So if a patient meets these criteria
for attention deficit disorder
or attention deficit
there are some things we can do to
help improve the circumstances.
The first is around behavioral
and family counselling.
It’s important to establish some key
goals for the family and the patient.
For example, we can work on helping
the family become more consistent
with their parenting.
Providing more positive reinforcement.
Reducing distractions such as television
watching or other things during tasks.
Likewise, we can work on
social skill modifications.
This can be done with help
from counsel or therapist.
And it’s important to intervene
with school as well.
Schools are used
to this problem.
Frequently, parents and
physicians may assist
with the development of an
individualized learning plan,
which can create a better environment
for that child in school.
Examples might be altering
the conditions of testing.
They may be recording or using
technology to record lessons
so that kids can later refer
to exactly what was going on.
It may be they can get
So we can alter the
educational environment too
to really improve the way that
child is doing in school.
Additionally, physicians go
through the decision process
of whether or not to
This is a somewhat controversial thing,
although stimulants are routinely
used in the United States.
It’s important though not
to just rely on stimulants,
but to address all aspects of care.
However, stimulants are commonly
used, so let’s go through it.
So stimulants are in fact the first line
therapy for attention deficit disorder.
We can use short or long-acting stimulants
depending on the behavioral pattern.
So for instance if a child mostly only has
troubles at certain times of the day,
a short-acting stimulant at a
certain time may be better
or if it’s a really
durational problem where
it happens both at school or
at home and it’s prolonged,
a long-acting stimulant
maybe your better choice.
There are also some non-stimulants
that may be beneficial to patients.
Atomexetine is one possibility.
However, these tend to be a
little bit less effective.
We usually employ them in cases
where stimulants would have a
substantial side effect profile
that would hurt the patient.
For example, a child with a bad
tic disorder or anxiety problem,
which is worsened by stimulants.
The side effects of atomexetine include
fatigue, somnolence or irritability.
Additionally, we can turn
to alpha-2 agonists.
Examples are Clonidine
These do not cause tic exacerbation and are
a little bit better for sleep disturbance.
But they do cause sedation, so
they might be a problem in school.
They also cause dry mouth.
We typically take these daily and
they shouldn’t be stopped abruptly.
They should be
gradually weaned off
if a decision is made to
discontinue this therapy.
So that’s my summary of attention
deficit disorder in children.
Thanks for your attention.