Health Tip: Recognizing Signs of ADHD

(HealthDay News) -- Attention-deficit hyperactivity disorder (ADHD) often is diagnosed in childhood but may well continue into adulthood.
The condition impacts areas of the brain that control one's ability to pay attention.

Symptoms of ADHD vary greatly, but typically include difficulty focusing on a particular task or paying attention. Forgetting directions, an inability to follow through with instructions, losing things, forgetting to complete tasks, or difficulty with organization also are common warning signs.

If you notice these symptoms in yourself or your child, contact your doctor. If ADHD is diagnosed, there are a number of medications to help alleviate symptoms. Also, many schools offer programs to help children with ADHD learn to how better focus and pay attention.

Lead Exposure Tied to ADHD Symptoms

(HealthDay News) -- It's known that lead exposure poses serious health risks, including cognitive function problems.

But new research suggests that certain children are more likely to develop attention-deficit hyperactivity disorder (ADHD) when exposed to lead in their environment.

The study found that youngsters with a specific genetic variation in a dopamine receptor, dubbed DRD4-7, had more problems with tasks that required attention and flexibility. The researchers also found that boys exposed to lead were at greater risk of attention problems than girls.

"Lead exposure leads to problems with attention and executive function. And certain kids are going to be more affected by the adverse effects of lead," said study author Dr. Tanya Froehlich, a developmental, behavioral and pediatric specialist at Cincinnati Children's Hospital Medical Center.

Froehlich was expected to present the findings Monday at the Pediatric Academic Societies annual meeting, in San Francisco.
An estimated 3 percent to 5 percent of American children -- 2 million -- have ADHD. Symptoms include the inability to pay attention, hyperactivity and impulsive behavior. The exact cause of ADHD isn't known, but there are numerous theories as to what contributes to its development.

Environmental factors, such as lead exposure, have long been suspected of being a contributing factor, according to the National Institute of Mental Health.

Since lead exposure can contribute to problems with attention and executive function -- the ability to plan and organize behavior -- and people with ADHD also have problems with attention and executive function, the researchers thought there might be some genetic connection.

So, they looked at the dopamine receptor gene DRD4, because it had been previously associated with children with ADHD, Froehlich said.

In a group of 172 boys and girls, the researchers looked at the DRD4 gene and tested the children for lead at 60 months of age. Then at 66 months, the children were given ADHD tests.
Eight percent of the children were diagnosed with ADHD, but about one-quarter of the children showed symptoms of ADHD.

The researchers found two types of DRD4 variations -- a low-risk and a high-risk one. Children with the high-risk variation were more likely to have ADHD symptoms, such as problems with spatial working memory (the ability to keep information in mind while performing a complex task) and "attentional flexibility" (the ability to change when you get new information or encounter an obstacle). Exposure to lead didn't seem to increase the symptoms in this group, however.

But in the low-risk group, whose members were less likely to have attention problems to start with, lead exposure significantly impaired their spatial working memory and attentional flexibility, the study found.

"In an environment contaminated with lead, a genetic variation that was protective becomes disadvantageous," Froehlich said.

The researchers also found that boys were more likely to suffer from lead's adverse effects. And, Froehlich noted, boys have higher rates of ADHD. "This could be one of the reasons why," she said.

Dr. Karen Ballaban-Gil, a pediatric neurologist at Montefiore Medical Center in New York City, said, "Lead exposure may have more cognitive consequences in a susceptible subset of the population."

"Parents need to be very vigilant about looking for homes that are free of lead. And it's not just houses -- lead can be in toys or ceramics, especially those bought outside of the U.S.," she said, adding that simple lead tests are available in stores.

"The most important thing is to prevent lead exposure in the first place," Froehlich said.

More information
To learn more about the effects of lead and steps you can take to minimize exposure, visit the U.S. Environmental Protection Agency.

ADHD Drugs Can Stunt Growth

(HealthDay News) -- A new review of past studies on the effect that attention-deficit hyperactivity disorder (ADHD) drugs have on children's growth concludes that the drugs do, in fact, suppress growth to some degree.

While the effect found was statistically significant, one of the study's authors, Dr. Omar Khwaja, an instructor in neurology at Children's Hospital Boston, said the average growth suppression for a 10-year-old boy was probably about three-quarters of an inch in height and a little more than two pounds in weight.

"Parents need to know that when children are on stimulant treatment, although they're probably the best way of treating ADHD, there's a possibility of growth restriction," Khwaja said. "Their physicians need to pay attention and monitor growth in these children, and if it falls off of what is expected, think about lowering the dose or changing the dosing schedule."

Results of the study were presented Monday at the Pediatric Academic Societies annual meeting, in San Francisco.

It's estimated that as many as 5 percent of American children have ADHD, according to the National Institute of Mental Health. The main symptoms are an inability to pay attention, hyperactive behavior and impulsivity. The standard treatment is with stimulant medications, such as Ritalin and Adderall. It seems counterintuitive, but these medications have a calming effect on children with ADHD and help them focus.

However, as with any medication, there's a potential for side effects. One suspected side effect is the suppression of appetite, which is believed to have an effect on a child's weight and possibly height. Dr. David W. Goodman, an assistant professor in the department of psychiatry and behavioral sciences at Johns Hopkins University School of Medicine, said the issue of whether these medications contribute to growth suppression has been debated for 35 years.

To try to settle this debate, Khwaja and his colleagues reviewed the literature, looking for studies on ADHD medications and their side effects. They found 22 studies that they considered to have valid, quality methodology.

They pooled the data from these studies and found there was, indeed, an effect on height and weight while children were taking these drugs.

"There was a significant effect on growth for both height and weight during the duration of treatment," Khwaja said.

What can't be gauged from this study, he said, is if those changes are lasting or if the children catch up when they go off the medications, or if they catch up as they get older.

Goodman said other studies have shown a height suppression of about a half inch, and that, in the long-term, children do catch up.

He said one limitation of the new analysis was that it didn't break down the data for short-term and long-term growth suppression.

What parents need to consider, Goodman said, "Is the quality of life improvement great enough to assume the possible risk of slight growth suppression? For most, it's my impression that parents and kids would accept that risk."

"These medications are remarkably helpful," he continued. "Let's put this risk in context with the tremendous benefits that can be gained. For parents that are reluctant to put children and adolescents on medications, I suggest a trial of a couple of weeks or months. You don't have to make a commitment to medication. For most, once they go on the medications, the improvement is so dramatic, they rarely go off."

Both Goodman and Khwaja said changing the timing of administering the medication might make a difference in growth suppression. Goodman said giving the medication after a meal might help offset appetite suppression. And Khwaja said some people just give their children medication when they must be able to focus and sit still, such as during school.

"Limiting the time they're taking medications might cause less of an effect."

Khwaja added that he believes more study needs to be done on this topic, and a prospective trial should be performed to look at the long-term effects these drugs have on children's growth.

More information
The American Academy of Pediatrics offers advice on starting an ADHD treatment plan for your child.