Attention-deficit/hyperactivity disorder, commonly referred to as ADHD, is a condition of excessive distractibility and impulsivity. Kids easily are drawn away from their tasks and make quick and sometimes poor judgments. They have difficulty waiting for rewards. You don’t have to be hyperactive to have the condition. In fact, you don’t even have to be a kid. Many adults now are diagnosed with ADHD.
 
Children are more frequently diagnosed with ADHD when they start school because the demands of paying attention at school are greater than at home. The problem occurs in the brain, where areas that control impulse are underactive. We know this from modern imaging studies, like MRIs. The main area that this occurs is in the frontal lobe. In addition to controlling impulses, the frontal lobe also is involved with our decision-making skills.
 
ADHD is common, occurring in about one in 25 kids. Boys tend to be more affected than girls. Girls often will have a lot of symptoms without being hyperactive. There are a few factors, such as prematurity, that can make ADHD more likely. For the most part, it is a condition that is present from birth. It is not caused by inappropriate parenting, the wrong diet (such as too much sugar) or stress. While genetics now are being tested, we know there is a strong family correlation. Other family members often have similar traits.
 
There are two main therapies for ADHD. One is behavioral. The other is medication.
 
Changing the school or home environment may help. Allowing for the strengths and weaknesses of each child is important as well. Working with schools and therapists can be beneficial.
 
Dietary measures usually do not change symptoms.
 
Most kids with ADHD do well with medication. There may be reluctance to use these medications, but with the proper dosage and administration they are safe and effective. There are several types of medications that can help. A health care professional can work with you to find the right one and the right dose.
 
Parents may wish to avoid labeling their child or, if diagnosed, use medication. This often leads to unnecessary school or social problems. Many physicians and other health care professionals have good questionnaire screening tools to help. If you are concerned, talk with your doctor.     

Paul Norton, MD, is a behavioral specialist at Children’s Medical Group-Greensquare Developmental Specialists.

FAST FACT: Children’s Medical Group physicians provide primary and behavioral care for children in 18 clinics throughout southeastern Wisconsin. In addition, the medical group oversees the School Nurse Program located in central city Milwaukee Public Schools, where Children's Hospital and Health System and private schools provide care for students. Find a local pediatrician at www.childrensmedicalgroup.org.

Ear pain, sore throats, the cold and flu, minor burns and cuts. For some children, childhood is marked by more than just a few visits to the local emergency room or urgent care clinic. Invariably, like Murphy's Law,  it seems that your child is sick or injured when your pediatrician's office is close. Parents are left asking whether to head to the emergency room or an urgent care clinic.

Urgent care clinics are for illnesses and injuries that your child normally would receive care for at his or her doctor’s offices. Most often, urgent care locations are open when regular doctor’s offices are closed. In many cases, urgent care clinics will offer lower co-pays and shorter wait times than emergency rooms.

Your child may need urgent care for:

•    Ear infections with pain and/or fever.
•    Sore or strep throat.
•    Cold or the flu.
•    Mild asthma attacks
•    Vomiting and diarrhea, especially in babies and small children.
•    Non-severe bleeding.
•    Minor burns or cuts.
•    Minor head injury with no loss of consciousness.
•    Hives, rash or diaper rash.
•    Bruises or sprains.
•    Lice, scabies or ringworm.
•    Drug reactions such as hives or rashes.

The emergency room is for more serious illnesses and injuries. Emergency rooms are equipped to care for all patients, from those with minor illnesses to those with life-threatening injuries. Because of this, patients with a less severe problem usually will have to wait – sometimes hours – until the more critically ill patients are treated. For appropriate cases, urgent care clinics have shorter wait times.

Your child may need emergency care for:

•    Serious broken bones, such as the leg or arm.
•    Gun or knife wounds.
•    Severe or unusual bleeding that will not stop.
•    Heart attack or severe chest pain.
•    Suspected stroke.
•    Sudden inability to see, move or speak.
•    Choking or trouble breathing.
•    Possible poisoning.
•    Unconsciousness.
•    Fainting or syncope.
•    Convulsions or prolonged, repeated seizures.
•    Drug overdose.
•    Major injuries.
•    Severe pain.

Unfortunately, some childhood injuries and illnesses may require more immediate care. In emergencies, always call 9-1-1 for the most immediate care.

While arming yourself with information is one of the best things you can do as a parent, remember to trust your instincts. You know your child best.

For more information about Children’s Urgent Care locations call (414) 266-4800. For more information about the Children’s Hospital of Wisconsin Emergency Department, call (414) 266-2000.

FAST FACT: Children's Hospital of Wisconsin had more than 61,000 visits to its Emergency Department and six Children's Urgent Care sites last year.

Jane Chevako, MD, is the medical director of Children’s Urgent Care.
 

Every year, young children are involved in automobile accidents and sports-related injuries. If the adult in the vehicle is seriously injured, unable to talk or not present, those responding to the emergency have no easy way of identifying the child. But, two new programs offer added protection through identification.

W.H.A.L.E. (We Have A Little Emergency)
Wisconsin law requires all youngsters under 4 years of age or up to 40 pounds be seated and harnessed in an approved child safety seat when riding in a car. The safety seat can provide vital information about its young occupant in the unfortunate event that the driver of the car is incapacitated in a car accident. W.H.A.L.E. stickers are placed on both rear side windows of the car and on both sides of the child safety seat so emergency personnel will know immediately there is vital information about the child on the back of the car seat. The W.H.A.L.E sticker includes the child's name, medical history, names and telephone numbers of two guardians and up to three emergency names and telephone numbers.

That’s Using Your Head
That’s Using Your Head is a sports helmet identification program designed to provide identification to emergency personnel in the event of
an injury or emergency. Helmets are a critical piece of equipment for safety during all sports such as bicycling, inline skating, baseball, rock climbing or skateboarding. That’s Using Your Head includes a large emergency information sticker to be placed on the inside of a helmet and a smaller sticker for the outside of the helmet. Stickers will help with emergency identification and medical safety information in a crisis situation.

Children’s Medical Group-Bayshore Pediatrics provides both W.H.A.L.E. and That’s Using Your Head packets to local North Shore police and fire departments for distribution during car seat installations and to parents and children through clinic visits, day care centers and preschools.

Sharyl Paley, MD, FAAP, is a pediatrician at Children’s Medical Group-Bayshore Pediatrics.

FAST FACT: Children’s Medical Group physicians provide primary and behavioral care for children in 18 clinics throughout southeastern Wisconsin. In addition, CMG oversees school-based health centers located in central city Milwaukee Public Schools. Find a local pediatrician at www.childrensmedicalgroup.org.

 

The spring months bring sunshine, warmer weather and sometimes a trip or two to your pediatrician. A trip to the pediatrician’s office can be stressful, but knowing how to make the most of your time there can make visits run smoothly.

Offer information:
•    It’s important your doctor be aware of any change in your family’s health history, including grandparents, aunts and uncles. Cases of heart disease, diabetes, high blood pressure and cancer are examples of things your doctor should know.
•    Tell the doctor if someone else has seen your child for an illness or injury, such as a visit to an emergency room, urgent care or a specialist.
•    Bring a list of all the medications your child is taking. This should include over-the-counter medications, vitamins and herbal supplements, as well as prescription medication.
•    If your child is sick, write down timelines of what symptoms began when. This is especially helpful if your child has a chronic or long-standing illness.

The more information you can offer your child’s doctor, the better he or she will be able to understand, diagnose and treat your child.

Ask questions. At regular check-ups:
•    Ask what you might need to know about caring for your child between this visit and the next one. Make sure you know when the next scheduled visit should take place.
•    Ask what changes your child might go through before your next visit such as growth, development and feeding stages. Your doctor can provide helpful nutritional and safety advice no matter your child’s age.
•    Ask where else you can get good information on parenting, safety and other related topics, such as Internet sites, books and magazines.

It is helpful to come with questions written down so you don’t forget to ask them. Also, make sure you understand the answers and information your doctor gives you, and don’t be afraid to ask for further information or clarification. Remember, these questions are best for well-child visits. When your child is sick, that visit should be focused on the current illness.

Come prepared. Make sure you bring the following to every visit:
•    Health insurance information.
•    Any changes in demographic information such as address and phone number or emergency contact information.
•    A game, book or favorite toy that can help keep your child entertained if there is a wait in the office. This also can help comfort your child and ease some anxiety.
•    Antiseptic wipes if your child plays with toys or has contact with other children in the waiting room.
•    A blanket and extra diaper for infants.
•    Unfortunately, waiting to see the doctor often is inevitable. Ask front office staff if you can call before your visit to find out if appointments are running on time. Being on time is a mutual responsibility between the doctor and patient. Sometimes a little advanced planning can lessen frustration and help visits run on time.

Most importantly, enjoy the time with your pediatrician. The two of you are talking about the most precious, unique and wonderful gift – your child.

Michael Gutzeit, MD, is a pediatrician and chief medical officer at Children’s Hospital of Wisconsin. For more information about Children’s Hospital call (414) 266-2000 or visit www.chw.org.

 
FAST FACT: Did you know that Children's Hospital and Health System has 17 pediatrician practices throughout Southeastern Wisconsin? For more information about Children's Medical Group visit the Web site at www.childrensmedicalgroup.org.