What Is ADHD?
ADHD (also known as Attention-Deficit Hyperactivity Disorder) is characterized by excessive restlessness, inattention, distraction, and an impulsive nature that interferes with the person's daily life, and his or her ability to function in everyday activities.
This disorder is most often diagnosed in childhood, although it can be diagnosed in adults, as well. ADHD is one of the most common neurobehavioral disorders of childhood and may persist until adulthood. Children with ADHD may have trouble paying attention in school, controlling their impulsive behaviors, or be overly active.
It's been estimated that 3-5% of children have ADHD, although some researchers claim that number to be far higher.
Although the symptoms of ADHD may characterize all children at various times throughout their lives, it is the constant presence of multiple symptoms that helps to determine a professional diagnosis.
Adults who have ADHD may have difficulties organizing, managing time appropriately, setting goals, and keeping a job. In addition, adults with ADHD may have problems with low self-esteem, addiction, and relationships.
It's important to note that ADHD is not an adult-onset disorder, which means that an adult with ADHD likely exhibited symptoms of the disorder during childhood.
What Are The Types of ADHD?
There are three different types of ADHD, which depend entirely upon the strongest symptoms that are exhibited.
While many people still use the term ADD rather than ADHD, it's important to note that that this term is no longer in widespread use. People who have been diagnosed with ADD are now using current terminology (probably), called ADHD: Predominantly Inattentive Type.
The three types of ADHD are:
1) Predominately Inattentive Type: people with this form of ADHD have trouble with organizing, completing a task, paying attention to details, or following instructions or conversations. A person with this type of ADHD is very easily distracted and often forgets important parts of a daily routine.
2) Predominately Hyperactive-Impulsive Type: people with this form of ADHD are known to fidget or talk a lot. They have trouble sitting still for long, feels restless, may interrupt others while speaking, may grab things from others, or speak at inappropriate times. It's very hard for people with this type of ADHD to wait his or her turn or listen to directions. A person with this type of ADHD may have more injuries and accidents than others.
3) Combined Type: the symptoms of the above are combined in equal ratios for a person with ADHD.
What Causes ADHD?
The precise cause for ADHD is currently unknown, although studies are currently underway to figure out what, exactly, causes ADHD. Neurological differences in brain development and functioning have been found to be present in those with ADHD. The underlying reason for these differences is unknown; however, heredity and genetics has been identified as a contributing factor through studies of families. ADHD tends to run in families.
It is important to note that research has not shown that ADHD develops due to parenting styles or family problems, dietary choices, television exposure, or hormones.
Signs And Symptoms of ADHD in Children:
Symptoms can be broken down into three main categories: Inattention, Hyperactivity and Impulsiveness.
1) Inattention: For children who have ADHD, signs of inattention may include the following:
- Difficulty focusing
- Doesn't finish tasks or follow directions.
- Makes very careless mistakes
- Can't organize tasks easily
- Dislikes activities that require being still for a long period of time.
- Loses personal items often
- Unable to keep attention upon tasks at hand
- Difficulty staying organized
- Unable to resist distractions
- Unable to remember rules or instructions
- May deal with forgetfulness
- Needs longer amount of time to process or understand information
- Appears to not be listening when spoken to
2) Hyperactivity: Children who have ADHD may experience bursts of extreme energy and exhibit signs such as:
- Higher energy levels than peers
- Squirms, fidgets, bounces while sitting.
- Unable to sit when necessary
- Has problems playing quietly
- Is always moving - climbing on things, behaving restlessly
- Excessive talking
3) Impulsiveness: a child who has ADHD may experience bouts of impulsiveness, in which there is no consideration for the consequences of an action.
- Impatient in nature
- Makes inappropriate comments
- Interrupts others often
- Answers questions before they've been completed.
- Unable to wait or take turns
How Is ADHD Diagnosed?
If the symptoms listed above are present in a child, based upon parental or self-report, a doctor will begin an evaluation of the child, including a complete medical history and thorough physical examination to rule out any other underlying conditions. There are some mental illnesses that have similar symptoms to ADHD, so those must be ruled out before a proper diagnosis of ADHD can be made.
If there are no underlying physical or mental illnesses responsible for the symptoms, the child will likely be sent to a childhood development specialist who can properly diagnose and treat ADHD.
The criteria for a diagnosis of ADHD as listed in the DSM-IV include:
I. Either A or B:
A) Six or more of the following symptoms of inattention that have been present at least six months to a point that it is inappropriate for the child's developmental level:
- Often does not give close attention to details, or makes careless mistakes in homework or other activities.
- Often has trouble keeping attention on tasks or play activities.
- Often does not seem to listen when spoken to directly.
- Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (which are not caused by oppositional behaviors or inability to understand instructions).
- Often has trouble organizing activities.
- Often avoids, dislikes, or doesn't want to do things that take a lot of mental energy for long periods of time (homework).
- Often loses things that are needed to complete tasks and activities (school assignments, toys).
- Is often easily distracted.
- Is forgetful in daily activities.
B. Six or more of the following symptoms of hyperactivity-impulsiveness have been present for at least six months to an extent that it is disruptive and inappropriate for level of development.
- Often fidgets with hands or feet, squirms in seat when sitting still is expected.
- Often gets up from seat when remaining in seat is expected.
- Often runs about and climbs around when it is inappropriate.
- Often has trouble playing or doing leisure activities quietly.
- Is always "on the go"
- Often talks to excess.
- Often blurts out answers before the question has been finished.
- Has trouble waiting for his or her turn
- Often interrupts or intrudes upon others.
II. Some symptoms that cause impairment were present before age seven.
III. Some impairment of symptoms is present in two or more settings (work/home, school/home)
IV. Clear evidence of clinically significant impairment in school, social, or occupational functioning.
V. Symptoms are not better explained by another disorder.
How Is ADHD Treated?
Unfortunately, ADHD is not a disorder that can be cured, however, it can be managed with the proper medications and/or therapies.
Medications: There are a wide variety of medications that can help treat ADHD, but each case of ADHD must be diagnosed and treated by a physician because what works for one person will not necessarily work for another.
Medication is often tried, tested, and adjusted until type or dosage of medication is able to effectively help reduce the symptoms of ADHD.
Therapy: In addition to medication, there are also different types of therapy, such as behavior therapy, that can help to change and monitor behavior, as well as work on improving everyday tasks. Having structure, rules and routine has also been shown to help control negative behavior associated with ADHD.
Behavioral treatments such as these in combination with helping parents, teachers and other people who are often around someone with ADHD to understand the disorder and its effects have proven to be successful in helping to manage these behaviors.
Therapies that have shown promise for children with ADHD include:
Behavior Modification: behavior modification includes strategies for supporting positive behavior and decreasing the amount of problematic behaviors of a child with ADHD.
Psychotherapy: counseling can help a person with ADHD to learn to handle their emotions and frustrations in a more positive fashion, which can lead to increased self-esteem. Family counseling may help family members better understand ADHD.
Social Skills Training: children who undergo social skills training can help the child learn how to behave with his or her peers, such as sharing, taking turns, so that the child will function better in social situations.
Special education - this type of education is designed to meet the needs of the child him or herself. Children who have ADHD often benefit greatly from a highly structured environment and a predictable routine.
Support Groups: most support groups are comprised of people with similar needs and problems, which can help with acceptance and support from others. Support groups are also beneficial for those who want to learn more about coping with their disorder and management of ADHD.
What Is The Prognosis for ADHD?
It's vital that children and adults who have ADHD seek professional treatment and care for their disorder. Without proper treatment, ADHD can interfere with scholastic performance, social skills, and self-esteem. Children with ADHD are more apt to have a learning disorder.
Teens with ADHD are at greater risk for pregnancy, car accidents, alcohol use, and tobacco use.
Adults who have ADHD have problems with time management, interpersonal relationships, and employment.
However, if ADHD is properly treated, nearly 80% experience the relief of ADHD symptoms. Many of the symptoms of ADHD diminish - but don't disappear entirely - by early adulthood.
50% of children who have ADHD have problems with ADHD as an adult.
Can ADHD Be Prevented?
ADHD can neither be prevented or cured, but it is important to note that the earlier ADHD is diagnosed and treated, the better the child with ADHD is able to adjust to the disorder, and learn to focus, pay attention, develop personal strengths, and become productive, successful members of society.
Tips To Stay Organized For Childhood ADHD:
Keep the same routine every day, from wake-up time to bedtime. Include time for homework, outdoor play, and indoor activities. Keep the schedule on the refrigerator or on a bulletin board in the kitchen. Write changes on the schedule as far in advance as possible.
Organize everyday items. Have a place for everything, and keep everything in its place. This includes clothing, backpacks, and toys.
Use homework and notebook organizers. Use organizers for school material and supplies.
Stress to your child the importance of writing down assignments and bringing home the necessary books.
Be clear and consistent. Children with ADHD need consistent rules they can understand and follow.
Give praise or rewards when rules are followed. Children with ADHD often receive and expect criticism. Look for good behavior, and praise it.
ADHD In Adults:
ADHD is one of the most well-recognized developmental disorders among children, characterized by inattention, impulsiveness, and hyperactivity. About 60% of children who have ADHD continue to have these symptoms into adults. That means 4% of the adult US population or 8 million adults in the US have ADHD. However, only a few adults are identified or treated for adult ADHD.
Adults who have ADHD might have problems following directions, recalling information, concentrating, organizing tasks, or finishing work within the deadline. If left un-managed, these problems can lead to emotional, social, work, educational, and behavioral problems.
Common Behaviors Among Adults With Adult ADHD:
The following problems and behaviors may stem from ADHD or be related to adjustment difficulties. The following behaviors may range from mild to extreme, vary with the situation, or be present constantly. Certain adults with ADHD can concentrate upon activities they're interested or excited about, while others cannot focus under any circumstances:
- Low self-esteem
- Chronic lateness
- Problems keeping a job
- Problems controlling anger
- Substance use or addiction
- Poor organizational skills
- Low threshold for frustration
- Chronically bored
- Difficulty concentrating while reading
- Mood swings
- Relationship problems
Relationship Problems Linked To Adult ADHD: many of these problems will go away with proper treatment for adult ADHD.
Adults who have ADHD are more prone to:
- Have marital problems
- Multiple marriage
- Higher amounts of separation and divorce
Scholastic Impairments Linked To Adult ADHD:
Adults who have ADHD have a history of:
- Poor educational performance
- More frequent disciplinary problems
- Were underachievers
- Had to repeat a grade
- Dropped out of school
Social Impairments Linked to Adult ADHD:
Adults who have ADHD are more prone to:
- Be of a lower socioeconomic status
- Have driving violations - speeding, license suspension, car accidents
- Use and abuse narcotics
- Smoke cigarettes
- Report that they are psychologically maladjusted
Work Impairments Linked to Adult ADHD:
Adults who have ADHD are more prone to:
- Change jobs frequently
- Perform poorly at work
- Have less work achievements
How Is Adult ADHD Diagnosed?
ADHD is not an adult-onset disorder, so diagnosing adult ADHD will rely upon self-report of childhood behaviors, including old report cards, discussion with parents about their child's behavior, complete medical history, developmental history.
To rule out any other physical or mental illnesses, a doctor may also perform a physical examination, run laboratory blood tests, and have the person undergo psychological testing.
How Is Adult ADHD Treated?
Similar to treating ADHD in children, treatment of adult ADHD generally involves a combination of medication and therapies. Therapy for Adult ADHD may focus on the following:
- Increase self-esteem
- Relaxation techniques
- Stress management
- Organizational techniques
- Job coaching
- Family education
Tips For Living With Adult ADHD:
Adults who live with ADHD can benefit from organizational concepts as well as behavioral management strategies. The following are techniques to help adults who live with ADHD:
Take all medication as directed, for ADHD or other conditions. Missing doses or doubling the dose may cause negative side effects.
Control Yourself. If you're an impulsive person and often engage in activities you'll later regret, learn to manage the impulses. Count to ten or twenty, breathing slowly, rather than acting out.
Organize. Train yourself to be more organized. Some people find list-making to be helpful, while others do not. Use a daily planner, find some sticky notes and make notes around the house, and set an alarm to remind you to take your medication and do other tasks.
Minimize Distractions. Distractions are a part of daily life, but find ways to reduce the things that distract you. Turn off the television or music if you find that distracts you.
Find outlets for your energy. Rather than pretend you don't have extra energy, put that energy to good use. Clean your house. Take up a hobby.
Don't hesitate to ask for help. Everyone needs help sometimes; there's nothing to be ashamed of. When you're struggling, ask for help rather than trying to go it alone.
ADHD Support - Support and information for individuals and families dealing with ADHD.
National Resource Center on ADHD offers information and education on the disorder, including tips for coping with ADHD.
Attention Deficit Disorder Association aims to assist adults living with ADHD through education, networking opportunities, and advocacy efforts.
CHADD (Children and Adults with ADD) is a non-profit organization dedicated to helping parents, children, and adults with ADHD. The organization has local chapters and those using their services sign up for an annual membership for a small fee.
The National Center for Gender Issues and ADHD provides news, research, and resources specific to females with ADHD.
The CDC provides a wonderful ADHD resource page with research and statistics, articles, parenting tips, and educational materials.