ADHD Causes and Treatments

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Causes of ADHD:

ADHD is one of the best researched disorders in medicine, yet the exact causes of ADHD remain unclear. Some experts believe a combination of factors are responsible for the development of this disorder. Some of the possible causes of ADHD are listed below:

Differences in the Brain:
Advanced imaging techniques have detected differences in the brains of ADHD children compared to those of non-ADHD children. Research has suggested that ADHD is a disorder of the right side of the brain. One specific area on the right side, the prefrontal cortex, may be particularly important in understanding ADHD. The prefrontal cortex is thought to be the brain's command center. It regulates the brain's ability to inhibit responses. A number of imaging studies indicate that the prefrontal cortex of the brain in ADHD may be underactive in comparison with those without ADHD.

Neurotransmitters:
Many neurotransmitters affect mental and emotional functioning and may play a role in ADHD. Levels of dopamine, a neurotransmitter that helps regulate concentration, attention, and inhibition, might be abnormal in the brains of those with ADHD, according to some studies. Deficiencies in norepinephrine, another brain chemical that is involved in the fight or flight response, may also be critical in ADHD.

Problems During Pregnancy:
Some research suggests that ADHD is associated with problem pregnancies and with difficult deliveries. Maternal smoking during pregnancy is also associated with a higher risk for ADHD. While birth injuries and maternal alcohol or tobacco use may be factors in some cases of ADHD, most experts agree that these factors account for less than 10 percent of cases.

Genetics:
Evidence is increasing that genetic factors play the most important role in ADHD. A child is 70 percent more likely to have ADHD if they have a parent with ADHD. Genetics can influence the way neurotransmitters function, and researchers are finding that a variation of a dopamine D4 receptor gene is common in a high proportion of people with addictions and ADHD. Other genes under investigation include one called the dopamine D2 receptor gene.

Diet and Allergies:
Studies on the effect of food and food-additive allergies are controversial. However, evidence suggests that certain children with behavioral difficulties may be sensitive to certain chemicals in foods. Since allergies themselves have recently been associated with a higher risk for behavioral problems, children who respond to allergen-restrictive diets may not have true ADHD in the first place.

Numerous scientific studies on the diet’s role in the development of ADHD show benefits from the addition of certain nutritional elements to the diet. A study published in the Journal of Child Psychology and Psychiatry revealed a significant correlation between essential fatty acids and ADHD. Researchers discovered decreased levels of amino acids and zinc in children suffering from ADHD.

Although parents often blame sugar for causing children to become impulsive or hyperactive, research has shown sugar consumption does not cause or exacerbate ADHD symptoms such as hyperactivity. One study actually reported that ADHD children had fewer problems after a high-carbohydrate breakfast than after a high-protein breakfast. Another study reported that children have a tendency to move more slowly after a high-sugar meal, suggesting that carbohydrates may have a sedative effect.

Poor Parenting Does NOT Cause ADHD!
It is a horrible myth that bad parenting can be blamed for the development of ADHD. Some parenting practices can complicate the course of ADHD and lower the success of treatment, but these practices do not cause ADHD.

Treatment of ADHD:

Getting appropriate treatment for ADHD is very important. There may be very serious negative consequences for persons with ADHD who do not receive adequate treatment, including low self-esteem, social and academic failure, substance abuse, and a possible increase in the risk of later antisocial and criminal behavior. Treating ADHD in children requires medical, educational, behavioral, and psychological interventions. This comprehensive approach to treatment is called “multimodal” and includes:

Education Accommodations:
School success may require a range of interventions. Many children with ADHD can be taught in a regular classroom with minor adjustments to the environment. Some children will require additional assistance using special education services or "pull out" programs. All children with ADHD should have an IEP in place to ensure they receive the best possible education.

NOTE: The school cannot force your child to take medication. Only a doctor, with the parents' consent, can make that decision.

Behavioral Intervention and Therapy:
Behavioral interventions are very important in the treatment of children with ADHD. Important strategies include being consistent, using positive reinforcement, teaching problem-solving techniques, and improving communication and self-advocacy skills. Treatment plans should be tailored to the specific needs of each individual and family.

Psychotherapy can assist the person suffering from ADHD in developing ways of recognizing and coping with the symptoms of the disorder. It can also help erase some of the problems with self-esteem that have developed during the time the illness went untreated.

Medication:
Medication is often an integral part of treatment for ADHD. Medication is not used to control behavior, but helps by improving the symptoms of the disorder so that the individual can function more effectively. Between 70 and 80 percent of people with ADHD respond positively to psychostimulant medications. Attention span, impulsivity, and distractibility improve, especially in structured environments. Some children also demonstrate improvements in other areas, including frustration tolerance, compliance, and relationships with parents, peers, and teachers.

Hundreds of studies have been conducted regarding the effects of psychostimulant medications in children, making them among the most studied medications in history. Unfortunately, there are no long-term studies on the use of these medications, and each family must weigh the pros and cons of choosing medication as part of their treatment plan for ADHD.

Most side effects related to these medications are mild and typically short-term. The most common side effects are reduction in appetite and difficulty sleeping. Some children may experience an increase in activity, called stimulant rebound, when the medication is losing its effect. This tends to occur in younger children, and is usually seen just as the child arrives home from school. If the child continues to exhibit signs of rebound after about two weeks, ask your doctor about having the dose and/or medication scheduled changed.