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This week we respond to questions about lice and ADHD.

Dear HOUSE Calls,    

My daughter went to summer camp and they told me that there had been a lice outbreak.  How will I know she has lice? What should I do? Are there any organic treatments?

Lice is very common. If your daughter gets them, you will probably first notice her itching her scalp – a lot. Inspect her hair and scalp, if she has lice, you will probably see nits. The nits look like a tiny grain of sand adhering to the hair shaft near the scalp. You may even see some lice jumping. Take a deep breath and stay calm!

The mainstay of treatment is shampoo containing permethrin (Nix) or pyrethrum extract (Rid). These will kill the lice and interrupt the life cycle. The products come with a fine tooth come to remove the nits. We recommend you wash bedding and hats in hot water, run hair brushes through the dishwasher, and seal up stuffed animals in a plastic bag for 2 weeks.  You may need to re-treat in 7-10 days.

All of these interventions work fairly well, but re-infection is common.  These critters run rampant in classrooms. Many schools have a ‘no nit’ policy. Unfortunately, this does not prevent spread, and results in absenteeism.

As to your last question, there are a few organic options that may help.  Coating the hair and scalp in Vaseline or Listerine will kill live lice (leave on for an hour). Also, coconut scented shampoo and tea tree oil are lice repellants. Good luck!

Dear HOUSE Calls,    

I think that my child has ADHD. How do I know for sure? How is ADHD best treated?

Those are great questions. Attention deficit hyperactivity disorder (ADHD) is quite common, affecting about 7 percent of children. Predominant symptoms are trouble sitting still, acting on impulses, and difficulty paying attention.  Your child’s family doctor can help you evaluate this concern.

There are specific criteria that doctors use to diagnose ADHD.  To make an accurate diagnosis, your doctor should want to gather feedback from caregivers and/or teachers in more than one setting, usually using standardized rating scales. A careful history, including a family history can be helpful. Also understanding the child’s social environment is important. Sometimes difficulty at home can lead to acting out which is easy to confuse with impulsivity. An interview with the child and a physical exam are key ingredients to the evaluation. The doctor will want to consider other psychiatric conditions (e.g. depression and anxiety) as well as medical conditions (e.g. lead poisoning, thyroid conditions, etc.)

The two most common treatment strategies are medications, usually stimulants like Ritalin, and behavioral therapy. Behavioral therapy often comes in the form of individual and family therapy, academic skills training, and in-classroom academic support.  It is key to work with your child’s teacher on establishing a diagnosis and treatment planning.  Good luck.

HOUSE Calls is a weekly column by Dr. Adam Zolotor, Dr. Adam Goldstein, and Dr. Cristy Page on behalf of YOUR HEALTH and the UNC Department of Family Medicine.

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