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An ADHD Research Update for Children and Teens

By Meghan Vivo

Recent studies have produced both good news and bad news for children and teens with Attention Deficit/Hyperactivity Disorder (ADHD).

The Bad News: Sleep Disorders Often Accompany ADHD

The bad news is teens with a childhood diagnosis of ADHD are more likely to have sleep disorders that may last a lifetime. A recent study, which included 281 children, aged 10 to 17, who had been diagnosed with ADHD, found that regardless of the severity of their attention issues, teens with ADHD were two to three times more likely to have short-term or lifetime issues with insomnia or nightmares, and were also more likely to experience night terrors, teeth grinding, and snoring than children without ADHD.

For some teens, their ADHD symptoms (e.g., hyperactivity, inattention, and behavioral or academic problems) are caused or exaggerated by a sleep disorder so treatment for the sleep disorder may improve ADHD symptoms, according to Susan Shur-Fen Gau, MD, PhD, the study’s principal investigator.

Interestingly, the rates of nightmare and lifetime nightmare disorder were more prevalent in girls, while snoring was more prevalent in boys. The study’s authors point to Internet addiction, use of stimulants, and the presence of other psychiatric disorders as potential causes of sleep problems in children with ADHD.

According to other recent research published in the journal Sleep, children with ADHD also tend to sleep less, spend less time in the rapid eye movement (REM) stage of sleep, and have a harder time falling asleep than children without ADHD.

Though little is known about the causes of sleep problems in children with ADHD, experts offer a number of recommendations for improving the quality and quantity of your child’s sleep:

• Set a regular bedtime and enforce it.
• Avoid long, late afternoon naps.
• Arrange for a period of quiet time before bed, free from video games, television shows, or news programs.
• Make sure your child gets plenty of exercise each day, but limit the amount of physical activity that takes place late in the evenings.
• Try playing calming music or background white noise to reduce anxiety as your child falls asleep.
• Limit or eliminate caffeine intake in the late afternoon and evening.
• Talk to your health care provider about adjusting your child’s medication and to determine if light therapy or other alternative treatments may improve your child’s sleep.

In general, teenagers need about 9 hours of sleep each night, preschoolers should get 11 to 13, and toddlers need 12 to 14. Sleep deprivation adversely affects memory, concentration, communication skills, and critical thinking, even among children without ADHD.

About half of parents of children with ADHD report that their child has difficulty sleeping. While no one is sure whether improvements in sleep will result in increased focus during the day in children with ADHD, experts believe better sleep is likely to decrease irritability and moodiness, improve academic performance, and make life more enjoyable for the entire family.

The Good News: ADHD Medications Help

Fortunately, the news isn’t all bad for children with ADHD. A recent study of nearly 600 children with ADHD published in Pediatrics shows that ADHD medications are offering real benefits for many children, resulting in higher scores on math and reading tests.

“Some 4.4 million children in the United States have been diagnosed with ADHD, a condition that is strongly associated with low academic achievement,” said the study authors. “With nearly 60 percent of diagnosed children taking prescription medications to treat the disorder, at a cost of $2.2 billion in 2003, the current findings have the potential for wide applicability, particularly because diagnostic prevalence and medication rates differ among demographic groups.”

The results of this study are particularly promising, according to researchers, because the study followed the children for a long period of time (from kindergarten until 5th grade). However, because the study results relied on the parents' word and not a consistent diagnosis method, experts agree that medication alone cannot solve many of the problems associated with ADHD.

"Medication gets you there part of the way, but we need other types of intervention," said Susan Stone, an associate professor in the school of social welfare and a co-author of the study.

Help for Children with ADHD

While medications have proven beneficial for many young people with ADHD, they may not always be sufficient in and of themselves. Many children and teens with ADHD have made great strides in ADHD summer camps and ADHD boarding schools.

For example, Talisman camps provide children ages 8 to 17, who have ADD and ADHD, Asperger’s syndrome, and high-functioning autism, with experiential wilderness learning camps full of fun, adventure, and new learning experiences. In an atmosphere that encourages and supports self-regulation and self-direction, a staff of trained professionals helps young people with ADHD and related issues develop essential life skills. Talisman also operates a semester-length ADHD school program for teens ages 13-17 to help students improve social awareness and interaction, independence, and academic self-motivation through integrated learning.

For parents looking for a longer term therapeutic environment for their child with ADHD, Stone Mountain School in North Carolina is a popular option. This ADHD boarding schools specializes in working with children and teens with attention issues and other learning challenges, offering a great deal of structure and individualized attention, intensive therapy, and top-notch academics.


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