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Fidgeting may be more than child-like behavior

Brunswick News - 3/14/2017

March 14--It is a surprisingly common mental health issue, and recently in Georgia, diagnoses have been on the rise.

Attention-deficit hyperactivity disorder, or ADHD, is a common neurobehavioral condition that affected 9.3 percent of Peach State children in 2011, according to the Centers for Disease Control and Prevention. That number is up from 6.9 percent in 2007.

Characterized by daydreaming, easy distraction, fidgeting and disorganization, ADHD generally presents at a young age, but may last into teenage years and even adulthood, said Dr. Lera Fina, chief pediatrician at Southeast Georgia Health System's Camden Campus.

"The 'hyper' children -- those with ADHD -- will often be diagnosed in the first few years of school, first to third grade," Fina said. "The inattentive children -- those with attention-deficit disorder -- will often be diagnosed later, usually in fourth to seventh grade."

Parents are likely to be the first to notice behavioral challenges associated with ADHD. A child might talk too much, seem unable to wait their turn or act absentmindedly. Most children don't "just grow out of these behaviors," the CDC reports. The symptoms can continue and cause difficulty at home, school and with friends.

While most youngsters may have some issues with impulse control, ADHD is different, and can have consequences beyond minor annoyances, Fina added.

"If ADHD is not treated, children are more likely to have poor school performance, low self-esteem, and poor impulse control leading to behavioral problems and potentially legal problems," she said.

Because behavioral problems can be caused by other health issues, a physician should diagnose ADHD.

"The most common way to diagnose ADHD is with a visit to your pediatrician," Fina said. "They will complete a history and physical -- possibly lab work to rule out medical causes such as thyroid disorders -- developmental and behavioral history and a screening questionnaire."

If a child is found to have ADHD, the condition can be treated with therapy, lifestyle changes and medication, Fina said.

"ADHD is usually not 'cured,'" she said. "It is managed with diet, medication and behavior modifications. Children can learn to modify their behaviors to overcome their ADHD. The majority of children with ADHD usually learn how to focus and stay on task by adulthood. Only a small portion will continue to need medications as adults."

Behavior-modification techniques can be used to help ADHD-diagnosed children learn new coping skills. But that kind of therapy can take week -- even months -- and there is a shortage of behavioral health specialists, Fina said.

Instead, physicians frequently prescribe medications. One of the most common ADHD medications, methlyphenidate -- often known by its brand name, Ritalin -- has been used by doctors for more than 50 years.

In the early 1980s, the manual used by health professions, the Diagnostic and Statistical Manual of Mental Disorders, first started using the term Attention-Deficit Disorder, according to the CDC. As the definition has changed and been reclassified over the years, new medications have emerged. Doctors treat it with brand-name medicines like Adderall, Focalin, Vyvanse and Concerta are used by doctors to treat ADHD. Some drugs are in the same family as Ritalin, while others are amphetamine-based products, according to the National Resource on ADHD.

Despite their name, the drugs do not work by increasing the stimulation of a patient. Rather, they help nerve cells in the brain communicate more effectively with each other. Between 70 and 80 percent of children respond positively to the medications, according to the National Resource on ADHD.

As with any drug, there are potential complications. A doctor can decide what is the best approach for each patient, Fina said.

"Just like with every medication, there are risk involved with taking stimulant medications," she said. "These risks are based on the medication and the personal and family history of the child. Your physician can better determine the risk for your child."

Lifestyle changes can also help a child overcome ADHD, Fina added.

"There are many-behavioral modification techniques that can be helpful, including guided imagery, biofeedback, meditation, exercise any many more," Fina said. "There are also many studies showing diet changes eliminating chemical additives and other possible food intolerances or allergies can be helpful with ADHD behaviors."

And although it may seem counterintuitive for dealing with a hyperactive child, helping him or her get the right amount of shut-eye is important, too.

"Sleep is also very important," Fina said. "Many children are not getting the sleep they need, which leads to hyperactive behaviors during the day or worsening their ADHD. Most children need a minimum of 10 to 12 hours of sleep each night."

For more information about ADHD, talk to a physician, or visit the nonprofit Children and Adults with Attention-Deficit/Hyperactivity Disorder online at


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