That study confirms what Von King said she has long observed as a clinical psychologist and supervisor of Mental Health Services at Hazelden Center for Youth and Families in Plymouth, Minn. "When it comes to co-occurring diagnoses, substance abuse and ADHD rank No. 1 among the young people [ages 14-24] who come to our center for treatment," said King.

At its Web site the National Institute of Mental Health (NIMH) describes the principal characteristics of ADHD as inattention, hyperactivity, and impulsivity, and they estimate that three to five percent of children in the United States (about two million) are challenged with this disorder. An ADHD diagnosis requires clear evidence of clinically significant impairment in more than one setting (school, work, or home), and some symptoms need to have manifested prior to age seven.

It's important to identify ADHD early in life. First, the disorder interferes with a child's ability to learn. Because they are so often scolded and punished by teachers and parents, children with ADHD often begin to develop low self-esteem early in life. This sets the child up to experience failure throughout his or her formative years. ADHD also puts children at risk for developing other problems, such as conduct disorder.

ADHD may be suspected when symptoms affect performance in school, social relationships with other children, or behavior at home. Because many children exhibit these symptoms from time to time for a variety of reasons, King urges parents to have a professional trained in ADHD, such as a child psychiatrist or psychologist, conduct a thorough assessment in order to make a clear diagnosis. Once diagnosed, the most effective treatment for ADHD usually consists of a combination of behavior therapy and medications.

"Caution needs to be exercised because some medications used to treat ADHD have the potential to be abused," King warns. And once the appropriate prescription is determined, parents should not take their kids off the medication without consulting a qualified physician.

NIMH emphasizes that it is important to remember that medications don't cure ADHD; they control the symptoms in order to help an individual use the skills he or she already possesses. Behavior therapy, emotional counseling, and practical support can go a long way in helping those with ADHD cope with everyday problems and feel better about themselves.

Because so many of the young people who come to Hazelden for substance abuse treatment also have ADHD, King said it is important to get a better overall understanding of behavioral problems and solutions.

"I think it's comforting and provides a sense of relief both for parents and our patients when they realize we understand that there are two issues at hand, and we are not going to ignore either one," said King. "You have to treat people with ADHD in a respectful way, be patient, and provide consistency in all aspects of treatment. You can't just hope their inattention will go away. You may have to direct and re-direct them and provide very focused and concrete tasks. However, kids with ADHD are pretty doggone bright and are very resourceful at figuring out ways to manage if you just give them a chance."

According to NIMH, oftentimes when a child is diagnosed with ADHD, a parent will recognize that they have had many of the same ADHD symptoms since their own childhood. The individual has brought into adulthood many negative perceptions of him or herself that may have led to low self-esteem. A correct diagnosis of and treatment for ADHD can bring a sense of relief for everyone.

To view an NIMH booklet on ADHD, go to www.nimh.nih.gov/publicat/adhd.cfm.

--Published July 12, 2004