ADHD

Attention Defecit Hyperactivity Disorder (ADHD) FAQ's

ADHD is a disorder that is characterized by a persistent and developmentally inappropriate pattern of hyperactivity/impulsivity and/or inattention.  How having this condition will affect a particular person is complicated, depending on many variables including their intellectual and academic abilities, personality traits, and family structure, as well as their level of insight and willingness to participate in treatment.  Hyperactivity can include being fidgety, being over-talkative, having trouble staying seated, or appearing like they are in  “perpetual motion.”  Impulsivity means such behaviors as calling out in class, not “thinking before acting,” and being  “accident prone.”  Inattentiveness may be seen in appearing extremely distractible, having difficulty concentrating on priorities, or being “spacey,” or  “daydreaming,” and often loosing track of what is happening around them.

ADHD impacts an estimated 8% of children between the ages of 4 and 17, as well as many adults.  There has, however, recently been some heightened concern that this condition is being over-diagnosed and over-treated.

Although finding the exact cause of ADHD in a particular person is beyond reach at present, research has shown that this condition tends to appear more often in certain families; therefore there are likely some genetic components to the development of this condition.  Additionally, lower than normal overall brain activity and smaller than normal size of certain neurological structures have been potentially linked to ADHD.  However, this absolutely does not necessarily mean that one or both parents- or any other relative- is “at fault” if a child has ADHD.

ADHD is a true condition, which is outlined in the Diagnostic and Statistical Manual of Mental Disorders.  However, it is best not to consider ADHD as an excuse to avoid taking responsibility for one’s actions or to justify negative behaviors or lack of achievement.  Many, many famous and highly accomplished people have ADHD.

Technically, in order to receive a diagnosis of ADHD, symptoms must be present before the age of seven. However, many individuals are diagnosed after symptoms have been present for many years.  Having as early a diagnosis of ADHD as possible is often a key to successful interventions.  Nevertheless, some parents are reluctant to pursue a diagnosis; fearful of their child being stigmatized or hoping they will eventually “grow out of it.”

Children with ADHD are often described as having problems in “executive functioning” as well as a “sluggish cognitive tempos.” Thus, abilities to plan, organize, and follow through on tasks to completion are often significantly below expectations.  Social immaturity is also often found among children with ADHD.  Having ADHD makes succeeding in school more challenging.  They often have trouble completing their homework, or remembering to turn it in.

ADHD is four to nine times more common in boys than in girls until adulthood at which point rates for males and females start to equalize more.  Girls with ADHD are more likely to be more inattentive than impulsive and hyperactive.  Unfortunately, this also means that they are more likely than boys to “fall between the cracks” and not be identified and receive help as early as possible.

There is no one definitive diagnostic test for ADHD.  ADHD is most effectively diagnosed after completing a comprehensive series of cognitive and neuropsychological tests, and combining these findings with a thorough clinical evaluation and behavioral observations across settings, including home and school.  It is important not to jump to a diagnosis of ADHD too quickly, as there are many other problems, conditions, and medical issues that can appear like ADHD at first glance.  For instance, a child that has been traumatized or is undergoing a great deal of stress within their family can seem like they have ADHD when they do not.

Many conditions are known to co-occur and inter-twine with ADHD including, but not limited to; Oppositional Defiant Disorder, Mood Disorders, Anxiety Disorders, Obsessive-Compulsive Disorder, Learning and Communication Disorders, and Tourette’s Disorder/Tic Disorders.  Sometimes these other conditions are triggered by or exacerbated by ADHD.

Very commonly, ADHD is treated with stimulant or non-stimulant medications, most often prescribed by pediatricians, however, especially when there are complicating emotional or behavior factors, by neurologists or psychiatrists.  However, many behavioral health experts question the use of these medications, no matter how seemingly effective, in the absence of other interventions, including individual counseling, cognitive-behavioral therapy (CBT), family therapy, and educational guidance.  Early over-reliance on medications may make some children more prone to misusing or abusing other substances later in their lives.  Additionally, the pros and cons of using medications always need to be expertly weighed against side effects, like negative effects on sleep or appetite, or other potential adverse effects on long-term health.

While this is always a decision that ultimately must be made by the child’s parents, telling a child’s school about an ADHD diagnosis may help the school to better understand the child’s needs and allow them to provide any necessary special services, like medication monitoring, accommodations for any associated learning issues, or behavioral interventions.  Making educators more aware can also reduce the potential for a child’s ADHD being confused with oppositional or defiant behavior or lack of interest or motivation.

With timely, consistent, and effective treatment the outcomes for children with ADHD can be greatly improved.  Also, in general ADHD SX can start to wane in later teenage or young adult years.  However, perhaps as many as 60% of children diagnosed with ADHD will continue to have at least some symptoms of this condition present into adulthood.  In fact, looking at their present and past difficulties, and seeking an explanation, is a common reason why adults might seek diagnosis and treatment. The way ADHD appears in adults can differ greatly from how it presents in children.  They are often prone to a variety of problems, including difficulties with substances, managing their finances, maintaining appropriate relationships/sexual behavior, and functioning effectively in the workplace.  In recent years, the problem of adult ADHD has received more focus, as it became clear that so many people had not received the proper diagnosis when they were younger.  Diagnosing adult ADHD can be very complicated, especially if sufficient early developmental, medical, and educational data is not available.  Treating adult ADHD is complex as well, one particular issue being that the medications that might have helped when they were children might not now be appropriate.