ADHD

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    Yes, the American Academy of Pediatrics (AAP) guidelines recommend treatments that differ, depending on the child’s age. For school-aged children (6-18 years of age) with ADHD, treatment can include ADHD medication or behavior therapy, with both medication and behavior therapy as the preferred treatment. Preschoolers (4-5 years of age) should receive behavior therapy first, before any medication. The Agency for Healthcare Quality and Research has determined that parent behavior training is the behavior therapy approach that is most effective for preschoolers.

    The AAP guidelines for ADHD do not make recommendations for children younger than age 4, because it is very challenging to accurately diagnose ADHD in younger children. However, children ages 2 and 3 do sometimes receive that diagnosis from their healthcare provider. Parent behavior training approaches for children with ADHD can be used with children younger than age 4.

    Learn more about ADHD treatment recommendations here: http://www.cdc.gov/ncbddd/adhd/guidelines.html

    The presence of the CDC logo and CDC content on this page should not be construed to imply endorsement by the US Government of any commercial products or services, or to replace the advice of a medical professional. The mark “CDC” is licensed under authority of the PHS.
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    Data from a national sample of children with special health care needs, ages 4-17 years, collected in 2009-10 showed that many children with ADHD were not receiving treatment as outlined in the best practice guidelines released in 2011 by the American Academy of Pediatrics (AAP).
    • Less than 1 in 3 children with ADHD received both medication treatment and behavioral therapy, the preferred treatment approach for children ages 6 and older.
    • Only half of preschoolers (4-5 years of age) with ADHD received behavioral therapy, which now is the recommended first-line treatment for this group.
    • About half of preschoolers with ADHD were taking medication for ADHD, and about 1 in 4 were treated only with medication.
    More recent data are needed to understand if the treatment patterns have become more aligned since the current guidelines were released.

    Learn more about treatment patterns here:
    http://www.cdc.gov/ncbddd/adhd/features/adhd-keyfindings-treatment-special-needs-children.html

    The presence of the CDC logo and CDC content on this page should not be construed to imply endorsement by the US Government of any commercial products or services, or to replace the advice of a medical professional. The mark “CDC” is licensed under authority of the PHS.
     
  • 1 Answer
    A
    Data from a national sample of children with special health care needs, ages 4-17 years, collected in 2009-10 showed that most children with ADHD received either medication treatment or behavior therapy; however, at that time many were not receiving treatment as outlined in the best practice guidelines released in 2011 by the American Academy of Pediatrics (AAP).
    • Less than 1 in 3 children with ADHD received both medication treatment and behavior therapy, the preferred treatment approach for children ages 6 and older.
    • Only half of preschoolers (4-5 years of age) with ADHD received behavior therapy, which now is the recommended first-line treatment for this group.  
    • About half of preschoolers with ADHD were taking medication for ADHD, and about 1 in 4 were treated only with medication.
    Learn more about ADHD treatment here: www.cdc.gov/ncbddd/adhd/treatment.html

    The presence of the CDC logo and CDC content on this page should not be construed to imply endorsement by the US Government of any commercial products or services, or to replace the advice of a medical professional. The mark “CDC” is licensed under authority of the PHS.
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    AAmen Clinics, Inc. answered
    In anxious attention deficit disorder (ADD), there is low activity in the prefrontal cortex while there is overactivity in the basal ganglia, which sets the body’s “idle speed” and is related to anxiety. The ADD symptoms in people suffering with this type tend to be magnified by their anxiety. Treatment for people with anxious ADD often includes both calming and stimulating the brain.

    Anxious ADD single-photon emission computerized tomography (SPECT) scan findings show increased activity in the basal ganglia at rest and during concentration. Additionally, there is decreased activity in the prefrontal cortex and cerebellum during concentration.
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    AAmen Clinics, Inc. answered
    In ring of fire attention deficit disorder (ADD), there is a pattern of overall high activity in the brain. Those with this type tend to have difficulty “turning off” their brains and typically feel overwhelmed with thoughts and emotions. This type tends to do much worse on stimulant medications alone.

    Ring of fire ADD can be related to some form of allergy, infection or inflammation in the brain, or it can be related to bipolar disorder. There are some subtle differences between ring of fire ADD and bipolar disorder in the scan data as well as some differences in the presentation of a person’s symptoms. For instance, kids with ADD tend to have their problems all of the time, whereas kids with bipolar disorder tend to cycle with their mood and behavior problems. Adults with bipolar disorder have episodes of mania while adults with ring of fire ADD do not -- their behavior issues tend to be consistent over long periods of time.

    Of note: It is possible to have both conditions -- in fact some research studies suggest that as many as 50% of those with bipolar disorder also have ADD.

    Ring of fire ADD single-photon emission computerized tomography (SPECT) scan findings show patchy increased activity in many areas of the brain, which looks like a “ring” of overactivity. There is some variability in ring of fire patterns from individual to individual. In differentiating between bipolar and ring of fire ADD, it is important to consider the SPECT scan data in addition to the person's clinical history.
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    AAmen Clinics, Inc. answered
    In limbic attention deficit disorder (ADD), the prefrontal cortex is underactive during concentration while the deep limbic area -- which sets your emotional tone, controlling how happy or sad you are -- is overactive.

    Depression is also associated with overactivity in the deep limbic area, yet a person’s developmental history in addition to some subtle differences on single-photon emission computerized tomography (SPECT) scans (between limbic ADD and depression) helps differentiate between the two conditions. This helps set the best course of treatment to resolve symptoms.

    Limbic ADD SPECT scan findings typically show increased deep limbic activity (thalamus and hypothalamus) at rest and during concentration. There is also decreased activity in the prefrontal cortex, cerebellum and basal ganglia during concentration.
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    AAmen Clinics, Inc. answered
    People with temporal lobe attention deficit disorder (ADD) have the hallmark features of ADD plus symptoms associated with temporal lobe problems, such as issues with learning, memory, mood instability, aggression, temper outbursts, and sometimes, even violence. It is not unusual to see this type of ADD in people who have had head injuries.

    Temporal lobe ADD single-photon emission computerized tomography (SPECT) scan findings show decreased activity (and infrequently increased) activity in the temporal lobes at rest and during concentration, as well as decreased activity in the underside of the prefrontal cortex, cerebellum and basal ganglia during concentration.
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    AAmen Clinics, Inc. answered
    In order to focus, it is necessary to continually be able to shift your attention. People suffering with overfocused attention deficit disorder (ADD) have most of the ADD features, but rather than not being able to pay attention, they have difficulty shifting their attention. They become hyper-focused on certain things while tuning everything else out. These folks tend to get stuck or locked into negative thought patterns and behaviors. This type of ADD is often found in substance abusers as well as the children and grandchildren of alcoholics.

    Overfocused ADD single-photon emission computerized tomography (SPECT) scan findings show increased activity at rest and during concentration in the anterior cingulate gyrus, as well as decreased activity in the underside of the prefrontal cortex, cerebellum and basal ganglia.
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    AAmen Clinics, Inc. answered
    Inattentive attention deficit disorder (ADD) is the second most common type of ADD. Those suffering with this type are usually quiet, more introverted and appear to daydream a lot. They may be labeled as unmotivated -- even slow or lazy. Inattentive ADD is common in girls and boys but is often missed because children with this type tend to have fewer behavioral problems. They don’t draw the negative attention to themselves as do those with classic ADD.

    Inattentive ADD single-photon emission computerized tomography (SPECT) scan findings show normal activity at rest, but during concentration there tends to be decreased activity in the underside of the prefrontal cortex, cerebellum and basal ganglia.

    Inattentive ADD is the perfect example of why the general term attention deficit hyperactivity disorder (ADHD) does not fit all ADD types. If clinicians and parents are looking for hyperactivity to reach a diagnosis, those with this type (absent of hyperactivity) may be left untreated and go on living life below their true potential.
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    AAmen Clinics, Inc. answered
    Classic attention deficit disorder (ADD) is usually evident early in life. As babies, they tend to be colicky, active and wiggly. As children, they tend to be restless, noisy, talkative, impulsive and demanding. Their hyperactivity and conflict-driven behavior gets everyone’s attention early on.

    Parents of these kids are often tired, overwhelmed and even embarrassed by the behavior of their non-stop and hard-to-control children. Classic ADD tends to be more frequently seen in boys.

    Classic ADD is often called attention deficit hyperactivity disorder (ADHD), with an emphasis on the hyperactive behavior trait.

    Classic ADD single-photon emission computerized tomography (SPECT) scan findings show normal activity at rest, but during concentration there tends to be decreased activity in the underside of the prefrontal cortex, cerebellum and basal ganglia. The basal ganglia are structures deep within the brain that produce the neurotransmitter dopamine, which is critical to motivation, attention and setting the body’s idle speed.