A simple tool to help you differentiate between ADHD and the most common overlapping comorbidities in children
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The care and resources required to manage a child’s ADHD can often cause substantial stress among caregivers—including parents and siblings. Parents may worry about their child’s ability to succeed in school and to become a well-adjusted and independent adult.1,2 They may wonder why their child developed ADHD or if it was something that could have been prevented.
Parents should be educated that ADHD is a “multifactorial” disorder that is influenced by the interaction of genetic and environmental factors on the structure and function
of the brain.2-4
They may also be surprised to learn that ADHD is one of the most common mental health issues affecting children in the United States5—and that they are not alone in their struggles.
Parents and caregivers can visit www.MoreToADHD.com for detailed information on identifying signs and symptoms of ADHD, treatment options, and community resources. They can also download a symptom checklist that can be used to structure provider visits.
Parents and caregivers of children with complex ADHD can feel overwhelmed by the treatment challenges inherent in the disorder. It may be expected that treatment will produce7:
Parents may also not understand why children may continue to express symptoms, or do not seem to “grow out” of their ADHD.
Understanding that ADHD is often a lifelong disorder that may require intensive intervention may help parents and caregivers set realistic expectations for therapy and outcomes.
As comorbidities are common in ADHD, a treatment that targets both ADHD symptoms and relevant psychiatric conditions may be considered.8 Determining the priority of symptoms to treat can be a clinical challenge, however, as somatic or physical symptoms often overshadow ADHD symptoms.9
A combination of pharmacologic and nonpharmacologic therapies has been shown to produce the best long-term, favorable outcomes in pediatric patients with ADHD.6 Therapeutic interventions for both parents and children (eg, parent training, cognitive behavioral therapy [CBT]) are helpful,10,11 as is specialized ADHD coaching. Enhanced school support in the form of individualized education plans (IEPs) or other accommodations can also involve teachers and school administrators in treatment goals.12 Parents can learn more about multimodal treatment of ADHD by visiting www.MoreToADHD.com/resources/community
While stimulants are generally considered the most effective agents for ADHD, they can wear off during the day, causing a rebound effect. Further, their use may be complicated (and even contraindicated) in patients with comorbid conditions, such as Tourette syndrome, anxiety disorder, or bipolar disorder13
For more information regarding CBT, ADHD coaching, support groups, and school support, please have your parents or caregivers visit www.MoreToADHD.com
References: 1. Harpin VA. The effect of ADHD on the life of an individual, their family, and community from preschool to adult life. Arch Dis Child. 2005;90(suppl 1):i2-7. 2. Banaschewski T, Becker K, Dopfner M, Holtmann M, Rosler M, Romanos M. Attention-deficit/hyperactivity disorder. Dtsch Arztebl Int. 2017;114(9):149-159. 3. Acosta MT, Arcos-Burgos M, Muenke M. Attention deficit/hyperactivity disorder (ADHD): complex phenotype, simple genotype? Genet Med. 2004;6(1):1-15. 4. Shadrin AA, Smeland OB, Zayats T, et al. Novel loci associated with attention-deficit/hyperactivity disorder are revealed by leveraging polygenic overlap with educational attainment. J Am Acad Child Adolesc Psychiatry. 2018;57(2):86-95. 5. Pliszka S. AACAP Work Group on Quality Issues. Practice parameter for the assessment and treatment of children and adolescents with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry. 2007;46(7):894-921. 6. Arnold LE, Hodgkins P, Caci H, et al. Effect of treatment modality on long-term outcomes in attention-deficit/hyperactivity disorder. PLoS One. 2015;10(2):e0116407. 7. Data on file. Supernus Pharmaceuticals. 8. Goodman D. In: Biederman J, ed. ADHD Across the Life Span: From Research to Clinical Practice—An Evidence-Based Understanding. Veritas Medical Education; 2005. 9. Hendriksen JG, Peijnenborgh JC, Aldenkamp AP, Vles JS. Diagnostic overshadowing in a population of children with neurological disabilities: a cross sectional descriptive study on acquired ADHD. Eur J Paediatr Neurol. 2015;19:521-524. 10. Aghebati A, Gharaee B, Shostari MH, Gohari MR. Triple P Positive Parenting Program for mothers of children with ADHD. Iran J Psychiatry Behav Sci. 2014;8(1):59-65. 11. Sprich SE, Burbridge J, Lerner JA, Safren SA. Cognitive-behavioral therapy for ADHD in adolescents: clinical considerations and a case series. Cogn Behav Pract. 2015;22(2):116-126. 12. Felt BT, Biermann B, Christner JG, Kochhar P, Harrison RV. Diagnosis and management of ADHD in children. Am Fam Physician. 2014;90(7):456-464. 13. Briars L, Todd T. A review of pharmacological management of attention-deficit/hyperactivity disorder. J Pediatr Pharmacol Ther. 2016;21(3):192-206.