work or liaisons with | | | | stopped if it does not suit your child, Children must |
| school and treating other problems and complications. | | | | have their height and weight monitored regularly for |
| | | | | this reason to help in this child interventions with ADHD. |
| In 1999 a large multi- centre study in the USA showed | | | | |
| clearly that the best treatment for ADHD , especially if | | | | Addiction and licensing |
| complicated by oppositional behavior ( a child shows | | | | |
| severe signs of stubbornness and tantrums over a | | | | The medication is not addictive in children and works |
| persistent amount of months where the problem | | | | best with consistent parenting, it is not licensed for use |
| escalates into aggressive and disruptive behavior like | | | | under the age of six, it is a controlled drug (prescription |
| hitting , kicking, swearing , throwing things out of spite . | | | | only) because it can be sold illegally for its paradoxically |
| Lying stealing, cheating or hurting others with no sign of | | | | stimulant effects in adults. Resent research has shown |
| remorse, the more serious condition of `conduct | | | | that treatment with Ritalin can prevent addiction to illicit |
| disorder ` is diagnosed, children with this problem may | | | | drugs, which can be a common complication of |
| also behave cruelly to animals or start fires) is used of | | | | untreated ADHD. |
| appropriate medication. | | | | |
| | | | | Prescribing Ritalin |
| Historically in the UK we have saved medication for | | | | |
| the last resort, partially as families are understandably | | | | Ritalin is often tested out first for a trial period of a |
| not keen to medicate their children. Although studies | | | | few weeks to make sure that it works, before being |
| have shown that behavioral treatments alone is likely | | | | prescribed on a long time basis but with regular |
| to be relatively ineffective except in children with | | | | check-ups, children tend to need medication for years |
| ADHD and anxiety symptoms who do not have | | | | sometimes into adulthood, sometimes the medicine can |
| oppositional behavior, where medication can be less | | | | be used for phases to allow a child to catch up to a |
| helpful. | | | | degree educationally and socially, with holiday periods |
| | | | | (no medication) in between. |
| With medication children are much more likely to be | | | | |
| able to respond to behavioral child interventions which | | | | Newer preparations |
| can make a big difference in children with oppositional | | | | |
| behavior, a combination of treatment is usually best in | | | | Ritalin is now available in slow-release preparations |
| the long term. | | | | with only once-a-day dosage, avoiding the |
| | | | | embarrassment of taking tablets in school , The |
| Liaison with the school and treatment of other | | | | dual-release tablet Concerta XL cannot be abused |
| problems are always crucial. | | | | because of its particular slow-release structure , A |
| | | | | non-stimulant alternative atomoxetine ( Strattera), has |
| Early evidence suggests that a crucial component of | | | | also recently become available. |
| positive outcome is the parent's ability to avoid blaming | | | | |
| and criticizing the child, yet to parent consistently and | | | | Parenting groups |
| firmly with the support of the child's school. | | | | |
| | | | | These groups are extremely helpful for children with |
| Medication | | | | ADHD who develop oppositional or conduct problems |
| | | | | because these children particularly need firm, caring |
| Although medication alone may not be a solution to all | | | | and consistent parenting, without which they gravitate |
| the problems, stimulant medicines such as methyl- | | | | towards trouble. |
| Phenidate (Ritalin) can dramatically improve the | | | | |
| symptoms in up to 90 per cent of children, and are the | | | | Where can you get help? |
| most effective child interventions treatment in most | | | | |
| cases. Ritalin works by stimulating neurotransmitters | | | | You will need to be referred by your doctor to a |
| receptors in the brain such as dopamine, which directly | | | | specialist pediatrician or to Child and Adolescent Mental |
| affects attention, concentration, impulsiveness and | | | | Health Services for diagnosis and treatment, some |
| hyperactivity, This literally allows your child to stop and | | | | doctors outside mental health services sometimes |
| think, perhaps for the first time in their life, this then | | | | have expertise in ADHD, but usually cannot offer the |
| enables a child to settle down and live a more normal | | | | wider range of treatments beyond medication for |
| life, build educational and social skills, boost self-esteem | | | | more complicated situations. |
| and restore hope. | | | | |
| | | | | Support is available through ADHD support agencies |
| Side effects | | | | that run parent support groups in most areas, schools |
| | | | | (educational psychologists and advice with special |
| Over five million people over 40 years have been | | | | needs support) and possibly social services, for family |
| treated with stimulant medications, with no long- lasting | | | | support, financial advice or support, or childcare support |
| adverse effects reported. Five to ten per cent of | | | | if relevant. |
| people get short-term side effects that are reversible | | | | |