Attention Deficit Hyperactivity Disorder

Attention Deficit Hyperactivity Disorder

Attention Deficit Hyperactivity Disorder

Attention Deficit Hyperactivity Disorder (ADHD) is a behavioral disorder characterized by:

  • Inattention – unable to sustain focus, disorganized, lacking in focus, walks away from incomplete tasks
  • Hyperactivity  – constantly moving, fidgety in inappropriate situations, lacking patience  – constantly moving, fidgety in inappropriate situations, lacking patience
  • Impulsivity – doing reckless, socially intrusive, and spur-of-the-moment things without considering consequences

Symptoms of ADHD can be mistaken for emotional problems or bad behavior, and this can lead to a delay in diagnosis. However, a number of situations can contribute to a child not getting the attention they need. In cases like this, the child may act out, but it is not the same as having ADHD.

Prevalence

Most cases of ADHD are diagnosed between the ages of 6 and 12. The symptoms of ADHD usually settle with age; however, they can persist into adulthood. ADHD can also develop in adulthood in people who did not experience symptoms in early life.

Symptoms of Attention Deficit Hyperactivity Disorder (ADHD):

A lack of focus, nonstop movement, and constantly being impulsive are hallmark ADHD behaviors, and most children with the disorder exhibit a combination of these behaviors. In preschool children, hyperactivity is seen more often than inattention and impulsivity.


Symptoms of Inattention

Children with ADHD might:

  • Lack organization with personal belongings – frequently lose items required for school like books, pencils, or handouts
  • Appear to not listen when spoken to
  • Have time management issues – forget to go to class, do chores, get groceries, respond to texts or calls, attend meetings or appointments
  • Exhibit trouble staying focused while playing, in class, reading, listening to a teacher, or when in a conversation
  • Fail to follow through all required steps to complete an assignment, like homework
  • Get derailed from responsibilities or activities because of minor distractions
  • Have trouble organizing tasks that have priorities or a required sequence
  • Exhibit a strong dislike for, or avoidance of, activities like homework, filling out reports, etc., where patience, focus, and attention to detail are required

Symptoms of Impulsivity

  • Interrupt others in conversations they are a part of, and other people’s conversations
  • Impatience with themselves and others
  • Trouble waiting their turn
  • Propensity to continually answer before the question is finished
  • Say or do things at inappropriate times

Symptoms of Hyperactivity
Hyperactive children with ADHD:

  • Fidget with hands or items
  • Squirm or constantly move when required to sit; or get up to walk around, climb, or run around in settings where that activity is not appropriate
  • Talk nonstop
  • Are unable to participate in activities quietly
  • Ongoing repetition of phrases, words, or actions because of impatience while organizing thoughts

Adults with undiagnosed ADHD may have a history of poor academic performance, problems at work, or difficult or failed relationships. While periods of lack of focus, hyperactivity, and impulsivity could be considered normal in most people, they are less frequent, less severe, and do not have a profound impact on the individual’s job or studies.

Many theories abound as to what makes children hyperactive. For example, a popular but scientifically unproven theory suggests that sugar leads to hyperactivity.

Diagnosing Attention Deficit Hyperactivity Disorder:

The diagnosis of ADHD requires a wide-ranging evaluation by a licensed pediatrician, psychologist, or psychiatrist with expertise in ADHD, and the administration of authorized scales and questionnaires. As part of the diagnosis, all other medical and psychiatric conditions will be ruled out as causes for the symptoms.

For a person to receive a diagnosis of ADHD, the symptoms of inattention and/or hyperactivity-impulsivity must:

  • Be chronic or long lasting
  • Impair the person’s functioning
  • Cause the person to fall behind normal developmental milestones for his or her age

Most children will be diagnosed during their elementary school years — signs often appear between the ages of three and six years old. As the years progress, the symptoms can and often do change. Generally, the hyperactivity along with the impulsivity are particularly dominant in younger children, while later in adolescence, the inattention symptoms will be more evident, along with some of the impulsivity.

Diagnosing adults
Diagnosing an adult or adolescent with ADHD can be done when the symptoms were present before the age of twelve. Many times, what is mistaken for discipline or emotional issues are actually symptoms of ADHD, which can remain undiagnosed until much later in compliant and obedient children. Relationship issues, issues in school, problems at work, etc. could all be symptoms in an undiagnosed adult.

Treatment for Attention Deficit Hyperactivity Disorder:

There is no cure for ADHD, but some of the following treatments can help reduce symptoms and improve functioning:

  • Medication – The primary category of ADHD medications includes stimulants or nonstimulants. It is often a case of trying a number of medications to see which is best suited to the child and their condition.

    • Stimulants such as methylphenidate target the central nervous system (CNS) and improve a child’s focus and concentration by increasing the levels of dopamine and norepinephrine in the brain. The reason why different stimulants are “tried out” is to see which one has the fewest side effects. Possible side effects from CNS stimulants include: increased levels of anxiety, depression, restlessness, irritability, problems sleeping, weight loss, facial tics, hyperventilation, increased heart rate, shaking, irritability, manic behavior, panic attacks, hallucinations, suicidal thoughts, and more.
    • Nonstimulants are often considered if there are undesirable side effects or a lack of anticipated progress with stimulants. Nonstimulants can increase both the child’s memory and attention through increasing levels of norepinephrine in the brain or lowering blood pressure and blood flow. Both options are approved for children between the ages of 6 and 17, and they are often prescribed for adults too. Possible side effects of nonstimulant ADHD medications include reduced appetite, fatigue, dizziness, mood swings, liver problems, skin reactions, low blood pressure, and suicidal thoughts.
  • Talk therapy – ADHD therapeutic treatment options include behavior therapy, psychotherapy, support groups, and social skills training.

    • Behavior therapy – teaches the child to be conscious of their behaviors and how to make adjustments to their responses and behaviors. Part of this treatment requires the child and caregivers — parent/s and maybe a teacher — to create individual response strategies for particular situations.
    • Psychotherapy – is a vehicle to enable children with ADHD to open up about their feelings about their diagnosis and how ADHD affects their friendships and interactions with adults. This helps children develop habits of making good choices and finding ways to better navigate relationships, especially when other members of the family are working through this with them.
    • Parental support groups – Through sharing experiences and hearing about other parents’ successes, challenges, and strategies, parents can feel less alone in their parenting efforts. The earlier parents can avail of a support group, the better — it improves their capability to handle any challenges and to be a more supportive and understanding parent.
    • Social skills training – Because the relational impact of ADHD can be severe, social skills training is designed to teach useful skills or behaviors for relational interactions — during playtime when they are younger, and in academic settings and the workplace as adults. Skills taught often include learning how to seek out assistance, how to share items, how to handle teasing, and how to wait until it is their turn to speak or do something.
  • Psychoeducation – information and support for both those diagnosed with ADHD and their loved ones. Described as an evidence-based intervention, its goal is to enable the family unit to have more understanding about the condition and to help them cope with it.
  • Parental skills training – Provides resources parents can use to help their children with ADHD. Training can include learning about:

    • Ambiguity – making conversation specific, clear, and brief when providing guidance, setting rules, or asking questions.
    • Choices – reducing options down to two to help the child feel less overwhelmed
    • Discipline – Responding calmly and gently and being consistent
    • Distractions – creating a distraction-free or low-distraction environment, and getting siblings’ support in implementing this
    • Health – healthy diet, exercise, enough sleep, and a range of activities
    • Opportunities – focusing more on strengths and talents than behavior
    • Organization – ways to add structure to daily living like organizing clothes and schoolbooks
    • Planning – breaking tasks down into more bite-sized, singular activities
    • Positivity – using positive reinforcement to highlight everything good
    • Rewards – establishing realistic goals with small, clear steps, and consistently giving rewards every time those goals are reached and documenting them
    • Scheduling – creating structure and routine such as a consistent bedtime, wakeup time, and mealtimes. Be sure to schedule time just to be together and to do fun things.

Risk Factors for Attention Deficit Hyperactivity Disorder:

Exact causes of ADHD are not known. Circumstances that might increase the likelihood of developing ADHD are:

  • Premature birth
  • Exposure to toxins like lead-based paint
  • Males are more likely to be diagnosed with ADHD
  • Smoking cigarettes, and/or substance abuse of alcohol or drugs, by the mother during pregnancy
  • If the mother has high blood pressure
  • Close blood relatives with ADHD or a different mental health condition
  • Exposure to pesticides
  • Head / brain injuries
 

Symptoms of Attention Deficit Hyperactivity Disorder (ADHD):

A lack of focus, nonstop movement, and constantly being impulsive are hallmark ADHD behaviors, and most children with the disorder exhibit a combination of these behaviors. In preschool children, hyperactivity is seen more often than inattention and impulsivity.


Symptoms of Inattention

Children with ADHD might:

  • Lack organization with personal belongings – frequently lose items required for school like books, pencils, or handouts
  • Appear to not listen when spoken to
  • Have time management issues – forget to go to class, do chores, get groceries, respond to texts or calls, attend meetings or appointments
  • Exhibit trouble staying focused while playing, in class, reading, listening to a teacher, or when in a conversation
  • Fail to follow through all required steps to complete an assignment, like homework
  • Get derailed from responsibilities or activities because of minor distractions
  • Have trouble organizing tasks that have priorities or a required sequence
  • Exhibit a strong dislike for, or avoidance of, activities like homework, filling out reports, etc., where patience, focus, and attention to detail are required

Symptoms of Impulsivity

  • Interrupt others in conversations they are a part of, and other people’s conversations
  • Impatience with themselves and others
  • Trouble waiting their turn
  • Propensity to continually answer before the question is finished
  • Say or do things at inappropriate times

Symptoms of Hyperactivity
Hyperactive children with ADHD:

  • Fidget with hands or items
  • Squirm or constantly move when required to sit; or get up to walk around, climb, or run around in settings where that activity is not appropriate
  • Talk nonstop
  • Are unable to participate in activities quietly
  • Ongoing repetition of phrases, words, or actions because of impatience while organizing thoughts

Adults with undiagnosed ADHD may have a history of poor academic performance, problems at work, or difficult or failed relationships. While periods of lack of focus, hyperactivity, and impulsivity could be considered normal in most people, they are less frequent, less severe, and do not have a profound impact on the individual’s job or studies.

Many theories abound as to what makes children hyperactive. For example, a popular but scientifically unproven theory suggests that sugar leads to hyperactivity.

 

Diagnosing Attention Deficit Hyperactivity Disorder:

The diagnosis of ADHD requires a wide-ranging evaluation by a licensed pediatrician, psychologist, or psychiatrist with expertise in ADHD, and the administration of authorized scales and questionnaires. As part of the diagnosis, all other medical and psychiatric conditions will be ruled out as causes for the symptoms.

For a person to receive a diagnosis of ADHD, the symptoms of inattention and/or hyperactivity-impulsivity must:

  • Be chronic or long lasting
  • Impair the person’s functioning
  • Cause the person to fall behind normal developmental milestones for his or her age

Most children will be diagnosed during their elementary school years — signs often appear between the ages of three and six years old. As the years progress, the symptoms can and often do change. Generally, the hyperactivity along with the impulsivity are particularly dominant in younger children, while later in adolescence, the inattention symptoms will be more evident, along with some of the impulsivity.

Diagnosing adults
Diagnosing an adult or adolescent with ADHD can be done when the symptoms were present before the age of twelve. Many times, what is mistaken for discipline or emotional issues are actually symptoms of ADHD, which can remain undiagnosed until much later in compliant and obedient children. Relationship issues, issues in school, problems at work, etc. could all be symptoms in an undiagnosed adult.

 

Treatment for Attention Deficit Hyperactivity Disorder:

There is no cure for ADHD, but some of the following treatments can help reduce symptoms and improve functioning:

  • Medication – The primary category of ADHD medications includes stimulants or nonstimulants. It is often a case of trying a number of medications to see which is best suited to the child and their condition.

    • Stimulants such as methylphenidate target the central nervous system (CNS) and improve a child’s focus and concentration by increasing the levels of dopamine and norepinephrine in the brain. The reason why different stimulants are “tried out” is to see which one has the fewest side effects. Possible side effects from CNS stimulants include: increased levels of anxiety, depression, restlessness, irritability, problems sleeping, weight loss, facial tics, hyperventilation, increased heart rate, shaking, irritability, manic behavior, panic attacks, hallucinations, suicidal thoughts, and more.
    • Nonstimulants are often considered if there are undesirable side effects or a lack of anticipated progress with stimulants. Nonstimulants can increase both the child’s memory and attention through increasing levels of norepinephrine in the brain or lowering blood pressure and blood flow. Both options are approved for children between the ages of 6 and 17, and they are often prescribed for adults too. Possible side effects of nonstimulant ADHD medications include reduced appetite, fatigue, dizziness, mood swings, liver problems, skin reactions, low blood pressure, and suicidal thoughts.
  • Talk therapy – ADHD therapeutic treatment options include behavior therapy, psychotherapy, support groups, and social skills training.

    • Behavior therapy – teaches the child to be conscious of their behaviors and how to make adjustments to their responses and behaviors. Part of this treatment requires the child and caregivers — parent/s and maybe a teacher — to create individual response strategies for particular situations.
    • Psychotherapy – is a vehicle to enable children with ADHD to open up about their feelings about their diagnosis and how ADHD affects their friendships and interactions with adults. This helps children develop habits of making good choices and finding ways to better navigate relationships, especially when other members of the family are working through this with them.
    • Parental support groups – Through sharing experiences and hearing about other parents’ successes, challenges, and strategies, parents can feel less alone in their parenting efforts. The earlier parents can avail of a support group, the better — it improves their capability to handle any challenges and to be a more supportive and understanding parent.
    • Social skills training – Because the relational impact of ADHD can be severe, social skills training is designed to teach useful skills or behaviors for relational interactions — during playtime when they are younger, and in academic settings and the workplace as adults. Skills taught often include learning how to seek out assistance, how to share items, how to handle teasing, and how to wait until it is their turn to speak or do something.
  • Psychoeducation – information and support for both those diagnosed with ADHD and their loved ones. Described as an evidence-based intervention, its goal is to enable the family unit to have more understanding about the condition and to help them cope with it.
  • Parental skills training – Provides resources parents can use to help their children with ADHD. Training can include learning about:

    • Ambiguity – making conversation specific, clear, and brief when providing guidance, setting rules, or asking questions.
    • Choices – reducing options down to two to help the child feel less overwhelmed
    • Discipline – Responding calmly and gently and being consistent
    • Distractions – creating a distraction-free or low-distraction environment, and getting siblings’ support in implementing this
    • Health – healthy diet, exercise, enough sleep, and a range of activities
    • Opportunities – focusing more on strengths and talents than behavior
    • Organization – ways to add structure to daily living like organizing clothes and schoolbooks
    • Planning – breaking tasks down into more bite-sized, singular activities
    • Positivity – using positive reinforcement to highlight everything good
    • Rewards – establishing realistic goals with small, clear steps, and consistently giving rewards every time those goals are reached and documenting them
    • Scheduling – creating structure and routine such as a consistent bedtime, wakeup time, and mealtimes. Be sure to schedule time just to be together and to do fun things.
 

Risk Factors for Attention Deficit Hyperactivity Disorder:

Exact causes of ADHD are not known. Circumstances that might increase the likelihood of developing ADHD are:

  • Premature birth
  • Exposure to toxins like lead-based paint
  • Males are more likely to be diagnosed with ADHD
  • Smoking cigarettes, and/or substance abuse of alcohol or drugs, by the mother during pregnancy
  • If the mother has high blood pressure
  • Close blood relatives with ADHD or a different mental health condition
  • Exposure to pesticides
  • Head / brain injuries