Press Releases
October 17, 2011
Dealing with ADHD in Poorer Neighborhoods Can Be Tough
It was almost a year ago that Brenda Jones (not her real name) received a call from her son’s first grade teacher saying the seven-year-old was having problems concentrating in class, was easily distracted and could not follow instructions.
“I was told that I needed to have my son evaluated for ADHD (Attention Deficit Hyperactivity Disorder),” said the Bronx mom. “This is very upsetting to any parent who is heavily invested in her child’s success.”
“In our community having a mental health problem of any kind often carries a stigma,” said Edgardo Quinones, Division Director for Children, Youth and Family Services at Fordham-Tremont Community Mental Health Center, which is part of St. Barnabas Hospital. “People may also lack the resources usually recommended to help the children improve their functioning. If you have a large family and live in a one-bedroom apartment, where do you put the child who needs a “time out?”
ADHD is the most commonly diagnosed behavioral disorder of childhood, often impacting on a child’s social development and ability to learn. While the Centers for Disease Control and Prevention state that three to seven percent of school-aged children have ADHD, recent data from surveys of parents reveals that number to be significantly higher (9.5%, or 5.4 million children between the ages of four and 17 diagnosed with ADHD as of 2007). Boys (13.2%) are more likely to be affected than girls (5.6%).
Inattentiveness, hyperactivity and impulsive behavior are the common symptoms of ADHD. Signs of inattention may manifest themselves as a failure to give close attention to details, an inability to listen when spoken to, difficulty in organizing tasks, a dislike of those tasks (like schoolwork) that require sustained mental effort, distractibility, and forgetfulness. Hyperactivity may show itself in terms of fidgeting with hands or squirming while sitting, running or climbing in inappropriate situations, difficulty playing quietly, or seeming to be always on the go. Impulsive behavior may be demonstrated by difficulty awaiting their turn, interrupting or intruding on others’ conversation or games, or blurting out answers before the questions have been completed. Children with ADHD often have other problems (e.g. oppositional behavior, anxiety, learning disorders and depression).
According to Quinones, it is important that those children believed to have ADHD be examined by a specialist.
Treatment
Quinones and other specialists believe in treating children with ADHD with a combination of medication and behavior modification therapy. A class of drugs known as psychostimulants is most commonly used. Very often the medication may need to be adjusted, and children may need to be put on such drugs as Ritalin, Concerta, Adderall and/or others, or a non-stimulant drug like Strattera before it is determined what works best.
While medication can help in terms of improving the ability to focus, even out their moods and control their impulsivity, Quinones warns that it needs to be given in combination with behavior modification therapy. Fordham-Tremont offers both individual and group therapy.
“The therapy helps these children develop social skills,” said Quinones. “We involve the family in the process because the consistency of the parents in continuing the behavior modification at home is very important. We provide family therapy, where we involve siblings who don’t manifest the condition so they can understand why the ADHD child needs special attention from the parent.”
There is no specific outcome protocol for ADHD, said Quinones, and each case is different. Some children outgrow the condition, and others can continue to be plagued by it throughout their life, with ADHD affecting their jobs and family relationships, and making them more prone to substance abuse and problems with the law.
For Brenda Jones, treatment has already made a remarkable difference in her son’s behavior, social abilities and performance at school – although she realizes that it’s a continuing battle.
“We have a ways to go, but the beginning of this school year has been just so much more positive,” she said. “His second grade teacher knows what he went through last year and when I saw her at parent-teacher conference, she gave me a big thumbs up sign.”