ADHD — Establishing a Treatment Plan

Part of treating Attention-Deficit/Hyperactivity Disorder (ADHD) is understanding the possible causes and origins of this disorder. And while it is one of the most studied conditions of childhood, the cause of ADHD is still not clear at this time.

However, the research done to date has shown the following:

• ADHD is a biological disorder. Children with ADHD have problems with chemicals that send messages in the brain.
• A lower level of activity in the parts of the brain that control attention and activity level may be associated with ADHD.
• ADHD appears to run in families. Sometimes a parent is diagnosed with ADHD at the same time as the child.
• In very rare cases, toxins in the environment may lead to ADHD.
• Very severe head injuries may cause ADHD in some cases.

Research also has shown that there is no evidence that ADHD is caused by the following:

• Eating too much sugar
• Food additives
• Allergies
• Immunizations

While the causes of ADHD may not be clear, the outlook for most children who receive treatment for ADHD is very encouraging. There is no specific cure for ADHD, but there are many treatment options available.

Each child's treatment must be tailored to meet individual needs. In most cases, treatment for ADHD should include the following:

• A long-term management plan with
  • Target outcomes for behavior
  • Follow-up activities
  • Monitoring
• Education about ADHD
• Teamwork among doctors, parents, teachers, caregivers, other health care professionals and the child
• Medication
• Behavior therapy
• Parent training
• Individual and family counseling

Treatment for ADHD uses the same principles that are used to treat other chronic conditions like asthma or diabetes. Long-term planning is needed because these conditions continue or recur for a long time. Families must manage them on an ongoing basis. In the case of ADHD, schools and other caregivers also must be involved in managing the condition.

Educating the people involved about ADHD is a key part of treating your child. As a parent, you will need to learn about ADHD. Read about the condition and talk to people who understand it. This will help you manage the ways ADHD affects your child and your family on a day-to-day basis. It also will help your child learn to help himself.

At the beginning of treatment, your pediatrician should set three to six "target outcomes" (goals) for your child's behavior. These goals will guide the treatment plan. Your child's target outcomes should focus on helping her function as well as possible at home, at school and in your community.

The following are examples of target outcomes:

• Improved relationships with parents, siblings, teachers and friends
• Better schoolwork
• More independence in self-care or homework
• Improved self-esteem
• Fewer disruptive behaviors
• Safer behavior in the community (eg, when crossing streets)

The target outcomes should be:

• Realistic
• Something your child will be able to do
• Behaviors that you can observe and measure (eg, with rating scales)

Your child's treatment plan will be set up to help your child achieve these goals.

For information on ordering the complete booklet, "Understanding ADHD" from the American Academy of Pediatrics, click here.