ADHD

Secondhand smoke exposure can increase the need for treatment or counseling for children with neurobehavioral disorders, according to a recent study published by the American Academy of Pediatrics.

Children between the age 4 and 17 had a 22 percent increase in parent-reported diagnosis of ADHD in a short four-year span, advised researchers from the Tobacco Free Research Institute in Dublin and the Center for Global Tobacco Control, Harvard School of Public Health reports from 2003-07.

The study advises, secondhand smoke, noted as not the cause of the disorder, is attributable to numerous physical health consequences in children. Respiratory problems, acute respiratory infections, ear problems and increases frequency and severity of asthma attacks.

Anne McHugh, inclusion specialist with the Early Learning Coalition of Pasco and Hernando Counties, Inc., said that exposure to secondhand smoke can possibly exacerbate the symptoms consistent with of ADHD in young children.

"Currently, a grant funded program focusing on three area daycares in Hernando County are receiving intensive training in order to promote the social emotional development of young children. This will assist children in functioning more successfully in academic and social aspects of the early learning experience," said McHugh.

Establishing Positive Behavior Support encourages increased attention spans and reduces aggressive tendencies, McHugh added.

Neurobehavioral disorders such as ADHD (attention-deficit/hyperactivity disorder) learning disabilities, and conduct disorders are often related, and generally begins in early years.

"A majority of the children referred for services present with a problem of high activity level, inattentiveness, impulsivity and aggression," said McHugh. "Many come from broken family systems and are being raised by grandparents or are in foster care."

Children often come into the centers smelling of tobacco smoke and often are asthmatic and in need of nebulizer treatments and medications, she added.

"Children on medications such as albuterol and prednisone exhibit side effects such as restlessness, loss of focus, irritability and mood swings," said McHugh.

Approximately two-thirds of children diagnosed with ADHD have at least one other co-existing disorder, advises CHADD (Children and Adults with Attentions Deficit/Hyperactivity Disorder).

ADHD is the most common chronic condition of childhood, according to American Academy of Pediatrics. Children diagnosed with ADHD can have severe, frequent problems that interfere with their ability to lead 'normal' lives.

Inattention, hyperactivity and impulsive behavior are symptoms of ADHD. Often children have behavior problems, however, these behaviors are often displayed in one or more environments (home, school and socially) including difficulty functioning in these environments daily.

The study concluded more than 270,000 children with disorders could have been prevented had they not be exposed to secondhand smoke in their homes.

A learning disability is a disorder preventing the brain's functions (receiving, processing, storing, and response) from being normal.

Behavioral and conduct disorders in children increase the risk for developing drug and alcohol abuse, anti-social personality disorder and anxiety related disorders, according to American Academy of Pediatrics.

Other variables used in the study other than being asked if someone in the home is a smoker, were derived when asked whether the parent was told by a health care provider or school official that the child has a learning disability, including Attention-deficit disorder (ADD) or ADHD, and included behavioral and conduct problems being defiant, oppositional or poor conduct, plus any emotional, developmental or behavioral problems in which the child needs treatment.

"There is a trend in early childcare centers encouraging families and caregivers to be mindful of the children, asking if they smoke to do so outside the home and car," said McHugh.

I work with preschool teachers, implementing schedules with consistent daily tasks with reasonable expectations and positive behavioral support, which is proven to help increase attention spans and reduces aggressive tendencies, McHugh added.

Treatment for ADHD

Once diagnosed with ADHD, a long-term treatment plan will need to be established. This includes target goals for behavior and improvement in school work.

Health care providers should monitor the progress and follow up on medication effectiveness and behavior modification methods.

Stimulant medications are a safe, effective method of relieving the ADHD symptoms. Additionally, behavior therapy, parent training, education and teamwork from parents, health care providers and other caregivers all play an important role in helping the child.

Stimulants are non-addictive, but can cause side effects. Decrease in appetite, trouble sleeping, weight loss, and involuntary movements (tics) are potential side effects and can be mild to temporary.

Some opt for "drug holidays" where the child can opt out of taking medication over the weekend or other times when not in school. Patients are advised to discuss this with their health care provider engaging in this practice.

Not all ADHD treatments involve medication, as behavior modification and therapy may only be necessary, changing the child's environment can be a common-sense approach.

Parents need to look at whether the child is over tired, scheduled, stimulated, plus whether the child is sleeping enough and has a daily routine.

As medications prescribed to stimulate the child more, by changing the environment, routine or diet could reduce the ADHD symptoms.

Complimentary and alternative medicine (CAM) treatments are not proven or confirmed and parents need to be advised, informs UpToDate an online service for physicians for continuing medical education.

Experts advise ADHD patients improve when in structured environments, as high energy levels are able to be focused on tasks throughout the day, and is not limited to sporting activities after school.

Children with ADHD seem to have lower magnesium levels, advises the National Institutes of Health. Limited research suggests that magnesium might help ADHD in children with low magnesium levels. Reducing the consumption of sodas and caffeine intake can improve the body's absorption of magnesium.

Other treatments can involve behavior.

Recommendations include implementing a daily schedule; having minimal distractions; specific, logical locations for toys, clothes and school supplies; setting small, reachable goals; rewarding positive behavior; charts or checklists to keep on task; physical activity or sports; limit options/choices; encourage activities the child can be successful; use calm discipline.

During the school year it is helpful for a child to write homework assignments down; have the child sit near the front of the classroom; provide plenty of time to complete homework; provide a private "signal" to notify child when he/she is not on task; provide daily reports to parents as monitoring a child's symptoms is needed during ADHD treatment.

The Early Learning Coalition of Hernando and Pasco Counties, Inc. is located at 15506 County Line Road in Spring Hill. Please call 727-233-8291 or visit www.phelc.org.