ADHD

ADHD stands for Attention Deficit Hyperactivity Disorder, a complex brain disorder that impacts approximately 11% of children. ADHD is a developmental impairment of the brain’s executive functions. People with ADHD have trouble with impulse-control, focusing, and organization.

Neuroscience, brain imaging, and clinical research tell us a few important things:

ADHD is not a behavior disorder. 

ADHD is not a mental illness. 

ADHD is not a specific learning disability.

ADHD is, instead, a developmental impairment of the brain’s self-management system. Both adults and children can be diagnosed with ADHD.

“Attention deficit” is, some experts assert, a misleading name. “Attention deregulation” might be a more accurate description since most people with ADHD have more than enough attention — they just can’t harness it in the right direction at the right time with any consistency. 

Individuals with ADHD tend to hyperfocus and lose track of time, misplace their keys, or blurt out an unrelated thought when their focus breaks free from its chains.

Many patients and clinicians describe ADHD as an iceberg, where most symptoms lay hiding under the surface — out of sight but ever present.

• Inattention
• Impulsive
• Impatient
• Lack of focus
• Poor time management
• Exaggerated emotions
• Hyperfocus
• Hyperactivity
• Executive dysfunction

ADHD symptoms vary by individual. Your child may experience all or just some of the above symptoms, along with others detailed in the DSM-V.

1.  Primarily Hyperactive-Impulsive ADHD

2. Primarily Inattentive ADHD (Formerly ADD)

Experts believe that many children with the inattentive subtype of ADHD may go undiagnosed because they do not tend to disrupt the learning environment.

3. Primarily Combined Type ADHD

Individuals with combined-type ADHD display a mixture of all the symptoms outlined below. A physician will diagnose patients with this Combined Type ADHD if they meet the guidelines for Primarily Inattentive ADHD and Primarily Hyperactive-Impulsive ADHD. That is, they must exhibit 6 of the 9 symptoms identified for each sub-type.

The symptoms of ADHD are spelled out in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), which lists nine symptoms that suggest ADHD–Primarily Inattentive and nine that suggest ADHD–Primarily Hyperactive/Impulsive. A child may be diagnosed with ADHD only if he or she exhibits at least six of nine symptoms from one of the lists below, and if the symptoms have been noticeable for at least six months in two or more settings — for example, at home and at school. What’s more, the symptoms must interfere with the child’s functioning or development, and at least some of the symptoms must have been apparent before age 12. Older teens and adults may need to consistently demonstrate just five of these symptoms in multiple settings.

9 Symptoms of ADHD – Primarily Inattentive Type:

• Overlooks details; makes careless mistakes in schoolwork.
• Difficulty sustaining attention in tasks, conversations, or lengthy reading.
• Does not seem to listen when spoken to directly; mind seems elsewhere.
• Does not follow through on instructions and fails to finish schoolwork and chores; starts tasks but quickly loses focus and is easily sidetracked.
• Difficulty organizing tasks and activities, managing sequential tasks, and keeping materials and belongings in order; messy, disorganized work; poor time management; fails to meet deadlines.
• Avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort such as schoolwork or homework.
• Loses things necessary for tasks or activities such as school materials, pencils, books, keys, eyeglasses, cell phones.
• Easily distracted by extraneous stimuli.
• Forgetful in daily activities such  as doing chores, running errands.

9 Symptoms of ADHD – Primarily Hyperactive-Impulsive Type:

• Fidgets, taps hands or feet or squirms in seat.
• Leaves seat in situations when remaining seated is expected such as in the classroom.
• Runs about or climbs in situations when it is inappropriate; feeling restless.
• Unable to play or engage in leisure activities quietly.
• Always “on the go,” acting as if “driven by a motor;” unable to be still for extended time, as in school or restaurants.
• Talks excessively.
• Blurts out an answer before a question has been completed; finishes people’s sentences.
• Difficulty waiting his or her turn while playing, waiting in line, or having a conversation.
• Interrupts or intrudes on others; butts into conversations, games, or activities; may start using other people’s things without permission.

According to the Centers for Disease Control and Prevention (CDC), 1 in 10 children between the age of 5 and 17 receive an ADHD diagnosis making ADHD one of the most common childhood neurodevelopmental disorders in the U.S.

The symptoms of ADHD are often identified at school, as many children with ADHD have difficulty succeeding in a classroom setting. While teachers cannot diagnose ADHD, they are often the first to suspect ADHD in children as the symptoms typically affect school performance or disrupt the rest of the class.

Many symptoms of ADHD can be typical childhood behaviors, so it can be difficult to know if a child is displaying ADHD symptoms. Children with primarily hyperactive-impulsive ADHD may initially be seen as disruptive or misbehaving, as they are often hyper, impulsive, impatient, and may interrupt at inappropriate times.

Boys are more than twice as likely as girls to receive an ADHD diagnosis in part because ADHD is still wrongly considered a male disorder and because boys are more likely than girls to exhibit outward signs of hyperactivity.

The causes of ADHD remain somewhat unclear. Research suggests that genetics and heredity play a large part in determining who gets ADHD. However, scientists are still investigating whether certain genes, especially ones linked to the neurotransmitter dopamine, play a defined role in developing ADHD. Additional research suggests that exposure to toxins and chemicals may increase a child’s risk of having ADHD. 

ADHD is not caused by bad parenting, too much sugar, or too many video games. ADHD is a brain-based, biological disorder. Brain imaging studies and other research show many physiological differences in the brains of individuals with ADHD. 

There is no single test for ADHD. To make a diagnosis, your doctor will assess for any ADHD symptoms exhibited by your child in the past six months. They will also do a physical exam and review your medical history to rule out any other medical or psychiatric conditions that could be causing symptoms. Your doctor or specialist may also review school records and questionnaires completed by your child’s teacher and/or caretakers. They will likely talk with and observe your child, as well as conduct screening for learning disabilities.

The best treatment strategies for ADHD are multimodal ones — combinations of several different, complementary approaches that work together to reduce symptoms. This ideal combination may include ADHD medication, nutrition, exercise, behavioral therapy, coaching, and practicing mindfulness. For children aged 6 and over, medication may be an important part of the treatment plan. ADHD medications can have many benefits, as well as side effects. The decision to manage ADHD symptoms with medication can be a difficult one. Finding the right medication to manage ADHD typically involves some trial and error but can lead to a significant reduction in symptoms.

(ADDitude. Sept. 2019. https://www.additudemag.com/what-is-adhd-symptoms-causes-treatments/)