By Chantay Banikarim, M.D. MPH

Does your teen struggle with forgetting homework, organization, making decisions without thinking, concentrating on schoolwork and being patient? Could your teen have Attention-deficit/hyperactivity disorder (ADHD)?

Absolutely. ADHD can be diagnosed during teen and young adult years. Attention deficit disorder is characterized by the following main symptoms: hyperactivity/ impulsivity and inattention. These core symptoms may present differently during the teenager years. Hyperactivity is less prominent in adolescents and typically manifests as feeling restless. Inattention, which is difficulty paying attention, tends to become more prominent and problematic for the teen as school becomes more challenging and stressful during the high school years. The combination of inattention and restlessness can lead to poor school performance and a low GPA at a point in your child’s education when grades matter most.

Impulsivity, which is making quick decisions, often persists into adolescence and adulthood, which can lead to engagement in high risk behaviors such as misuse of drugs and alcohol. To be diagnosed with ADHD, the main symptoms should start prior to age 12 and should exist in two different settings, at school and outside of school for at least six months. It is not uncommon for an adolescent with ADHD to have other psychiatric conditions at the same time such as depression, anxiety, and oppositional defiant disorder.

What does an evaluation for ADHD entail?

The physician will collect medical and psychosocial information from both teen and parent. The evaluation has two main sections: medical evaluation including a physical exam and a behavior rating assessment tool. Ideally, the healthcare provider will spend some time alone with your teen to gather more sensitive information that may assist with the diagnosis and exclude other conditions including substance use and a mood disorder. There is some overlap between the symptoms of depression/anxiety, substance use and ADHD. To further support the clinical information obtained during the history, a specific ADHD questionnaire will be given to the parent and teachers to complete which will provide information on your teen’s behavior and school performance. Adolescents with ADHD are at higher risk for a learning disability. The frequent use of digital media may interfere with the normal development of sustained attention and impulse control. Determining time spent on electronics is an important piece of the clinical history in teens that develops symptoms during adolescence. Electronic devices have the capability of tracking daily digital use. More studies are needed to clarify the relationship between electronic use and development of ADHD.

What are the treatment options and recommendations for ADHD in a teenager?

ADHD is a chronic condition and requires ongoing frequent monitoring by parents, teachers and primary care physicians. An integrated model of care is ideal for ADHD management. In this new model, the physician and behavioral health consultant can see your teen during the same office visit.

ADHD management recommendations

Medications: Medications are considered the first line of treatment for children and adolescents. Various medications are available that can significantly reduce the symptoms of ADHD. Your doctor will discuss the risks and benefits associated with each medication option.

Education: Primary care physicians or adolescent medicine specialist will educate the parent and teen on how ADHD can affect their social life and academic performance. When the teen fully understands the condition and how it is affecting his or her life, he or she will be motivated to follow through on the treatment recommendations.

Therapy: A behavioral health consultation will help parent and your teen formulate a plan to improve the following key areas: relationships with peers, teachers and parents; school performance; and reduction in conflicts at school and home.

School based interventions/special accommodations: The physician may request certain accommodations at school to improve your teen’s academic performance such as more time to turn in assignments or complete a test.

Exercise: By following the current exercise recommendation, which is 60 minutes of physical activity per day, your teen will likely experience a reduction in impulsivity/ hyperactivity and an increase in ability to focus.

Driving: Before allowing your teen with ADHD to drive, ensure that he or she is compliant with their medication as inattention can lead to motor vehicle accidents.

Substance use: Adolescents with ADHD are at higher risk of drugs use most likely due to impulsivity. Always know your teen’s whereabouts and friends.

Coexisting psychiatric conditions: It is important to recognize and treat all coexisting conditions as the management of anxiety or depression is not the same as ADHD.

 

Chantay Banikarim, M.D. MPH is an Adolescent Medicine Physician at Devereux Adolescent Health & Wellness Clinic. For more information, visit 1837 S. Mesa Dr. Suite A-201 in Mesa or call 602-313-3525.

 

 

 

 

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