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ADHD - Domains of Impairment

Abstract: What kind of impairment is necessary to use psychostimulants for ADHD treatment

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ADHD - Domains of Impairment

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Question(s): 
Written by: Martin Winkler
First version: 22 Jul 2008.
Latest revision: 22 Jul 2008.

Do all children with ADHD symptoms have to take psychostimulants?

Answer:

No. But you should always consider all possibilities of improvement depending on the individual domains of impairment and main target symptoms of the kid. To develop an appropriate treatment scheme for ADHD children can only be done by addressing all possible areas of impairment and personal resources and interests of the children and their environment. So a multimodal treatment approach will start by gathering information from the child, the parents, teachers and other relevant persons in contact with the patients. This will help to assess specific presentations of problems or coping facilities of the individual patient in different domains.

Symptoms or behaviours in the context of ADHD (or any other psychiatric diagnosis) will only be treated if they cause problems in the patient´s life or interfere with the individual development. So medication will only be one part of a complete treatment approach to help the client to reach his or her full potential of functioning in all domains of the individual environment. Sometimes this can be done without medication, but very often psychostimulants are the basis of a better awareness and self-control of the children.

There are very different opinions about the number of adhd children, who need psychostimulants. Some experts think that less than 30 percent of all adhd children might need them. Other experts say, that you should always offer a pharmacological treatment option because it will have the best outcome for the child on the long run. About 80 percent of all adhd-children that get a medication will get significant improvements. Any other treatment approach will not achieve similar benefit for the children.

To define the individual benefits or side effects of the treatment a baseline of specific target symptoms should be defined and a close follow-up (at least once a month in the beginning) should monitor all positive or negative changes.

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