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Children with ADHD have smaller brains

New research has further confirmed that the brains of people with ADHD are smaller, and the differences become clear by as young as four.  

Scientists have observed that, by the time they reach school-age, children with ADHD show distinct differences in the development and size of parts of their brains. 

The new study, conducted by Johns Hopkins University, however, showed that the four-year-olds already have less brain matter in the regions responsible for self-control.

Children involved in the study will be followed into adulthood in order to give scientists insight into exactly what changes happen when, and how they might determine the severity of a child’s struggle with the disorder. 

At as young as four years old, children with ADHD have less brain matter in the regions responsible for self control, a new study reveals

ADHD affects more American children than any other psychological or behavioral disorder, and the symptoms start early.   

Some may be diagnosed, according to their symptoms, at as young as four years old.  

But young children and toddlers – with out without ADHD – are in one of the most energetic, exploratory times of their lives.  

Some children with ADHD may be able to focus on something they particularly like, while others without the disorder may simply have more energy than others.  

The new study confirms that, by the time these symptoms become apparent, there are already distinct differences in the development of the brain of a child with ADHD. 

In 2016, the Centers for Disease Control and Prevention found that an alarming 75 percent of children diagnosed with ADHD were being treated for it with medication. 

Some studies have warned that these drugs may have risky side effects for the development of children’s brains and the functioning of their hearts. 

Others warn that children are over-medicated, but would benefit more from therapy, as many will ‘grow out of’ ADHD with time. 

On the other hand, children whose ADHD goes undiagnosed and untreated are more likely to struggle with school and, as adults, with work. Early detection and treatment have been shown to give these kids a better chance at success down the road. 

Knowing when differences in the physical make up of children’s brains – with our without ADHD – begin and when they become permanent may help families to understand what treatments are best, and when. 

In older children and adults, researchers have long studied the network of areas that are responsible for attention and learning, searching for these physical markers. 

The prefrontal cortex is the part of the brain that acts like a supervisor, checking our impulses and weighing potential consequences. 

Scans of older children’s brains have shown that the worse their outward ADHD symptoms are, the smaller this region – as well as the parts of the brain responsible for fine motor skills and interpreting sensory information – is. 

When most people concentrate on something, their the prefrontal cortex kicks into high gear. but in those with ADHD the opposite happens. 

These findings confirm what parents have known for a while – even in very young children, ADHD is a real biological condition with pronounced physical and cognitive manifestations

Dr Mark Mahone, lead study author, co-director of the Kennedy Krieger Institute department of neuropsychology

So for many of the 6.4 million children in the US with the disorder, the harder they try to focus, the more distracted they feel. 

The new National Institutes of Health (NIH)-funded study shows that, even in children as young as four, the size and structural abnormalities involved in this struggle have already become apparent.  

The researchers from the Kennedy Krieger Institute of Johns Hopkins took high resolution anatomical (MPRAGE) images of the brains of 90 children, half of whom had ADHD but were not medicated.

All of the children were between four and five years old, and, as the scientists monitored the development of their brains, they also observed their behavior. 

The children who had ADHD symptoms also had less gray matter in the areas of their brain that are meant to help them maintain self-control. 

‘These findings confirm what parents have known for a while – even in very young children, ADHD is a real biological condition with pronounced physical and cognitive manifestations,’ said lead study author Dr Mark Mahone. 

Uncovering the early appearance of these distinctions in the brain structures may eventually be key to treatment decisions and even prevention as scientists map the brain development of children with and without ADHD over time. 

The John Hopkins team will continue to track both the behavioral and anatomoical changes the group of kids in the study undergo as they grow into adolescence. 

‘Our hope is that by following these children from early on in life, we will be able to determine which early brain and behavioral signs are most associated with later difficulties, or even better, which aspects of early development can predict better outcome and recovery from the condition,’ said Dr Mahone. 

‘By understanding the brains of children who grow into the disorder as well as those who grow out of it, we can begin to implement targeted, preventative interventions in young children with the goal of reducing adverse outcomes or even reversing the course of this condition,’ he concluded.