Steven Pavlakis MD Ped Neurology Medical School Brown University Resident and Fellowship Columbia Presbyterian Medical Center talks about attention deficit hyperactivity disorder (ADHD). For more information visit www.DrMDK.com
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Interviewer: A lot of kids in school seem to be daydreaming and not focusing and the teachers are concerned. Maybe the kid has some kind of a focusing problem that fell all about. Interviewee: Well, there is such a thing as attention deficit disorder with or without hyperactivity and the usual children that have problems on concentration, destructibility, impulsivity and they may be hyperactive as well. They do not have to be. The boys that have it are more likely to be hyperactive. Girls are less likely to be hyperactive. Interviewer: What is the ratio between boy and girl? Interviewee: I do not know the exact number but I think it is 2:1 or3:1. Boys more commonly have it than girls. It is also probably under diagnosed in girls. One of the problems for this whole condition is that the teachers worry about the kids that are hyperactive because of disrupting the class and that is not necessarily something that is worth worrying about. It is really the teacher’s problem in that situation whereas you might have a child that sits there and is inattentive and does not learn anything and the teacher does not worry about that child because the child is not disruptive. And that child is actually one that we do not want to miss because that child might be the one who is truly falling behind. Interviewer: How can we diagnosed? Or are there tests we can do? Interviewee: While ADHD is just in general is usually a genetic condition. These children tend to be disorganized, tend to be felt to be immature and the key thing to know about ADHD is it does and can get better as you get older. It is an immaturity of attention. And that is usually what we should look at. It is not really a disease as such but it is an immaturity of concentration where the concentration improves. Interviewer: Is there any written tests that can get better? Interviewee: What we do is we can do tests forth. There are several ways of diagnosing it. One way is by a standard scale that has been validated. Sometimes parents look at this and say, well this is ridiculous but it does work where we give us scale that is check off list to the parents and to the teachers and we can score that scale and make a diagnosis that way. Interviewer: So, when they different tests? Interviewee: There are different tests. There is a Connor’s which is most commonly used. There is a Vanderbilt. There is also a snap form that I tend to like and this is generally the way we diagnose it. Once we diagnosed ADD or ADHD, the treatment really is two-fold, three-fold actually. First is educational. These children need more structure, discipline, consistency and that really is the first thing to do. Interviewer: Some kids might be all you do. Interviewee: That is right. Some kids already had the structure, discipline and they do very well and their attention gets better as they get older. And that really is the first step. Interviewer: What percentage of the kids truly diagnosed would you think it would be better if just looked like better structure. Interviewee: I do not know that answer much as any body really does know that answer. ADHD is a little more complicated than just taking a percentage because some truth of ADHD is rather more usual to their more likely to have learning disabilities, depression. Again, most do not but if you take they are more likely than other children to have other issues, obsessive compulsive behaviors, tics. It is a very complicated disease or constellation of symptoms so I do not really know the percentage but the first step I think is to give structure discipline consistency and then in part to pick and choose your battles. Interviewer: If you would go and treat the kid, how would you treat the kid? Interviewee: Picking and choosing your behavior sometimes some behavioral interventions for the parents and the kids can be helpful in that sometimes children have a hard time doing a certain task especially if the parents keep pushing it all you got to do is get resis

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