Attention Deficit Hyperactivit... Health Article

Recovery and rehabilitation

After a patient has been stabilized, typically using medication, follow-up visits to the physician are recommended every few months for the first year. Then, follow-ups every three or four months may be sufficient. The use of medications may continue for months or years.

Recovery and rehabilitation are not terms that apply to ADHD. Rather, a child with ADHD can be assisted to an optimum functionality. Assistance can take the form of special education in the case of those who prove too hyperactive to function in a normal classroom; the child may be seated in a quieter area of the class; or by using a system of rules and rewards for appropriate behavior. Children and adults can also learn strategies to maximize concentration (such as list making) and strategies to monitor and control their behavior.

Clinical trials

Beginning in 1996, the U.S. National Institute of Mental Health (NIMH) and the Department of Education began a clinical trial that included nearly 600 elementary school children ages seven to nine. The study, which compared the effects of medication alone, behavior management alone, or a combination of the two, found the combination to produce the most marked improvement in concentration and attention. Additionally, the involvement of teachers and other school personnel was more beneficial than if the child was examined only a few times a year by their family physician.

As of January 2004, a number of clinical studies were recruiting patients, including:

• Behavioral and functional neuroimaging study of inhibitory motor control. The basis of the inability to control behavior in ADHD was assessed using behavioral tests and the technique of magnetic resonance imaging (MRI).
• Brain imaging in children with ADHD. MRI was used to compare the connections between brain regions in children with and without ADHD.
• Brain imaging of childhood onset psychiatric disorders, endocrine disorders, and healthy children. MRI was used to investigate the structure and activity in the brains of healthy people and those with childhood onset psychiatric disorders, including ADHD.
• Genetic analysis of ADHD. Blood samples from a child with ADHD and his or her immediate family members were collected and analyzed to determine the genetic differences between ADHD and non-ADHD family members.
• Biological markers in ADHD. People with ADHD, their family members, and a control group of healthy people who had previously undergone magnetic resonance examination were assessed using psychiatric interviews, neuropsychological tests, and genetic analysis.
• Study of ADHD using transcranial magnetic stimulation. The technique, in which a magnetic signal is used to stimulate a region of the brain that controls several muscles, was used to investigate whether ADHD patients have a delayed maturation of areas of their nervous system responsible for such activity. Detectable differences could be useful in diagnosing ADHD.
• Clonidine in ADHD Children. The trial evaluated the benefits and side effects of two drugs (clonidine and methylphenidate) used individually or together to treat childhood ADHD.
• Nutrient intake in children with ADHD. The study determined if children with ADHD have a different eating pattern, such as intake of less food or a craving for carbohydrates, than children without ADHD. The information from the study would be used in probing the origins of ADHD and in devising treatment strategies.
• Preventing behavior problems in children with ADHD. The study was designed to gauge the effectiveness of a number of treatment combinations in preventing behavior that is characteristic of ADHD in children.
• Psychosocial treatment for ADHD Type I. The study focused on ADHD that is characterized by inattention. The aim of the study was to develop effective treatment strategies for Type I ADHD.
• Treatment of adolescents with comorbid alcohol use and ADHD. The effectiveness of a drug (bupropion) that is designed to be released at a constant rate over time was evaluated in the treatment of ADHD adolescents (14–18 years) who are also alcohol abusers.
• Behavioral treatment, drug treatment, and combined treatment for ADHD. The effectiveness of the three treatment approaches was compared, and the interactions between different levels of the behavioral and drug treatments were examined.
• Attention deficit disorder and exposure to lead. The effect of past exposure to lead was studied in children with ADHD.