ADHD is a developmental disorder characterized by inattention, hyperactivity, and impulsivity. It affects 8-12% of school-aged children. While the specific causes are unknown, genetics and environmental factors during pregnancy are thought to play a role. Symptoms include difficulty paying attention, excessive movement, and acting without thinking. Treatment involves behavioral therapy, lifestyle changes, and sometimes medication to manage symptoms.

1. ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD)
ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD)Attention deficit hyperactivity
disorder (ADHD) can be said to be a development disorder that is exhibited through
impulsivity, hyperactivity and inattention (Raishevich and Jensen, 2007). There are many
other behavioral disorders that can be diagnosed in children but ADHD is most common
having 8 – 12% of school aged children being affected by it (Kim et al, 2009). Impulsivity,
hyperactivity and inattention are not uncommon in people but in people with ADHD these
symptoms are found to greatly interfere with their daily life. The symptoms mostly start to
show before 7 years of age and pose problems mostly at school and at home (Brown, 2006).
The symptoms continue to show in majority of children with ADHD as they grow up.
Because of the lack of an objective way that can measure the behavior of a child and the lack
of lab tests for ADHD, controversy can arise in the diagnosis. Disagreement can also be
found among experts on the best approach to treat the disorder. However, it is generally
agreed that early action would improve the social and educational development of the
child.Signs and SymptomsThe symptoms of ADHD can be categorized into three;
inattentiveness, hyperactivity and impulsivity (Raishevich and Jensen, 2007). One type can
be very prevalent in a child or the child may have a combination of the types. Children
exhibiting Inattentiveness are often less disruptive hence hard to realize their problem
early enough. In the symptom of inattentiveness the child is unable to pay close attention to
details and their school work is full of careless mistakes. During tasks or play the individual
has a hard time keeping attention. When spoken to directly, the child seems to not listen
and behaves as if he or she is not being addressed. The person lacks to follow through on
instructions and does not complete assigned duties in the workplace, school work or chores.
Organizing duties, activities and tasks poses a problem to him or her. Tasks that require
sustained mental efforts are very challenging to them therefore they dislike or avoid them.
The person is also likely to lose tools needed for activities and tasks such as pencils, books,
spanners, rakes and the likes. Distraction comes easily and forgetfulness is also more
frequent in their daily activities (Raishevich and Jensen, 2007).Hyperactivity symptoms
include fidgeting with hands and feet or squirming in the seat. When required to seat the
person leaves the seat. In children running around and climbing in inappropriate situations
is seen. The individual also has difficulty in doing their activities quietly. Often he or she acts
as if “ driven by a motor” and doesn’ t seem to stay at one place concentrating on one thing
(Akhondzadeh and Noorbala, 2006).Very impulsive behavior is present in a person with
ADHD. A good example is blurting out of answers even before the complete question has

2. been asked. During group activities the person has a hard time waiting for their turn and
often engages in the activity before their turn. Interruption and intrusion into other
people’ s affairs is common for instance the individual can butt into their colleagues’
conversation.Causes and incidencesCauses of ADHD are not known specifically and
research continues into the factors leading to this disorder. However, there are some factors
that are considered to cause or exacerbate the problem such as genetics, physical and social
environments and diet. The disorder is highly inheritable with 75 percent of the cases
having a genetic factor (Farone and Mick, 2010). Exposure to particular toxins during
childhood or maternally is a factor. ADHD develops in children born by women who were
exposed to smoking, drinking and Polychlorinated Biphenyls (PCBs) during their time of
pregnancy (Kim et al, 2009). Exposure to lead, phthalates or PCBs increases the likelihood
of developing the disorder. The brains of ADHD children and those of non ADHD children
are different as evidenced by brain scans. An example is the altered brain activity observed
in the prefrontal cortex in ADHD children. This part of the brain is thought to be the
command centre therefore the altered brain activity in this part may affect the child or
individual’ s ability to control their hyperactive or impulsive behaviors (Heinrich et al,
2007). According to researchers, excessively slow wave or theta activity in particular
regions of the brain can cause hyperactivity in children.Risk FactorsGender is one factor
considered in the diagnosis of ADHD with boys developing the disorder 4 – 9 times more
than girls (Farone and Mick, 2010). There are experts who believe that ADHD is
undiagnosed in girls. However, recent research opposes the idea and considers there to be
no association between the sex of a child and ADHD. Children with ADHD commonly have a
relative of the first degree suffering from the same disorder hence heredity is another risk
factor. Prenatal and early postnatal health is also factors that pose risk to the child. Use of
drugs, alcohol and cigarettes in pregnant women, as well as exposing infants or the fetus to
toxic substances and deficiencies in nutrition can lead to the development of ADHD (Nigg et
al, 2010). Other behavioral disorders such as conduct disorder should also be taken
seriously as they might be initial signs of the development of ADHD.Signs and
TestsIncorrect labeling is very common in ADHD. Also, ADHD children sometimes remain
undiagnosed. In order to clarify the test and diagnosis of ADHD, the American Academy of
Pediatrics (AAP) has some guidelines to be used (Radar et al, 2009. During diagnosis,
specific symptoms are investigated in different settings. At least six attention, hyperactivity
or impulsivity symptoms should be present and some of these are supposed to be observed
before age 7. The symptoms must be seen in the individual for at least six months, in more
than one setting and not be caused by any other problem. The level of difficulty caused by
the symptoms in different settings should be high. As a result of the symptoms being severe,
school, home and relations with peers will be difficult (Brown, 2006). Partial remission is
observed in older children who have the symptoms still but the disorder is not fully defined.
Evaluation of a child is required once suspicion of the disorder sets in. In the evaluation
parent and teacher questionnaires may be used. This is because school and home are the
settings where the symptoms and effects of the disorder are observed most. Psychological
evaluation of both the child and the family is also carried out. In the psychological
evaluation IQ tests and other psychological tests are performed. Examination of the

3. psychosocial, physical, mental, nutritional and developmental aspects of the patient will be
carried out too (Radar et al, 2009).PreventionThere are no stipulated preventive measures
in ADHD since the specific causes of the disorder are not known. However, the condition can
be managed with behavioral therapy, changes in lifestyle and medication. Early
identification and treatment of the condition is also beneficial as it helps to prevent most of
the problems that are associated with the disorder.TreatmentTreatment of ADHD especially
in children is a controversial matter. Currently, therapy, medication or both are used in
treatment (Radar et al, 2009). Some studies show that using medication to treat the
disorder without some sort of therapy reduces the long term outcomes of the child. Therapy
includes family and behavioral therapy as well as training in social and parental skills. Most
parents investigate nutritional therapies but the effectiveness of the nutritional therapies
has so far not been proven. Homeopathy and mind/body techniques may help improve
behavior in ADHD children as shown by preliminary evidence (Frei et al, 2006).LifestyleIn
order to manage the child’ s behavior, skilled clinicians offer parental skills training which
equip the parents with tools and techniques. Rewarding of appropriate behavior and
discouraging destructive behavior is taught. Parents and teachers in conjunction with
doctors and therapists perform this technique. Written behavioral contracts, tokens and
points are examples of rewards that can be used by parents on older children with ADHD
(Brown, 2006). Charts with stars for good behavior can be created for younger children.
Undesirable behavior can be discouraged through the use of timeouts. There are other
techniques that can be used, such as rules that are understandable, suitable in development
progress and not that harsh. Repeated commands need to be avoided after reminding the
child of the repercussions that will follow. Discipline should come before anger and
frustration sets in. it is also encouraged for praise to be given to the child after he or she
follows the rules and behaves in an appropriate manner.Additionally, changes in the
workplace or classroom play a significant role in the treatment plan. Highly structured
settings should be created for hyperactive children by the teacher who should be qualified
in handling behavior that is disruptive and one who easily adapts to the distinctive
cognitive style of hyperactive children (Frei et al, 2006). As a result of the challenges faced
by an ADHD child in interacting, social skills training, appropriate placement in the
classroom and elaborate engagement rules with peers are important. Family, couple and
behavioral therapies would benefit ADHD adults.Therapy through medicationThe most
commonly prescribed and most widely researched medications in the treatment of ADHD
are stimulants. The principle behind their improvement of ADHD symptoms is not yet fully
understood by researchers. However, studies indicate that the level of concentration of
serotonin and dopamine in the brain is increased by taking these drugs. Serotonin is
associated with mood and well being whereas dopamine is associated with activity
(Akhondzadeh and Noorbala, 2006). Atomoxetine is the first drug that is a non stimulant
medication approved to treat ADHD. This drug increases dopamine and norepinephrine
levels in the brain. Since it was first developed as an antidepressant, it carries a warning
indicating its possible effect of causing suicide thoughts in teenagers and children.
Methylphenidate, Lisdexamfetamine dimesylate, Amphetamine and Dextroamphetamine
are the most common stimulants prescribed for ADHD (Radar et al, 2009). Trouble sleeping,

4. nervousness and decreased appetite are some common side effects of these
medications.Alternative TherapiesRecent survey shows that alternative treatments are
being used by parents of children with ADHD. The most commonly used alternative
treatment is nutritional therapy. Despite the conflicting results shown by studies,
elimination of foods that the child is sensitive to should be considered after consulting with
the doctor in order to see if the symptoms will improve (Brown, 2006). The doctor’ s
supervision is necessary when a parent decides to undertake alternative
treatment.DietsBenjamin Feingold developed the Feingold diet in 1970s in his belief that
hyperactivity and learning disabilities in children were influenced majorly by flavors,
artificial colors, naturally occurring salicylates and preservatives (Weber and Newmark,
2007). Mixed results have been found in studies with some showing no benefits of diet
while others finding a little improvement in the symptoms. The Feingold diet is complex,
difficult to follow and changes the lifestyle of the family hence consultation with the doctor
before trying it is important.The other dietary therapies focus on more consumption of
foods rich in protein and complex carbohydrates and minimal consumption of foods with
sugar and artificial sweeteners. Hyperactivity in a certain study was found to increase
among children after consumption of foods with additives and food coloring. There is
however no study that has proved any relation between sugar and ADHD. There is also
another study that found no difference in behavior between the children whose diets were
high in artificial sweeteners and sugar and those whose diet was free of them (Weber and
Newmark, 2007). This result was obtained even in parents who considered their children
were sensitive to sugar. The doctors who concentrate on nutrition express their confidence
as they have experienced positive results from food allergies testing and the use of an
elimination diet. Parents that consider food allergy testing and elimination diet to be
beneficial are encouraged to talk to a doctor experienced in nutrition for ADHD children.
Magnesium is one mineral that is believed to cause symptoms of ADHD when deficient.
Magnesium supplements offered to magnesium deficient ADHD children may improve
behavior. Vitamin B6 is required in the manufacture of brain chemicals such as dopamine
and serotonin which are thought to cause ADHD (Weber and Newmark, 2007). The
doctor’ s supervision is critical before administering B6 to a child due to its dangerous
effects when taken in high doses. Zinc, essential fatty acids and L – Carnitine are the other
vitamins and minerals that are believed to improve behavior in ADHD children. All of these
mineral and vitamins have dangerous side effects when taken in high doses therefore they
should not be administered before talking to a doctor.Use of HerbsUse of herbs is generally
safer when strengthening and toning the body’ s systems. Herbs can be used as dry
extracts, tinctures or glycerites. A teaspoon of herb per cup of hot water is recommendable
unless directed otherwise. Two to four cups of the herb can be taken per day. There are no
scientific studies that have been carried out yet to establish whether the herbal remedies
sold in Europe and the United States improve symptoms of the disorder. The common
recommended calming herbs for ADHD include Valerian, Lemon balm, Roman Chamomile
and Passionflower (Radar et al, 2009).Other techniques:HomeopathyThe physical,
psychological and emotional make-up of an individual is first considered before a remedy is
prescribed in homeopathy. Experienced homeopaths ensure all these factors are assessed in

5. order to determine the most appropriate treatment for each individual. Cina, Stramonium
and Hyoscyamus niger are among the homeopathic remedies that have been found to be
most effective (Frei et al, 2006).MassageMassage can be used as a relaxation technique in
reducing anxiety and activity levels in teens and children. Compared to muscle relaxation,
massage is found to be more effective in improving behavior and concentration in children
and teenagers (Weber and Newmark, 2007).BiofeedbackHypnotherapy, biofeedback and
progressive relaxation are examples of mind/body techniques that can be used in treating
teens and children (Holtmann and Stadler, 2006). These techniques teach the children
copying skills which they can use the rest of their lives. The treatments give the children
and teenagers a sense of control and mastery, decrease stress and increase their self-
esteem. The principle behind biofeedback is that brain activity associated with ADHD can be
modified in children through training as well as increasing the brain activity associated with
attention and concentration (Holtmann and Stadler, 2006).ConclusionAttention deficit
hyperactivity disorder (ADHD) is a term associated with developmental problem affecting
children, teenagers and adults. The characteristics of the ailment include, being inattentive
and impulsive as well as being hyperactive. The specific causes of the disorder are not
known but there are some factors considered to lead to or increase symptoms of the
problem (Brown, 2006). Since the specific causes of the disorder are not known, prevention
measures are not available. The testing of the problem requires a series of tests,
observations and interviews. Treatment can be administered through medication, therapy
or both. Utilizing both therapy and medication in the treatment of ADHD reduces behavioral
problems of patients as they grow up and ensures the disorder is effectively managed
throughout the life of the individual.References:Brown, T. E. (2006). Attention Deficit
Disorder: The Unfocused Mind in Children and Adults. London: Yale University
Press.Farone, S. & Mick, E. (2010). Molecular Genetics of Attention Deficit Hyperactivity
Disorder. Psychiatric Clinics of North America 33(1).Frei, H., von Ammon, K. & Thurneysen
A. (2006). Treatment of hyperactive children: increased efficiency through modifications of
homeopathic diagnostic procedure. Homeopathy. 95(3):163-70.Heinrich, H., Gevensleben,
H. & Strehl U. (2007). Annotation: neurofeedback – train your brain to train behaviour. J
Child Psychol Psychiatry. 48(1):3-16.Holtmann, M. & Stadler, C. (2006).
Electroencephalographic biofeedback for the treatment of attention-deficit hyperactivity
disorder in childhood and adolescence. Expert Rev Neurother. 6(4):533-40.Kim, B.N. et al.
(2009). Phthalates exposure and attention-deficit/hyperactivity disorder in school-age
children. Biol Psych. 66(10):958-63.Nigg, J.T., Nikolas, M., Knottnerus, M., Cavanaugh, K. &
Friderici, K. (2010). Confirmation and extension of association of blood lead with attention
deficit/hyperactivity disorder (ADHD) and ADHD symptom domains at population-typical
exposure levels. J Child Psychol Psychiatry. 51(1):58-65.Noorbala, A.A. & Akhondzadeh, S.
(2006). Attention-deficit/hyperactivity disorder: etiology and pharmacotherapy. Arch Iran
Med. 9(4):374-80.Rader, R., McCauley, L. & Callen, E. (2009). Current Strategies in the
Diagnosis and Treatment of Childhood Attention Deficit Hyperactivity Disorder. Am Fam
Phys. 79(8).Raishevich, N., & Jensen, P. (2007). Attention-deficit hyperactivity disorder. In:
Kliegman RM, Behrman RE, Jenson HB, Stanton BF , eds. Nelson Textbook of Pediatrics. 18th
ed. Philadelphia, Pa.: W.B. Saunders Company; ch. 31.Weber, W. &Newmark, S. (2007).

6. Complementary and Alternative Medical Therapies for Attention Deficit Hyperactivity
Disorder and Autism. Pediatric Clinics of North America 54(6).