ADHD

ADHD (Attention Deficit Hyperactivity Disorder)

Attention Deficit Hyperactivity Disorder, ADHD, is one of the most common behavioral disorders that develop in children. ADHD is a condition that becomes apparent in some children in the preschool and early school years. It is hard for these children to control their behavior and / or pay attention. It is estimated that between 3 and 7 percent of children have ADHD.  A thorough evaluation by a qualified professional is important in order to diagnose and treat ADHD. 

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What is ADHD?

The primary characteristics of ADHD are inattention, hyperactivity, and impulsivity. These symptoms appear early in a child's life. Symptoms of ADHD usually appear over the course of many months, often with the symptoms of impulsiveness and hyperactivity preceding those of inattention. Different symptoms of ADHD may appear in different settings. All children are occasionally restless, act without thinking, and don't pay attention. When the child's hyperactivity, distractibility, poor concentration, or impulsivity begin to affect performance in school, social relationships with other children, or behavior at home, ADHD may be suspected. 

Symptoms of Hyperactivity-Impulsivity:

  • Feeling restless, often fidgeting with hands or feet, squirming while seated, incessant talking or constantly in motion
  • Running, climbing, or leaving a seat in situations where sitting or quiet behavior is expected
  • Blurting out answers before hearing the whole question
  • Having difficulty waiting in line or taking turns
  • Unable to control immediate reactions or think before they act
  • Often blurting out inappropriate comments, displaying emotions without restraint, and acting without regard for the later consequences of their behavior

Symptoms of Inattention:

  • Frequently becoming easily distracted by irrelevant sights and sounds
  • Have difficulty completing tasks
  • Frequently failing to pay attention to details and making careless mistakes
  • Rarely following instructions carefully
  • Losing or forgetting things like toys, or pencils, books, and other items needed for a task
  • Frequently skipping from one uncompleted activity to another
  • Frequently appears to be daydreaming

For more information see Pediatric Web ADHD article.

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Diagnosing and Managing ADHD

Our ADHD management plan has been carefully developed following a thorough review by our ADHD Task Force. We continue to monitor the latest advancements in ADHD care and make ongoing updates whenever appropriate. Advanced Pediatrics' ADHD program is based on the following principles:

  • Using nationally recommended testing tools to diagnose ADHD
  • Ensuring regular follow-up appointments, medication review and repeat testing
  • Encouraging ongoing communication to ensure that the child is functioning well

Diagnosing ADHD: Initial Evaluation
If you are concerned your child may have ADHD and would like to have him or her evaluated, please call our Nurse Line at 303-699-6200 (option #2) to speak with one of our registered nurses. Our nurses will ask some initial questions about your child's behavior and then schedule an appropriate evaluation appointment. Based upon your child's symptoms, our nurse will let you know what paperwork should be filled out prior to your child's appointment.

Managing ADHD
If your child has been diagnosed with ADHD, regular follow-up and close medication management are important aspects of care. Your provider will coordinate your child's initial and follow-up care consistent with the following Advanced Pediatrics ADHD program management requirements:

Follow-Up Appointments

  • After the initial evaluation and diagnosis of ADHD, a medication recheck visit should be scheduled in 2-3 weeks to discuss how things are going and deal with any immediate problems or concerns. Additional office visits may be necessary until we feel that your child is doing well on the medication prescribed.
  • An ADHD follow-up evaluation should be scheduled for 3 - 6 months after the initial evaluation. This visit will require new parent and teacher forms to be completed and evaluated by the provider.
  • If no significant changes are made at the 6-month follow-up visit, your child should return for an ADHD follow-up visit every 6 months. These visits include follow-up forms from parents and teachers. If medication changes are made at any 6 month follow-up visit, the provider may want to see your child again prior to the next follow-up visit.
  • Our ADHD specialists can assist you in scheduling appointments, answering questions regarding refills, and completing appropriate forms. You can reach them or leave a message at 720-974-7188.
  • APA requires an annual well-care appointment for all children on ADHD medications. Your child must be current on his or her well-care exams to continue on ADHD medications.

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Medication Refill Requests

  • Requests for medication refills may be made online through our MyChart  patient portal or by calling our central prescription refill line at 720-870-0244.
  • If a medication refill is requested and your child has not had a re-evaluation within the last 6 months, you will be given a 1-month prescription and asked to schedule a visit. No further refills will be given until your child has been seen by a provider and is current for follow-up visits.
  • If your child has been off medication for more than 3 - 6 months, he / she must be seen by a provider for a follow-up visit before medication will be prescribed.
  • If your child has been off medication for more than 1 year, he / she must be seen for a new initial evaluation before medication will be prescribed.
  • Most medications prescribed for ADHD are "scheduled" drugs. This means that they are regulated and monitored by the Government. Regulations regarding the prescribing of stimulant medicines state that the prescriber must: 1) Write the prescription - it cannot be called in and 2) Only give a prescription for 30 days (90 day mail-order pharmacies can be an exception).
  • We ask parents to call our office at least 3 business days before the supply of medication runs out to arrange for a new prescription to be written. A parent or their authorized representative may pick up and sign for the prescription. (For example, a teenage sibling who is driving may pick up the prescription if they have a letter from the parent authorizing them to do so.) A photo ID is required for pick up of all controlled medications.

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Taking ADHD Medications

We recommend children take their ADHD medication right before or just after a meal to minimize the appetite suppression that normally occurs 1 - 2 hours after the medication is given. If it appears that your child's ADHD medication works better some days than others, consider his or her vitamin C intake. Citric acid and ascorbic acid MAY impair the absorption of some ADHD medications from the gut. Patients may be advised not to ingest citrus fruit, all fruit juices (including Kool-aid, Gatorade, etc.), most carbonated beverages, Pop Tarts, granola / breakfast bars, high vitamin cereals, oral suspension medication or vitamin C within one hour before or after their dose of stimulant medication.  For more information on ADHD medications, see the links below:

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Alternative Treatments

There are many popular unscientifically tested alternative medications and treatment programs available in the community and on the internet which we do not recommend to our patients. Our program follows proven treatment plans developed by nationally recognized experts in the field, and we recommend that patients coordinate all care through our practice or specialists recommended by our providers.

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Recommended Resources

APA Parent Handouts / Diagnostic Forms
Recommended Reading
Helpful Websites