Search for tag: "adhd"

This content was originally created for audio. Some elements such as tone, sound effects, and music can be hard to translate to text. As such, the following is a summary of the episode and has been edited for clarity. For the full experience, we encourage you to subscribe and listen— it's more fun that way.

Scot: This is "Who Cares About Men's Health," giving you inspiration, information, and a different interpretation to better understand and engage in your health so you can have the life you want today and into the future.

My name is Scot. I'm the manager of thescoperadio.com. And I care about men's health.

Troy: And I'm Dr. Troy Madsen. I'm an emergency physician at the University of Utah, and I care about men's health.

Dr. Weir: I'm Dr. Rachel Weir. I'm a psychiatrist at the University of Utah, and I care about men's health as well.

Scot: So we're going to talk today about adult ADD or ADHD. One of the things I do want to clarify right away is . . . I mean, are those the same? Are they different? I've always used them interchangeably.

Dr. Weir: A lot of people say ADD, attention deficit disorder, versus ADHD, attention deficit and hyperactivity disorder, because they don't feel like they have hyperactivity, especially for adults. Kids, you see the hyperactivity symptoms much more frequently than you do in adults.

But if you wanted to be strict in terms of the definition, it all is ADHD. So you would say ADHD predominantly inattentive type or ADHD predominantly hyperactive type or a combination of the two.

Troy: See, Scot, I didn't actually know that, so I'm glad we clarified that. But you're right. I had heard years ago ADD, and then now I always just use the term ADHD, but I did not understand the reasoning for that.

But it sounds like, Dr. Weir, you're saying if we're . . . basically, we don't use the term ADD anymore. It's ADHD, and then there are different subtypes within that.

Dr: Weir: Yeah, exactly.

Scot: So I'm going to make an admission here that's not going to make me look like a great person nowadays. And I think a lot of people out there do this as well. Joke at one time or another when they're having trouble focusing on something, or they get easily distracted, "Oh, man, I really got some ADD today." But just because I can't focus at any particular given time doesn't mean that I have ADHD, right?

Dr. Weir: No, absolutely not. And most of the time, it's not going to be ADHD in adults, especially adults who . . . if you're presenting with new symptoms in your 30s, 40s, 50s, that's not going to be ADHD. ADHD is a diagnosis originally of childhood. It can span the whole lifespan. It doesn't for everybody. But you do have to have symptoms present before the age of 12.

Troy: Scot, we're talking about adult ADHD today. But, Dr. Weir, it sounds like you're saying that it's not something that an adult would develop. Like, this has been a pattern and maybe it just wasn't diagnosed until they were an adult.

Dr. Weir: So it is possible that . . . sometimes I see people for an assessment that tell me, "Oh, gosh, I always struggled in school. My teachers, their comments always said I was hyperactive or always out of my chair or blurting answers out. And my parents didn't really believe in mental health and never really got me treatment."

So if you hear a story like that, even though someone didn't have a diagnosis at a young age, they still can have the diagnosis, of course. It's just that it wasn't picked up on when they were younger.

But if you're in your 40s and 50s and you're having symptoms of inattention, distractibility for the first time, it's very likely something else.

Scot: How many adults do you encounter that have the symptoms but just weren't diagnosed when they were younger? Is that something you encounter often?

Dr. Weir: That that does happen frequently, yeah. It also happens probably just as frequently that it's something else that's causing the problems now.

Scot: Oh, okay. On your definition, you kind of focused in on that example you told of the child. The hyperactivity part was kind of the theme I got there. Is that generally the case? So am I incorrect in thinking it's just kind of lack of attention even in a child? It's more about the hyper?

Dr. Weir: It can be both in kids. It is much easier to identify in kids who are hyperactive in a school setting. For the kids that don't have hyperactivity, if they're just distracted, they're kind of daydreaming, gazing out the window, they're not picked up on nearly as frequently as someone who's causing a lot of commotion in a classroom setting.

Troy: As we're talking about this, like I said, sometimes I joke that if I didn't have ADHD when I started my job, I do now. But it sounds like you're saying I don't have ADHD. I was a focused student. I was not hyperactive as a kid in elementary school, junior high, high school. Not an issue.

But I'll tell you, I struggle with just paying attention. If I'm in a lecture, 15 minutes in, I zone out. You've got to do something to keep my attention. Is that abnormal, or if someone has this experience, is this something abnormal where they should seek attention? Or is that just kind of typical for most people?

Dr. Weir: The key to really making a diagnosis, other than some of the things that we'll go into and, like I said, the symptoms presenting in childhood, would be, "Is this impacting your life? Is this interfering with your functioning day to day, in multiple settings too, not just in a work environment, but at home? Is it somehow affecting your relationships? Have you had repeated school failure, maybe legal problems, car accidents, job losses?" Those types of things that really, obviously, can contribute to a lot of impairment and functioning for people versus just, "Sometimes I'm not quite as on task and as sharp as I could be."

Troy: And that's a great point, because I think we all look at ourselves, and like you said, sometimes you feel down, sometimes you're depressed, you're sad, but it doesn't meet that clinical definition, or distractibility or tough time focusing. But it's not really a clinical thing unless . . . We all experience that, but it's not necessarily an issue where you need to be on medication or have treatment unless it really does affect function and personal relationships, jobs, etc. So yeah, I think it's helpful for all of us to know that.

Dr. Weir: Yeah, absolutely. A lot of the screeners if you just Google . . . because everyone does Dr. Google now, right?

Troy: Yeah.

Dr. Weir: Like, "Do I have . . ."

Troy: Such a bad, bad doctor.

Scot: Everything is going to kill you according to Dr. Google.

Troy: That's why people come to the ER, Dr. Google.

Dr. Weir:But if you Google, "Do I have adult ADHD?" it's probably going to guide you towards a rating scale that's based on symptoms. So it's not going to be very sensitive in terms of actually giving you a diagnosis and saying, "Do you have some functional impairment?" It's just looking at symptoms. So I've seen a lot of people bring those kinds of screeners to me saying, "I'm pretty sure I have ADHD."

Scot: I understand you developed a protocol to help diagnose people that may have adult ADHD. Can you talk about that a little bit? What are some of the things that you do look for?

Dr. Weir: Yeah, that's part of my work. I supervise psychiatry residents who rotate through our university community clinic system in primary care clinics. The first year we did it, I was expecting to see a lot of depression, anxiety, possibly bipolar disorder. And we were really surprised at the number of requests we got for adult ADHD assessments.

So we really had to come up with a protocol that was thorough but reasonable to kind of help our primary care colleagues in how to really make this diagnosis.

So one thing I would say is if, as a patient, you're wondering about this, and you're going to a provider, and you're just saying, "Oh, I can't really focus, and I filled out this scale," and there's not really much of a discussion of, "Is this lifelong? Is there collateral information maybe from a school or a parent?" and screening for other mental health conditions or other medical conditions, and you're leaving that appointment with a diagnosis and a prescription, that probably wasn't an adequate assessment.

So we developed . . . it's still shorter than doing a full neuropsych testing and neuropsych battery. But it is a two-part evaluation. At that first appointment, what we can focus on is screening for possible comorbidity, other mental health problems, substance abuse problems, underlying medical problems that could be contributors, giving the patient some scales to take home and fill out and maybe have a spouse or a parent fill out.

And then coming back and kind of looking at all that information together in the second appointment, and going through if an ADHD diagnosis looks like it's likely.

Troy: So what's the downside then of . . . let's say someone takes a scale in, they see their doctor, and their doctor says, "Yeah, it looks like on this scale you have ADHD." What's the downside of going on treatment? Is that a detrimental thing for these patients? Does it help them function better?

Dr. Weir: That's a . . .

Scot: Well, there are two questions, if it was a misdiagnosis and if it's a proper diagnosis. Right?

Troy: Yeah. It sounds like what you've seen is maybe a lot of potentially overdiagnoses, where people are maybe just going in and saying, "Hey, I did this scale." Obviously, a lot of primary care physicians are very busy and sometimes the easiest thing is to say, "Here's a prescription."

Dr. Weir: Yes.

Troy: I guess, number one, are you seeing that quite often? And number two, what's the what's the downside of that?

Dr. Weir: I'll try to remember all the parts to that question.

Troy: I'll ask you first, does that happen often?

Dr. Weir: Yeah, it certainly does. And that's kind of why we wanted to come up with a good way to really screen people and make sure we were treating comorbidities.

There was one very good study done that was published in the last few years. And this had actually been a longitudinal study of kids with ADHD, and then they had kids without ADHD in the control group, and they followed them over time.

In fact, the length of time that they followed them was into . . . the average was about 14 years. So this was long-term follow-up.

Now, of the children that they followed who were in the control group, we knew at age 10 that they did not have ADHD because they had very good assessments at that time. When they did screeners as they became adolescents and adults, almost half of them had what would be considered a positive screen for possible ADHD.

Now, when they went back with that group and they did a really thorough assessment looking at all those things, impairment in functioning, multiple settings, not just self-report but parent report as well, psychiatric comorbidities, substance abuse, 95% of that group did not have a diagnosis of ADHD.

Troy: Oh, wow.

Dr. Weir: Yeah. So very, very high. It's not going to be that high in the real world, because like I said, they knew these kids didn't have ADHD, and obviously, we're treating people who most of them haven't had any kind of assessment, let alone a thorough assessment at age 10.

But usually, the symptoms they were experiencing were due to another condition. So trauma was one. Depression. That can affect concentration. Cognitive effects of marijuana use was one, and alcohol use as well.

So that is one thing. You want to make sure you're getting your diagnosis right.

Now, if you're not getting your diagnosis right . . . and let's say you do get an ADHD diagnosis, and you start a medication. Let's say it's a stimulant, because that's what most people get prescribed. So methylphenidate, or the common name would be Ritalin, or amphetamine salts, or Adderall would be the common name there. That can be very helpful for symptoms of concentration, but that's not diagnostic.

If all three of us took Adderall right now, it would help us focus better. That doesn't mean that we have ADHD, right?

So what would be the downside of doing something like that? Well, first of all, just improving your concentration alone doesn't inherently fix a lot of the problems that people with ADHD have around planning and being less impulsive, improving executive functioning. You still need some skill-based treatment for that.

And then if you're prescribed a stimulant, you might feel like, "Wow, this isn't really affecting me." But it could make anxiety worse. It could make you not sleep as well.

And then sometimes what we see is people get into these prescription cascades where they didn't really need that original prescription, and then they're prescribed something for sleep. Then they're feeling groggy the next morning from that, and then they want their stimulant dose increased.

You can see you can kind of get down these paths where you're treating more side effects than you are really treating a condition.

And then, of course, there can be some concerns about stimulant use, especially in men, especially as you get older. Blood pressure increases. Pulse increases.

Now, it's not that significant, but if you're talking about taking these medications for 10 or 20 years, then that can be a significant strain on your heart.

So those are just some things to think about.

Scot: That's interesting. But it sounds like that study . . . my takeaway from that study is if I go online and I do one of these self-assessments for ADHD, it's pretty much a coin flip as to whether I will be diagnosed based on that with ADHD versus not, and I probably don't have it even if I'm diagnosed by that.

Dr. Weir: Yes. There was actually a good "New York Times" article several years ago, where they had 1,100 adults take an online ADHD quiz, and almost 50% scored in that range that told them ADHD was possible or likely.

Troy: And of those, it sounds like the large majority, once they undergo a more rigorous assessment, don't have ADHD.

Dr. Weir: That would be correct, yeah.

Troy: Wow. Interesting.

Scot: So this is interesting. It's always interesting when we go into these conversations on "Who Cares About Men's Health," because when I came in, I . . . here's the way I thought it was going to go in my brain. We were going to talk about all these people that are adults and were misdiagnosed or undiagnosed for ADHD. Not misdiagnosed. Let me rephrase. That were undiagnosed. They are struggling in their life, they finally get the proper diagnosis, they get the proper treatment and medication, the . . . I can't remember what you referred to those as, impulse control, that sort of thing. Those exercises?

Dr. Weir: Oh, yeah. Mindfulness and skill-based therapy.

Scot: But what I'm hearing instead is it's a lot more likely that you're going to go in with some symptoms of something completely different, perhaps get a misdiagnosis, end up on some medication you don't really need to be on, and you're not really even solving the problem that you had in the first place. Which one is the bigger risk for an adult here?

Dr. Weir: Well, there's a reason that we've seen the number of stimulant prescriptions increase threefold in just a five-year time period. And at this point, adults make up the majority of those prescriptions. It's no longer that a majority of prescription stimulants are prescribed to children. Now, it's to adults.

Yeah, a lot of people wonder, "Well, if this helps my concentration and my focus, and I feel like I'm functioning better, what's the harm?" I think these medicines . . . I mean, we have to remember they are controlled substances. They are addictive, but they don't have the same . . . there hasn't been the same concern about them like you've seen with the opioid epidemic, with people overdosing and dying.

These medicines are very, very commonly misused, but most people are not getting addicted to them. So high misuse, high rate of diversion or sharing medication, especially when you get to college students, but low in terms of actual addiction.

Troy: You mentioned that increase in the last five years. Just in the last year with the pandemic, are you seeing kind of anecdotally significant increases in the number of stimulant prescriptions and diagnoses of ADHD?

Dr. Weir: I am not aware of that. I don't know. Certainly, the effects of the pandemic I think are going to be very long lasting. Typically, mental health sequelae of something like this, it develops a little bit more after the fact. But people are very concerned about that, especially with depression, anxiety, and post-traumatic stress disorder.

But I do think there are some things going on related to the pandemic that might make more people think that they have ADHD. So one is a lot of us started working from home. That can be much more distracting than being in your office. And just kind of dealing with those distractions, especially if you have kids at home, you have other things you look up and see and think, "I have to go do that right now instead of focusing on work."

And alcohol use has increased as well. So any time you have an increase in alcohol use, people might think, "Oh, gosh, this isn't really affecting me. I'm just having a couple extra glasses of wine a night," or whatever. But it is likely impairing sleep, which if you're not getting great sleep, you're not going to be very focused and energetic. And then that can kind of carry over into a sluggish feeling the next day.

And then just depression and loneliness as well. So one of the core symptoms of major depressive disorder is impairment in concentration. That is also one of the core symptoms of anxiety, generalized anxiety disorder, is impairment in concentration.

So it makes sense that we might see more people presenting with this concern than we already do. But yeah, I think those are some reasons.

Troy: That's what I wondered. We talked to Dr. Ben Chan as well, who I'm sure you know . . .

Dr. Weir:Yeah.

Troy:. . . who works at Primary Children's. He talked about that same thing, how we're all experiencing that, distractions and difficulty concentrating. And I've wondered how many of us have thought to ourselves, "Wow, I must have ADHD. I just can't focus. It's so difficult to get tasks done." And then potentially doing online assessments and potentially being diagnosed and prescribed medications.

Yeah, it's interesting, but sounds like maybe that is something we might see as more data comes out in the next couple of years in terms of prescriptions and diagnoses during this time.

Scot: It also seems as though that distraction could be a symptom of a lot of different things.

Dr. Weir: Absolutely.

Scot: I'm kind of understanding that just because you're distracted and can't focus, you think, "Well, I've got ADHD." Probably not. It's probably something else. So go see somebody who can help you sort through some of those things if they are actually impacting your life in a negative way.

Dr. Weir: Yeah, absolutely.

Scot: Dr. Weir, help me sum up what we've learned today. We set out on this journey talking about adult ADHD. Is that something that somebody could have? Would they want to seek treatment for that? We kind of ended up someplace else. What would your ultimate summary be of what we should take away from this?

Dr. Weir: Well, I'd say that ADHD in children and adults is a very real condition, and it can cause some very significant problems for people. So it is important to get it assessed and treated if you think that you suffer from it, or if you know you do, if you've had the diagnosis or testing in the past, but maybe you kind of stopped getting treated and now you're noticing some problems again, especially when we get to that kind of functional impairment.

I think it would be worth noting that medication is very helpful for this condition. It's very helpful. However, it can't really help with some of the skills that people need in terms of being able to plan, multitask, think about future, planning things like that. So it is important to do some skill-based work as well, and maybe mindfulness too, being able to learn how to stay in the moment, stay on one task. That can be very helpful as well.

And then I think just reiterating that this is a diagnosis that originates in childhood. So if you're noticing something now, if no one ever noticed any problems when you were younger, a parent, a teacher, yourself, and you don't really have that functional impairment, you're noticing things like, "Oh, my work performance isn't top notch. I'm not at the top of my game. I forget what I'm doing," you probably don't really meet the criteria, even though you might have some symptoms.

And then I just always think it's important to think about what some other underlying conditions are that could be contributors. We talked about depression, anxiety. Sleep problems, for sure. We didn't get to that too much. But especially in men, thinking about sleep apnea, and what that can do to your thinking and concentration throughout the day. That's all very important.

Scot: Troy, do you have any final questions you'd like to throw out there?

Troy: I mean, my takeaway from this is if you have concentration difficulty that's affecting your function, relationships, work, etc., you should really talk to someone. But again, it sounds like you're saying it probably is something else. Maybe adult ADHD, but probably not.

Dr. Weir: It's probably something else. And if it's a new problem, it is definitely something else.

Scot: Hey, thanks for checking out the "Who Cares About Men's Health" podcast. If you think there's somebody in your life that would find this podcast helpful, this episode in particular or any of our episodes, please do us a huge favor and let them know about it so they can check it out.

Also, you can go to our Facebook page, and if you have any reflections on today's episode, that goes a long way to helping other people find this podcast that might find it interesting as well. Our Facebook page is facebook.com/whocaresmenshealth.

Thanks for listening, and thanks for caring about men's health.

Dr. Gellner: ADHD in elementary school, on the rise or over-diagnosed?

Announcer: Keep your kids healthy and happy. You are now entering The Healthy Kids Zone, with Dr. Cindy Gellner on The Scope.

Dr. Gellner: ADHD seems to be one of those diagnoses that we're hearing a lot about lately. Is it really increasing, especially among our youngest elementary school kids? A recent study out of Harvard says it may all come down to what month of the year a child is born in. "The New England Journal of Medicine" article found that the youngest kids in a class have a 30% higher chance of being diagnosed with ADHD than older students. In fact, they also found that for every 100,000 students with August birthdays, 53 of them were given ADHD medication, but only 40 out of 100,000 were medicated if they were born in September. The researchers proposed that many of these younger kids are over-diagnosed and over-treated for ADHD because they are just more immature compared to their older classmates.

Older kids have had more time to develop social skills and have better internal control. When teachers are thinking that a child born in late summer or early fall may have ADHD, they're looking at a whole classroom of kids whose birthdays fall within a 12 month period. They may have some who barely meet the September 1st cutoff, and then they have some who are born in September and are almost a whole year older than those August babies. It's hard for teachers of young kids to work with such a diverse range of little kids, especially with all different maturity levels. Sometimes it's hard to give the younger ones more attention because of their behavior, and the behaviors of the younger kids can disrupt the classroom, making a teacher's job even harder.

Now, I have a lot of parents bringing their kids ages four and five to me because their preschool and kindergarten teachers think they have ADHD, and often the parents will agree. "Yes, they are like little Tasmanian devils at home. They're all over the place. They don't listen, and they can't remember to clean up their toys after I've told them three times." Parents start to think, maybe my child does have ADHD. And I can't tell you the number of parents of two and three-year-olds who ask me if their child has ADHD. The problem is those behaviors are still normal and age appropriate for many kids. They most likely don't have ADHD, and medication isn't a good choice if the treatment is actually more structure and playtime.

Another tricky part with ADHD is that, for the diagnosis, there are questionnaires to be completed by both the parent and the teacher. These are called Vanderbilt or Conners Tests. And one thing with these tests is that they are standardized for kids ages seven and up. Kids under seven naturally would still have all the inattention and hyperactive symptoms on those forms because they're still normal at those ages. A child also has to have symptoms for six months or more. And as parents know, a lot of development and maturity changes happen in six months in those age ranges.

You can always tell if a child has just turned five or if they're actually just about to turn six, because a six-year-old normally has a longer attention span, they'll listen to instructions better, they can sit longer. And younger kids want to play more, and classrooms require focus which they don't yet have.

When a parent asks me if their child under seven has ADHD, I try to figure out what else could be going on. Are there changes in the family situation, like siblings, a divorce, moving homes? Is there separation anxiety when being dropped off at preschool or kindergarten? Quite often, there's something other than ADHD that can explain their symptoms.

Some parents of August babies hold their children back a year in school as well and start kindergarten just after they turn six. Every child is different. So remember, as a parent, do what's best for your child and be sure to talk to your child's pediatrician if you have any questions about their development.

Announcer: Have a question about a medical procedure? Want to learn more about a health condition? With over 2,000 interviews with our physicians and specialists, there's a pretty good chance you'll find what you want to know. Check it out at thescoperadio.com.

Dr. Gellner: Parents often worry about their child being too hyperactive, even at a very young age. But when should parents start worrying that their child may have ADHD?

Announcer: Keep your kids healthy and happy. You are now entering the "Healthy Kids Zone" with Dr. Cindy Gellner on The Scope.

Dr. Gellner: Parents of kids as young as two or three often ask me if their child has ADHD. It's actually quite normal for a young child to have a lot of energy and seem hyperactive. They have such short attention spans at that age, and they are constantly being bombarded with new information and scenarios they've never encountered before. It's a lot for their little inquisitive minds to process.

Adults forget that what they have been through, time and time again, is actually a brand-new experience for young children. Parents often wonder if this high level of energy is going to be a problem for them as they grow older and have to deal with environments where they need more control, like the classroom.

The Centers for Disease Control and Prevention estimates that 6.1 million children in America have been diagnosed with ADHD. Currently, as part of the evaluation process to diagnose a child with ADHD, they have to have symptoms for at least six months and not be attributed to their developmental level, and these symptoms need to interfere with the child's behavior or performance in at least two different settings, usually home and school. This is why ADHD is normally not diagnosed until a child is in first or second grade. Often, medication isn't even covered by insurance companies until a child is at least six years old.

One key factor that needs to be considered when determining if a child has ADHD is where are their symptoms worst. If both at home and at school, then ADHD is pretty high on the list. If their issues are mainly at school and they are well-behaved at home, then they may actually have a learning disability. The school psychologist can help do some testing to see if this is the case, and if so, they can help write up an individualized education plan, or IEP, that includes accommodations to help your child succeed.

If they are well-behaved at school but a Tasmanian devil at home, think about what is going on in the home environment that could be stressing your child out, and see if there's anything you can do to help.

If you think your child does have ADHD, talk to your child's pediatrician to see if they can do the evaluation or refer you to a specialist who works with children who have ADHD to make sure your child has the correct diagnosis and gets the help they need.

Announcer: Have a question about a medical procedure? Want to learn more about a health condition? With over 2,000 interviews with our physicians and specialists, there's a pretty good chance you'll find what you want to know. Check it out at thescoperadio.com.

Interviewer: Common myths about ADHD that prevent parents from seeking treatment for their children. Dr. Trevor Wilde, what are those misconceptions?

Dr. Wilde: Parents commonly think that, "Well, it's not a real problem, and it'll just go away." They think that medications are dangerous and should not be used, or they feel that that child just needs more discipline.

Interviewer: And then not getting them help is actually pretty detrimental?

Dr. Wilde: It certainly can be. It can cause delays in their school and their learning. It can also cause problems with the law down the road if these problems are not recognized and taken care of appropriately.

Interviewer: If a parent does have a child with ADHD, what's your advice then?

Dr. Wilde: Come in, talk with a medical professional, go through a thorough evaluation, and then let's work together to come to find out what will be the best solution or the best direction to go for your child.

updated: March 9, 2021
originally published: March 7, 2018

Dr. Gellner: ADHD is a very common medical diagnosis in pediatrics and parents are often concerned about the medications. I hope to relieve some of those concerns on today's Scope. I'm Dr. Cindy Gellner.

Announcer: Keep your kids healthy and happy. You are now entering the "Healthy Kids Zone" with Dr. Cindy Gellner on The Scope.

Dr. Gellner: Your child has been diagnosed with ADHD and now your pediatrician is talking to you about medications. Stimulant medications have repeatedly been shown to be the most effective treatment for the symptoms of ADHD. They help kids concentrate, manage their impulsive choices, and avoid risky behavior. About 80% of kids who try stimulant medications for ADHD find that they have a positive effect on symptoms. To put that in perspective, there is no other medication for a mental health diagnosis that has such a high response rate.

It's understandable that you may have concerns about medication that affect your child's brain, especially if it's taken for a long time. First, it's important to understand how these medications work. These medications change the level of dopamine in the brain. Dopamine is a chemical that plays a critical role in attention and decision-making. Kids with ADHD don't have enough dopamine and so the medicines help increase the level of dopamine in the brain.

They only raise the level enough to help with ADHD symptoms. They should not change your child's personality like if they're really cranky, or acting like a zombie, the dose of the medication is likely too high. You will notice within a few days of starting the new ADHD medicine if it's working and you should your doctor call right away if there are issues. Problem sleeping and loss of appetite, though, are two common side effects. Still, mention any concerns to your child's pediatrician.

We get a lot of questions about long-term effects of using ADHD stimulant medications. In the over 50 years of using stimulant medications for ADHD and hundreds of studies, no negative effects of taking the medication over a period of years have been observed. Actually, in 2013, a study done by the National Institute on Drug Abuse did a number of studies to better understand how ADHD and the medication used to treat it affect the brain. It showed that some children developed tolerance to the medications, needing their doses increased, but not all of the children had this. Often, the dose increase happens in the first several years of being treated. But then, during the later teenage years, a child's body may be able to metabolize the medication more efficiently.

A big concern about ADHD meds is the worry that kids who take them will be at higher risk for substance abuse when they're older. Several studies have shown no correlation. In fact, recent research shows that while teens and young adults with ADHD are at a higher risk for substance abuse than other kids, treating them with stimulant medication neither increases nor reduces the risk. What this study shows is that the risk is linked to the ADHD diagnosis itself, not to the treatment. Addiction is a risk when these stimulants are abused, that is they're taken in doses or in ways other than that prescribed, such as being crushed or snorted.

So a history of substance abuse would be an important factor when considering whether a teenager is a good candidate for ADHD medication. So, as with any medication, speak up at your child's appointment and if you have any concerns about the treatment being prescribed, ask. You can help your child's pediatrician choose the right medication for your child's ADHD.

Announcer: Want The Scope delivered straight to your inbox? Enter your email address at thescoperadio.com and click "Sign Me Up" for updates of our latest episodes. The Scope Radio is a production of University of Utah Health Sciences.

Dr. Gellner: Your child has been diagnosed with ADHD. Now what? I've got tips to help your child and you on today's Scope. I'm Dr. Cindy Gellner.

Announcer: Keep your kids healthy and happy. You are now entering The Healthy Kids Zone with Dr. Cindy Gellner on The Scope.

Dr. Gellner: ADHD seems to be more and more commonly diagnosed now. It's a disorder that affects 5 to 7% of children. Children with ADHD have problems with attention span, hyperactivity and impulsive behavior. And ADHD is more common in boys than girls.

A normal attention span is three to five minutes per year of a child's age, so you'd expect a two-year-old to be able to concentrate on a particular task for at least six minutes. And a child entering kindergarten should be able to concentrate for at least 15 minutes. Please note, a child's attention span while watching TV is not an accurate measure of his or her attention span.

A child with ADHD is over six and has trouble listening when someone talks, trouble waiting his turn, completing a task, or returning to a task if interrupted. Eighty percent of boys and 50% of girls with attention problems are also hyperactive. A child who has symptoms of hyperactivity is restless, impulsive and always in a hurry.

Fifty percent of children with ADHD also have a learning disability. The most common learning disability is an auditory processing deficit. This means they have difficulty remembering verbal directions. However, the intelligence of most ADHD children is usually normal.

Current theories suggest that ADHD is probably due to small differences in brain chemistry and function. ADHD often runs in the family. Changes in daily routines such as not getting enough sleep can make the symptoms of ADHD worse.

It is important to note that ADHD is not caused by poor parenting. Medicine alone is not the answer. ADHD is like any other chronic condition. Your child will need special interventions at home and school to help with impulsive behaviors, work on structuring your child's life at home and improving discipline.

If your child also has a poor attention span, you can do activities to help them learn to listen and complete tasks. First, accept the fact that your child is active, energetic, and probably always will be.

The hyperactivity is not intentional. Don't expect to eliminate the hyperactivity, just merely bring it under reasonable control. Any criticism or other attempt to change an energetic child into a quiet model child will cause more harm than good. Nothing helps a hyperactive child more than having a tolerant, patient, low-key parent.

Daily outdoor activities such as running, sports and long walks are good outlets for excess energy. In bad weather, your child needs a room where they can play as they please with minimal restrictions and supervision.

Your child should not have too many toys. This is can cause them to be more easily distracted. The toys should be safe and relatively unbreakable. And encourage your child to play with one toy at a time. Although the expression of hyperactivity is allowed in these ways, it should not be needlessly encouraged.

Don't initiate rough housing with your child. Forbid siblings to say, "Chase me, chase me," or to instigate other noisy play. Encouraging hyperactivity can lead to its becoming your child's main style of interacting with people in general, and that's not good.

Household routines help the hyperactive child to accept order. Keep the wait times for a wake up, meals, chores and bed as regular as possible. And try to keep your environment relatively quiet to encourage thinking, listening and reading at home. In general, leave the TV and radio off.

Predictable daily events help your child's responses become more predictable. ADHD symptoms are made worse by sleep deprivation and hunger, so be sure your child has an early bedtime and a big breakfast on school days.

When a hyperactive child becomes overtired, his self-control often breaks down and the hyperactivity becomes worse. Try to have your child sleep or rest when he's exhausted. For children who have trouble slowing down at bedtime, night lights and background music or white noise are often helpful.

Except for special occasions, avoid places where hyperactivity would be extremely inappropriate. You may also wish to reduce the number of times your child goes with you to stores and supermarkets. After your child becomes older and develops adequate self control at home, they can be gradually introduced to these situations.

Children with ADHD are usually difficult to manage. They need more carefully planned disciplined than the average child. Rules should be made mainly to prevent harm to your child and to others.

Aggressive behavior should be no more accepted from the hyperactive child than any other child. Try to stop aggressive behaviors, but avoid unnecessary or impossible rules. For example, don't expect your child to keep his hands or feet still. The hyperactive child tolerates fewer rules than the child without ADHD, so be sure to enforce a few clear, consistent and important rules. Avoid constant negative comments like, "Stop that." Develop a set of hand signals and use them rather than telling your child to calm down.

Physical punishment suggests to your child that physically aggressive behavior is okay. We want to teach hyperactive children to be less aggressive, not more.

Your child needs adult models of control and calmness. Try to use a friendly, matter of fact tone when you discipline your child. If you yell, your child will be quick to imitate you. Be sure to give your child consequences for misbehavior immediately. When your child breaks a rule, isolate them in a time out if a show of disapproval doesn't work.

While your child's attention span may never be normal, it can usually be improved. Encouraging and increased attention span and persistence with tasks is helpful for preparing your child for what is expected in school.

Set aside several brief periods everyday to teach your child listening skills. When they are younger, start with reading to them daily. Coloring pictures should also be encouraged. Teach games to your child. Matching pictures is an excellent way to build your young child's memory and concentration. Later, consequence games such as checkers or tic-tac-toe can be used. When your child becomes restless, stop and return to the game later. Praise your child for being attentive. The process is slow but it's very valuable.

Plan to have your child do homework and other tasks that require attention in short blocks of time, and be sure to have breaks in between.

Try to have your child study with low level backgrounds such as white noise or instrumental music, not just the radio. Do homework and sitting away from the television, the radio or others talking. But keep your child where other adults can watch them.

Ask your neighbors that know your child to be helpers. If your child is labeled by some adults as a bad kid, it's important that the image of your child doesn't carry over into your home life. At home, your child should be noted to be a good child with excess energy.

It's extremely important that you not give up on them. Your child must always feel loved and accepted within the family. As long as a child has his acceptance, their self esteem will survive. If your child has trouble doing well in school, help him or her gain a sense of success to a hobby or sport that they enjoy and are good at.

Some theories suggests you should consider enrolling your child in kindergarten a year late, that is at age six rather than age five, because the added maturity may help them fit in better with their classmates.

Once your child enters grade school, the school is responsible for providing appropriate programs for your child's ADHD and any learning disability he or she may have. Often the schools will have the parents and pediatrician fill out paperwork for something called a 504 plan to help with their behavior needs.

Some standard approaches that teachers use to help children with ADHD are smaller class sizes and isolated studies spaces. They may also include your child in tasks to help keep them busy. Many of these children spend part of their day with the teacher who specializes with learning disabilities who helps them improve their skills and self-confidence.

Usually you can get the help your child needs with school work by working closely with the school staff to a parent teacher conferences and special meetings. Your main job is to continue to help your child improve his attention span, self-discipline and friendships at home.

Stimulant medications can improve a child's ability to concentrate. If you and your child's teacher both feel that your child's short attention span is interfering with school performance, discuss the use of prescription medications with your child's pediatrician. Stimulants are even more effective if they are part of a broader treatment plan including special education and behavior management. By working together with your child's school and pediatrician, your child will receive the support they need to be successful with ADHD.

Announcer: The ScopeRadio.com is University of Utah Health Sciences Radio. If you like what you heard, be sure to get our latest content by following us on Facebook. Just click on the Facebook icon at TheScopeRadio.com.