*Parents may also find it helpful to learn stress management techniques, which could increase their ability to productively deal with their [[frustration]] and enable them to interact with their child in a calm manner.
*Parents may also find it helpful to learn stress management techniques, which could increase their ability to productively deal with their [[frustration]] and enable them to interact with their child in a calm manner.
*[[Support groups]] can assist the parents and families of ADHD patients by connecting them with others who have similar problems and concerns. Groups often meet regularly to share frustrations and successes, to exchange information about recommended specialists and strategies, and to talk with experts.<ref name="#1">National Institute of Mental Health (NIH). (2016). "Attention Deficit Hyperactivity Disorder."</ref>
*[[Support groups]] can assist the parents and families of ADHD patients by connecting them with others who have similar problems and concerns. Groups often meet regularly to share frustrations and successes, to exchange information about recommended specialists and strategies, and to talk with experts.<ref name="#1">National Institute of Mental Health (NIH). (2016). "Attention Deficit Hyperactivity Disorder."</ref>
==Monitoring response to treatment==
Methods of monitoring treatment for ADHD have been reviewed<ref name=""></ref>CHADD (2017). Which ADHD Rating Scales Should Primary Care Physicians Use? Available at https://chadd.org/adhd-weekly/which-adhd-rating-scales-should-primary-care-physicians-use/<ref name="pmid31150173">{{cite journal| author=Gaba P, Giordanengo M| title=Attention Deficit/Hyperactivity Disorder: Screening and Evaluation. | journal=Am Fam Physician | year= 2019 | volume= 99 | issue= 11 | pages= 712 | pmid=31150173 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31150173 }} </ref><ref name="pmid28184164">{{cite journal| author=Ramsay JR| title=Assessment and monitoring of treatment response in adult ADHD patients: current perspectives. | journal=Neuropsychiatr Dis Treat | year= 2017 | volume= 13 | issue= | pages= 221-232 | pmid=28184164 | doi=10.2147/NDT.S104706 | pmc=5291336 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28184164 }} </ref>.
The Wender-Reimherr Adult Attention Deficit Disorder Scale (WRAADDS) has higher diagnostic accuracy than the WHO Adult ADHD Self-Report Scale (ASRS)<ref name="pmid32285644">{{cite journal| author=Brevik EJ, Lundervold AJ, Haavik J, Posserud MB| title=Validity and accuracy of the Adult Attention-Deficit/Hyperactivity Disorder (ADHD) Self-Report Scale (ASRS) and the Wender Utah Rating Scale (WURS) symptom checklists in discriminating between adults with and without ADHD. | journal=Brain Behav | year= 2020 | volume= 10 | issue= 6 | pages= e01605 | pmid=32285644 | doi=10.1002/brb3.1605 | pmc=7303368 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32285644 }} </ref>.
This scale includes the Conners Adult ADHD Rating Scales (CAARS). It has 66 items. It is available for download<ref>Australian Council for Educational Research. Available at </ref>.
The CAARS has been used to measure response to treatment in [[randomized controlled trial]]s<ref name="pmid26536057">{{cite journal| author=Philipsen A, Jans T, Graf E, Matthies S, Borel P, Colla M | display-authors=etal| title=Effects of Group Psychotherapy, Individual Counseling, Methylphenidate, and Placebo in the Treatment of Adult Attention-Deficit/Hyperactivity Disorder: A Randomized Clinical Trial. | journal=JAMA Psychiatry | year= 2015 | volume= 72 | issue= 12 | pages= 1199-210 | pmid=26536057 | doi=10.1001/jamapsychiatry.2015.2146 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26536057 }} </ref<ref name="pmid26536057">{{cite journal| author=Philipsen A, Jans T, Graf E, Matthies S, Borel P, Colla M | display-authors=etal| title=Effects of Group Psychotherapy, Individual Counseling, Methylphenidate, and Placebo in the Treatment of Adult Attention-Deficit/Hyperactivity Disorder: A Randomized Clinical Trial. | journal=JAMA Psychiatry | year= 2015 | volume= 72 | issue= 12 | pages= 1199-210 | pmid=26536057 | doi=10.1001/jamapsychiatry.2015.2146 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26536057 }} </ref>.
===Affective Lability Scale–Short Form (ALS)===
The ALS has 18 items.<ref name="pmid28152669">{{cite journal| author=Weibel S, Micoulaud-Franchi JA, Brandejsky L, Lopez R, Prada P, Nicastro R | display-authors=etal| title=Psychometric Properties and Factor Structure of the Short Form of the Affective Lability Scale in Adult Patients With ADHD. | journal=J Atten Disord | year= 2019 | volume= 23 | issue= 10 | pages= 1079-1089 | pmid=28152669 | doi=10.1177/1087054717690808 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28152669 }} </ref>
===Vanderbilt NICHQ===
===WHO Adult ADHD Self-Report Scale (ASRS)===
The Adult ADHD Self-Report Scale (ASRS) is the World Health Organization's (WHO) rating scale for adult ADHD. It has 18 items. It also has a 6 item scale for screening. ASRS-v1.1 is available for download at the Attention Deficit Disorder Association<ref name="">Attention Deficit Disorder Association. https://add.org/wp-content/uploads/2015/03/adhd-questionnaire-ASRS111.pdf</ref>
The Wender-Reimherr Adult Attention Deficit Disorder Scale (WRAADDS)m has higher diagnostic accuracy than the WHO Adult ADHD Self-Report Scale (ASRS)<ref name="pmid32285644">{{cite journal| author=Brevik EJ, Lundervold AJ, Haavik J, Posserud MB| title=Validity and accuracy of the Adult Attention-Deficit/Hyperactivity Disorder (ADHD) Self-Report Scale (ASRS) and the Wender Utah Rating Scale (WURS) symptom checklists in discriminating between adults with and without ADHD. | journal=Brain Behav | year= 2020 | volume= 10 | issue= 6 | pages= e01605 | pmid=32285644 | doi=10.1002/brb3.1605 | pmc=7303368 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32285644 }} </ref>.
=== ADHD Rating Scale (for children and adolescents) ===
For children and adolescents, the ADHD Rating Scale<ref>DuPaul GJ, Power TJ, Anastopoulos AD, Reid R. ADHD Rating Scale IV (for Children and Adolescents): Checklists, Norms, and Clinical Interpretation. New York, NY: Guilford Press; 1998</ref> has been used in [[systematic review]]s<ref name="pmid27163988">{{cite journal| author=Chan E, Fogler JM, Hammerness PG| title=Treatment of Attention-Deficit/Hyperactivity Disorder in Adolescents: A Systematic Review. | journal=JAMA | year= 2016 | volume= 315 | issue= 18 | pages= 1997-2008 | pmid=27163988 | doi=10.1001/jama.2016.5453 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27163988 }} </ref>. In a systematic review, "A clinically meaningful response is generally considered to be improvement of 25% or greater from baseline (a within-group reduction of approximately 10-15 absolute points or a mean difference of approximately 6-7 points between the treatment and placebo groups"<ref name="pmid27163988">{{cite journal| author=Chan E, Fogler JM, Hammerness PG| title=Treatment of Attention-Deficit/Hyperactivity Disorder in Adolescents: A Systematic Review. | journal=JAMA | year= 2016 | volume= 315 | issue= 18 | pages= 1997-2008 | pmid=27163988 | doi=10.1001/jama.2016.5453 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27163988 }} </ref>.
The mainstay of therapy for ADHD is the administration of such stimulants as Ritalin and Adderall. While there is no cure for ADHD, currently available treatments can help reduce symptoms and improve functioning. Other treatment options include psychotherapy, education and training, or a combination of therapies.[1]
Medical Therapy
Several different types of medications may be prescribed to mitigate the symptoms associated with ADHD.
Stimulants, such as Methylphenidate (Ritalin) and amphetamine salts (dextroamphetamine and amphetamine; Adderall), are used to increase the patient’s supply of the brain chemicals dopamine and norepinephrine, which play essential roles in thinking and attention.[1] Ritalin is safe and effective in preschool-aged children suffering from ADHD so long as they are closely monitored while taking the drug.[2]
Lisdexamfetamine is a prodrug of dextroamphetamine. It may be dosed once a day and is less likely to be abused.
Atomoxetine (Strattera) is a selective norepinepherine reuptake inhibitor (SNRI) approved for the management of ADHD. It is effective in adult ADHD and is often favored due to lack of abuse potential[3]. Atomoxetine carries a black box warning as there is an increase risk of suicidal ideation in adolescents[4]. While it is non-inferior to methylphenidate in children, its adverse effects in children and adolescents render it a less favorable treatment option.[5]
Non-stimulants such as extended release Guanfacine and Clonidine (both alpha-2 adrenergic agonists) are also used to treat ADHD[6].
Other drugs, including anti-depressants, may also be prescribed in cases of ADHD depending on the patient’s co-morbidities.[1]
Education and training
Educating the patient and his or her family members can prove useful in combating the negative effects of ADHD. For the parents or guardians of young patients, parenting skills training can help teach them the skills they need to encourage and reward positive behaviors in their children. Such training helps parents learn how to use a system of rewards and consequences to change a child’s behavior. In this intervention, parents are taught to give immediate and positive feedback for behaviors they want to encourage, and ignore or redirect behaviors that they want to discourage.
Parents may also find it helpful to learn stress management techniques, which could increase their ability to productively deal with their frustration and enable them to interact with their child in a calm manner.
Support groups can assist the parents and families of ADHD patients by connecting them with others who have similar problems and concerns. Groups often meet regularly to share frustrations and successes, to exchange information about recommended specialists and strategies, and to talk with experts.[1]
References
↑ 1.01.11.21.3National Institute of Mental Health (NIH). (2016). "Attention Deficit Hyperactivity Disorder."
↑Garnock-Jones KP, Keating GM (2009). "Atomoxetine: a review of its use in attention-deficit hyperactivity disorder in children and adolescents". Paediatr Drugs. 11 (3): 203–26. doi:10.2165/00148581-200911030-00005. PMID19445548.
↑Barry, Colleen (01/21/2014). [www.ncbi.nlm.nih.gov/pmc/articles/PMC3896970/ "ADHD Medication Use Following FDA Risk Warnings"] Check |url= value (help). NIH. Retrieved 06/12/2018. Check date values in: |access-date=, |date= (help)
↑Michelson D, Adler L, Spencer T, Reimherr FW, West SA, Allen AJ, Kelsey D, Wernicke J, Dietrich A, Milton D (2003). "Atomoxetine in adults with ADHD: two randomized, placebo-controlled studies". Biol. Psychiatry. 53 (2): 112–20. PMID12547466.
↑Southammakosane, Cathy (August 2015). [www.pediatrics.aappublications.org/content/136/2/351 "Pediatric Psychopharmacology for Treatment of ADHD, Depression, and Anxiety"] Check |url= value (help). AAP. Retrieved 06/12/18. Check date values in: |access-date= (help)