Troubled Teen Diagnosis


·Attention Deficit Hyperactive Disorder
· ADHD
· ADD
· Attention Deficit Disorder

Much of the information from this site comes from SAMHSA's National Mental Health Information Center.

What Is Attention-Deficit/Hyperactivity Disorder? Attention-Deficit/Hyperactivity Disorder is sometimes referred to as ADHD. Young people with Attention-Deficit/Hyperactivity Disorder are typically overactive, unable to pay attention, impulsive, and tend to be accident-prone. Despite normal or above-normal intelligence, children or adolescents with Attention-Deficit/Hyperactivity Disorder may not do well in school or possibly fail.

What Are the Signs of Attention-Deficit/Hyperactivity Disorder? There are three different types of Attention-Deficit/Hyperactivity Disorder. The different categories are referred to as inattentive, hyperactive-impulsive, and combined Attention-Deficit/Hyperactivity Disorder, each with different symptoms. We will try our best to describe the different symptoms that accompany each category.

Children with the inattentive symptoms:

· Short attention spans
· Easily distracted
· Do not pay attention to details
· Make numerous mistakes
· Fail to finish things
· Forgetful
· Don't seem to listen
· Cannot stay organized

Children with the hyperactive-impulsive symptoms:

· Fidget and squirm
· Unable to stay seated or play quietly
· Run or climb too much when they should not
· Talk too much when they should not
· Blurt out answers before questions are completed
· Trouble taking turns
· Interrupt others

Children with symptoms of combined Attention-Deficit/Hyperactivity Disorder may show a combination of the symptoms listed above.

A diagnosis of Attention-Deficit/Hyperactivity Disorders is made when a child has a number of the above symptoms which began before age 7 and lasted at least 6 months.

Generally, symptoms need to be seen in at least two different settings (for example: at home and at school) before a diagnosis is made.

How Common Is Attention-Deficit/Hyperactivity Disorder?
Attention-Deficit/Hyperactivity Disorder is found in as many as 1 in every 20 children. Studies have shown that boys with Attention-Deficit/Hyperactivity Disorder outnumber girls with the disorder by about three to one. Children and adolescents with Attention-Deficit/Hyperactivity Disorder are at risk for many other disorders. About half of all young people with Attention-Deficit/Hyperactivity Disorder also have oppositional or Conduct Disorder and about one fourth have an anxiety disorder. About one-third of these young people that have a depression problem and about one-fifth have a learning disability. Sometimes a child or adolescent will have two or more of these disorders in addition to Attention-Deficit/Hyperactivity Disorder. Also, children with Attention-Deficit/Hyperactivity Disorder are at risk for developing personality disorders and substance abuse disorders when they are adolescents or adults.

Attention-Deficit/Hyperactivity Disorder is a major reason why children are referred to mental health care. Boys are more likely to be referred to treatment rather than girls. This is possibly because many boys with Attention-Deficit/Hyperactivity Disorder also have a Conduct Disorder. The mental health service and special education required by children and adolescents with Attention-Deficit/Hyperactivity Disorder can cost millions of dollars each year. Underachievement and lost productivity can cost young people and their families millions of dollars or even more.

What Causes Attention-Deficit/Hyperactivity Disorder?

Many causes of Attention-Deficit/Hyperactivity Disorder have been studied but no certain cause seems to apply to young people with the disorder. There is strong evidence that genetic factors are important. Some factors such as viruses, harmful chemicals in the environment, problems during pregnancy or delivery, or things that impair brain development may also play a role.

Medication

The most widely used drugs for treating Attention-Deficit/Hyperactivity Disorder are stimulants, such as amphetamine (Dexedrine, Dextrostat, Desoxyn), methylphenidate (Ritalin), and pemoline (Cylert). Stimulants increase the activity in parts of the brain that are under-active in children and adolescents with Attention-Deficit/Hyperactivity Disorder. Experts believe that this is why stimulants improve attention and reduce impulsive, hyperactive, or aggressive behavior. Individuals may respond better to one medication than to another. For example, clonidine (Catapres) is often used although its effectiveness has not been clearly shown. A few anti-depressants may also work for some patients. Tranquilizers like thioridazine (Mellaril) have also been shown to work for some young people. Care must be used in prescribing and monitoring all medication.

Like most medications those used to treat Attention-Deficit/Hyperactivity Disorder have side effects. When taking these medications some children may lose weight, have a smaller appetite, temporarily grow more slowly, or have trouble falling asleep. However, many doctors believe the benefits of medication outweigh the possible side effects. Side effects that occur can often be handled by reducing the dosage.

Behavior treatments include:
  • Teaching parents and teachers how to manage and modify the child or adolescent's behavior such as rewarding good behavior.
  • Daily report cards to link the home and school efforts (where the parent can reward the child or adolescent for good school performance and behavior)
  • Summer and Saturday programs.
  • Special classrooms that use intensive behavior modification.
  • Specially trained classroom aides.
It is clear that both stimulants and behavior treatment can be helpful in the short run (a few weeks or months), but it is not clear how long the benefit will last. The Federal Government's National Institute of Mental Health is supporting research on the long-term benefits of various treatments as well as research to determine if medication and behavior treatment are more effective when combined. There is also research on new medicines and other new treatments. Federal agencies carrying out research on Attention-Deficit/Hyperactivity Disorder include the Center for Mental Health Services and the Department of Education.

A child or adolescent in need of treatment or services may need a plan of care based on the severity and duration of symptoms. Optimally, this plan is developed with the family, service providers, and a service coordinator also referred to as a case manager. Whenever possible the child or adolescent is involved in decisions.

Can Attention-Deficit/Hyperactivity Disorder Be Prevented?

Because there are so many suspected causes of Attention-Deficit/Hyperactivity Disorder, prevention may be difficult. However, it is wise to obtain high-quality prenatal care, avoid alcohol, tobacco, and other harmful chemicals during pregnancy. It is also important to provide your child with good general health care. These recommendations may be particularly important if Attention-Deficit/Hyperactivity Disorder is in the family so parents can take pre-caution with other family members.

What Help is Available for Families?

Many treatments - some with good scientific basis and some without - have been recommended for children and adolescents with Attention-Deficit/Hyperactivity Disorder. Medication and behavior treatments prove to give the best results. Options for parents also include placement in specialty schools for defiant teens, boot camps, residential treatment centers, and military-style schools. Call toll free 800 781 8281 and we will help you find your way through the myriad of options available to you.

What Can Parents Do?

When it comes to Attention-Deficit/Hyperactivity Disorder, parents and other caregivers should be careful not to jump to conclusions. In a child or adolescent, a high energy level alone does not mean that he or she has Attention-Deficit/Hyperactivity Disorder. The diagnosis depends on whether the child or adolescent can focus well enough to complete tasks that suit his or her age and intelligence. This ability is most likely noticed by a teacher and their input should be taken seriously.

If parents or other caregivers suspect Attention-Deficit/Hyperactivity Disorder, they should:

  • Make an appointment with a psychiatrist, psychologist, child neurologist, or behavioral pediatrician for an evaluation. (Check with the child's doctor for a referral.)
  • If the young person is diagnosed with Attention-Deficit/Hyperactivity Disorder try to be patient because the disorder may take a lot of time to improve.
  • Instill a sense of competence in the child or adolescent and try to promote his or her strengths, talents, and feelings of self-worth.
  • Get accurate information from libraries, hotlines, or other sources.
  • Ask questions about treatments and services.
  • Talk with other families in the community.
  • Find family network organizations.
Help for children with the above diagnosis may also be sought in specialty-type schools, boot camps, and behavior modification-type programs.

What Is Conduct Disorder?

Children with Conduct Disorder repeatedly violate personal or property rights of others and the basic expectations of society. A diagnosis of Conduct Disorder is likely if the behavior continues for a period of 6 months or longer. Because of the impact Conduct Disorder has on the child or their family, neighbors, and classmates, Conduct Disorder is known as "disruptive behavior disorder". Another disruptive disorder, called Oppositional Defiant Disorder, often occurs before Conduct Disorder and may be an early sign of Conduct Disorder.

Oppositional Defiant Disorder (ODD) is diagnosed when a child's behavior is hostile and defiant for 6 months or longer. Oppositional Defiant Disorder can start in pre-school years, whereas Conduct Disorder generally appears when children are somewhat older. Oppositional Defiant Disorder is not diagnosed if Conduct Disorder is present. We will try our best to list some signs or symptoms common in ODD and Conduct Disorder.

Some symptoms of Conduct Disorder include:

· Aggressive behavior that harms or threatens to harm other people or animals
· Destructive behavior that damages or destroys property
· Lying or theft
· Skipping school or other serious violations of rules.

Children with Oppositional Defiant Disorder or Conduct Disorder may have other problems including:

· Hyperactivity
· Anxiety
· Depression
· Academic difficulties
· Problems with peer relationships

How Common is Conduct Disorder?

As many as 1 in 10 children and adolescents may have Conduct Disorder. Most children and adolescents with Conduct Disorder do not have lifelong patterns of conduct problems and antisocial behavior.

Who Is at Risk?

Years of research show that the most troubling cases of Conduct Disorder begin in early childhood often by the pre-school years. In fact, some infants who are especially "fussy" are at risk for developing Conduct Disorder. Other factors that might make a child more likely to develop Conduct Disorder include:

· Inconsistent rules and harsh discipline
· Lack of enough supervision or guidance
· Frequent change in caregivers
· Poverty
· Neglect or abuse
· Delinquent peer group.

What Help Is Available for Families?

Conduct Disorder is one of the most difficult behavior disorders to treat successfully. However, young people with Conduct Disorder often benefit from a range of services which might include:

· Parent training on how to handle their child's or adolescent's behavior
· Family therapy
· Training in problem-solving skills for children or adolescents
· Community-based services that focus on the young person within the context of family and community influences.

The same type of procedure is taken when applying help for a child with Conduct Disorder as with Attention-Deficit/Hyper Activity Disorder. A child or adolescent in need of treatment or services may need a plan of care based on the severity and duration of symptoms. Optimally, this plan is developed with the family, service providers, and a service coordinator also referred to as a case manager. Whenever possible the child or adolescent is involved in decisions.

What Can Parents Do?

Antisocial behavior in children and adolescents is very hard to change after it becomes ingrained. Therefore, the earlier the problem is identified and treated, the better. Recent studies have focused on promising ways to prevent Conduct Disorder among children and adolescents who are at risk for developing the disorder. Most children or adolescents with Conduct Disorder are possibly reacting to events and situations in their lives. More research is needed to determine if biology is a factor in Conduct Disorder.

If Parents suspect Conduct Disorder they should:

· Pay careful attention when a child or adolescent show possible signs of Oppositional Defiant Disorder or Conduct Disorder and try to understand the reasons behind it. Then parents can try to improve the situation and their reactions.

· If parents cannot reduce their child or adolescent's antisocial behavior on their own we advise them to talk with a mental health or social service professional, such as a teacher, counselor, psychiatrist, or psychologist specializing in childhood and adolescent disorders.

· Get accurate information from libraries, hotlines, or other sources.

· Talk to other families in their community.

· Find family network organizations.

Options for parents also include placement in specialty schools for defiant teens, boot camps, residential treatment centers, and military-type schools. Call toll free 800 781 8281 and we will help you find your way through the myriad of options available to you.