Parents often come to the pediatrician with concerns about their preschooler's temper tantrums. Should we reassure them that tantrums are normal, or should we refer the child for further evaluation? What clues suggest that tantrums might be a sign of future problems?
Parents often come to the pediatrician with concernsabout their preschooler's temper tantrums.Should we reassure them that tantrums arenormal, or should we refer the child for furtherevaluation? What clues suggest that tantrumsmight be a sign of future problems?
A long-term study of children with attention-deficit hyperactivity disorder (ADHD) found that the disorder?s long-term effects appear regardless of treatment...
ADHD is an equal-opportunity condition, affecting children from all walks of life. But what role, if any, does ethnicity have on the response to diagnosis and treatment?
Adolescents with ADHD are different from other patients. Impulsiveness and inattention pose bigger problems than hyperactivity, which can translate into lower medication adherence and growing behavioral problems. And adolescent girls tend to exhibit more problems than boys in the same age range.
There are frequently stories in the news and talk among the public of the over-diagnosis and treatment of attention deficit hyperactivity disorder (ADHD) in today's hypervigilant society. However, a study recently published in Archives of Pediatrics and Adolescent Medicine may serve to debunk this common belief.1
Perhaps some aspects of this scenario sound familiar? Many pediatricians feel ill-equipped to meet the often complex needs of adolescents. Some physicians have a challenging time convincing teenagers to talk to them about anything. Others worry about opening a Pandora's box of issues that cannot fully be addressed. Given the time and reimbursement constraints facing primary care providers, the wish to avoid time-intensive patients is understandable.
The keys to optimal use of psychostimulant and nonstimulant medications for attention deficit hyperactivity disorder are careful screening of patients, appropriate dosage regulation, and?most of all?close monitoring of both positive and adverse outcomes.
ABSTRACT: Most cases of cerebral palsy (CP) are the result of congenital, genetic, inflammatory, anoxic, traumatic, toxic, and metabolic disorders. A minority of cases result from asphyxia at birth. Nearly three-quarters of children with CP aged 7 years had a normal neurological evaluation at birth. Abnormal motor development usually provides the first diagnostic clue. Neuroimaging is recommended if the cause of CP has not been established with perinatal imaging. MRI is preferred to CT. Management of the multisystemic manifestations begins with a comprehensive medical evaluation by a multidisciplinary team that includes family members. Therapy is aimed at maximizing the patient's level of function. Key areas include ambulation, cognitive skills, activities of daily living, hygiene, and rehabilitation into society.
Seven books addressing ADHD for children and adults to enjoy.
ABSTRACT: Adolescent drivers with attention deficit hyperactivity disorder (ADHD) are more likely to be involved in--and to die of--a driving accident than any other cause. The higher occurrence of driving mishaps is not surprising given that the core symptoms of ADHD are inattention, impulsivity, and hyperactivity. Safe driving habits can diminish the risk, however. The first step is to inform patients of the dangers of driving; the significance of adolescence, ADHD, and medication can be underscored in a written "agreement." Strategies to promote safer driving--especially optimally dosed long-acting stimulant medication taken 7 days a week--may be critical. A number of measures lead to safer driving by reducing potential distractions during driving (eg, setting the car radio before driving, no drinking or eating or cell phone use while driving, no teenage passengers in the car for the first 6 months of driving, and restricted night driving).
The keys to optimal use of psychostimulant and nonstimulant medications for attention deficit hyperactivity disorder are careful screening of patients, appropriate dosage regulation, and-most of all-close monitoring of both positive and adverse outcomes.
It's long been suggested by research that adolescents who have ADHD are more likely—nearly four times so—to be involved in a motor vehicle accident than unaffected drivers in the same age group. Furthermore, young adults with ADHD have a significantly higher rate of traffic violations and license suspensions than patients without ADHD.
Attention deficit hyperactivity disorder (ADHD) is very common. In the United States, between 6% and 10% of children and adolescents are affected, as are 4% of adults.1 Children in other countries also have ADHD, although rates of comorbid disorders may vary from those found in the United States.2
There are many exciting new studies of the biologic basis of ADHD that use neuroimaging and genetic testing. However, none of these methods can reliably diagnose this complex disorder. Someday, these technologies will be used to help subtype ADHD and improve treatment matching.
Attention deficit hyperactivity disorder (ADHD) is the most commonly diagnosed bio-behavioral disorder of childhood. It occurs in 6% to 9% of children--about the same prevalence as childhood asthma. It is also one of the most controversial diagnoses in children; parents are often perplexed about whether ADHD is underdiagnosed or overdiagnosed, or undertreated or overtreated. A good deal of this confusion stems from the fact that there are no laboratory tests, imaging studies, or psychological testing profiles that can be used to make the diagnosis.
Two excellent review atricles on attention deficit hypertention disorder (ADHD) follow. The first, by Michael Reiff MD, of the university of Minesota, presents an overview of the assessment and diagnosis of ADHD with clear, straightforward recommendations for the primary care practictioner illustrated with clinical vignettes. The format lends itself to a quick read, but the details are included if you want to drill down.
Infants and toddlers will put just about anything into their mouths. Each year in this country, between 100,000 and 200,000 incidents of foreign-body ingestions are reported to poison control centers.1,2 The large majority of ingestions are accidental. (In adolescents, ingestions are usually intentional.)
New research reported at the annual meeting of the American Psychiatric Association in Toronto in May shows that Shire Pharmaceutical Group's methylphenidate transdermal system (Daytrana) appears a safe and well-tolerated alternative to OROS methylphenidate, and is equally efficacious.
The second of a four-part series on nutritional interventionsexamines evidence of a salicylate-elimination diet for ADHD.
A new study on potential interactions between genetic and environmental factors in ADHD suggests that current limits on lead exposure are too high. Lead exposure below the current limits allowed by Environmental Protection Agency regulations produced measurable impairment of executive functions, especially in boys, who have a specific variation in the DRD4 dopamine receptor gene.
A 9-year-old girl presents with multiple hyperpigmented lesions, some of which have been present since birth (Figure 1). The lesions have increased in size and number. There is no history of seizures. Her 40-year-old mother has multiple skin nodules (Figure 2).
