Attention-Deficit/Hyperactivity Disorder (ADHD): What You Need to Know

As part of National ADD/ADHD Awareness Month in October, myths about Attention Deficit Disorder and Attention Deficit Hyperactivity Disorder will be dispelled and the facts about these disorders will be shared.

In spite of the fact that most children who suffer from either ADD or ADHD first exhibit symptoms between 3 and 7 years, many do not receive a diagnosis. Misdiagnosis occurs in others as well.

ADHD is a condition that affects both children and adults. According to various sources (CDC, add.org, addrc.org), ADHD can be caused by a variety of factors. In some cases, brain injury and environmental exposure are listed as causes. However, other sources dispute these claims. Genetics, however, is universally acknowledged.

Most people with ADD or ADHD receive therapy and medication in conjunction with their diagnosis. It is possible for some people to require medication throughout their lives. In some cases, however, symptoms may be managed without medication in adulthood depending on severity.

What is ADHD?

In the U.S., approximately 11% of children and almost 5% of adults suffer from attention deficit hyperactivity disorder. There is a developmental impairment in executive functions of the brain that results in ADHD. Those with ADHD have difficulty controlling their impulses, focusing, and organizing their activities.

There is no behavior disorder associated with ADHD, as indicated by neuroscience, brain imaging, and clinical research. A person with ADHD does not have a mental illness. Also, the disorder is not a specific form of learning disability. Rather, ADHD is a neurological impairment related to the brain's self-management system. A child or an adult can be diagnosed with ADHD.

What are the Symptoms of ADHD?

Symptoms associated with ADHD include:

• Inattention. Not being able to pay attention.

• Hyperactivity. An excessive amount of energy or excessive moving and talking.

• Impulsivity. Taking action without thinking or having difficulty controlling oneself.

There are some people with ADHD who mainly suffer from inattention symptoms. There are others who suffer from hyperactivity-impulsivity symptoms. Both types of symptoms may be present in some individuals.

Signs of inattention may include:

• Schoolwork or other activities are not completed carefully or mistakes are made carelessly.

• A difficult time sustaining attention during play and tasks, including conversations and tests.

• Inability to pay attention when directly spoken to.

• Having difficulty following directions, completing schoolwork or chores on time, getting sidetracked easily, or losing focus during tasks.

• Trouble organizing tasks and activities, like doing things in sequence, keeping things in order, and managing time.

• Avoiding mental labor-intensive tasks.

• Misplacing or losing items that are necessary for tasks or activities, such as school supplies, books, eyeglasses, keys, and cellphones

• An ability to easily be distracted by unrelated stimuli or thoughts.

• Forgetting daily tasks, chores, errands, and appointments.

Signs of hyperactivity and impulsivity may include:

• A tendency to fidget or squirm when seated.

• Having extreme restlessness, trouble sitting still for long periods, and/or wearing others out with their activities

• Not being able to play or engage in leisure activities quietly.

• Moving constantly or acting as if driven by a motor and/or constantly on the move.

• Excessive talking.

• Answering a question before it has been asked or finishing the sentence of another person.

• When standing in line, having difficulty waiting for one's turn.

• Taking over another's conversation, game, or activity without their permission.

The symptoms of ADHD vary from person to person. All or some of these symptoms may be experienced by you or your child.

How is ADHD is Diagnosed in Children and Teens?

With the help of diagnostic guidelines from the American Academy of Pediatrics and the Diagnostic and Statistical Manual of Mental Disorders (DSM), health care professionals such as pediatricians, psychiatrists, and child psychologists can diagnose ADHD.

In addition to your health plan, your child's teacher or school counselor, parents of ADHD children, or nonprofits such as CHADD (Children and Adults with Attention-Deficit/Hyperactivity Disorder) can help you find a professional who specializes in ADHD diagnosis.

Several sources are consulted in the diagnosis process, including schools, caregivers, and parents. In order to document these behaviors, a health care professional may use standardized rating scales to compare a child's behavior with that of other children of the same age.

Your child should undergo a comprehensive physical exam, including vision and hearing tests, before being diagnosed with ADHD. Additionally, the FDA has approved the Neuropsychiatric EEG-Based Assessment Aid (NEBA) System, which measures theta and beta brain waves noninvasively. Among children and adolescents with ADHD, the theta/beta ratio is higher than in children without ADHD. As part of a complete medical and psychological evaluation, the scan is approved for use in children aged 6 to 17.

A child's evaluation may also include interviews with you, teachers, and other adults who have a great deal of influence on your child. Your child's behavior could be rated on standardized forms called "behavior rating scales" by the evaluator.

It is possible to use these scales later on in the treatment process to monitor progress.

In order to check for other conditions that might affect a child's behavior, the health care professional should take a complete medical history. The following conditions can mimic ADHD or trigger ADHD-like behaviors:

• Significant life changes, such as a divorce, death in the family, or moving recently.

• Seizures that are not detected.

• Issues related to the thyroid.

• Problems with sleeping.

• Suffering from anxiety and/or depression.

• Toxicity from lead.

ADHD is not necessarily present in every child, even if they exhibit some of its symptoms. In order to be diagnosed with ADHD, these behaviors must be persistent for at least 6 months, some symptoms must have begun before the age of 12, symptoms must be present in more than one setting (such as at school and home), and the symptoms must have a significant impact on the child in more than two places (school, social life, etc.).

How is ADHD is Diagnosed in Adults?

Diagnoses of ADHD in adults are difficult for health care professionals. It is possible for adults to recognize the symptoms of ADHD in themselves when their children are diagnosed with it. In other instances, they seek professional help for depression, anxiety, or other symptoms and discover that they have ADHD.

Aside from inattention and impulsivity, adults with ADHD may also experience:

• A tendency to be late and forgetful all the time

• A lack of organizational skills

• Having difficulty finishing a task.

• Inability to control behavior due to unthinking and immediate responses.

• Restlessness

• Anxiety

• Low self-esteem

• Problems with employment

Adults may experience emotional, social, occupational, and academic difficulties if these difficulties are not managed appropriately.

Symptoms associated with ADHD must date back to childhood for an adult to be diagnosed. Up to half of children with ADHD continue to experience ADHD symptoms into adulthood. In order to make an accurate diagnosis, it is recommended that you:

• Childhood behavior of the adult

• Interviews with the adult's partner, parents, close friends, or other close associates

• Physical examination including neurological testing

• A psychological evaluation

What are the Treatments for ADHD?

Current treatments may reduce symptoms and improve functioning even though ADHD has no cure. The most common treatment for ADHD is medication, education or training, therapy, or a combination of these.

Medication

The most common type of medication used to treat ADHD is stimulants. The effectiveness of these medications has been proven by research. A health care provider should monitor how an individual is reacting to the medication since all medications can have side effects.

Additionally, non-stimulant medications are available. Although the FDA has not approved antidepressants specifically for treating ADHD, doctors sometimes prescribe them to treat children and adults with the disorder. The best medication or dosage may need to be tried several times before an individual finds what works.

Psychotherapy and Psychosocial Interventions

Psychosocial interventions have been shown to improve everyday functioning for children and adults. When ADHD is co-occurring with depression or anxiety, therapy is especially beneficial.

• Therapy aimed at changing a person's behavior is called behavioral therapy. One could receive practical assistance, such as help organizing tasks or finishing schoolwork, learn social skills, or monitor one's own behavior and receive praise or rewards for exhibiting the desired behavior.

• By working on skills to improve focus and awareness, cognitive behavioral therapy helps individuals deal with attention and concentration challenges.

• It can be helpful for family members to learn how to handle disruptive behavior, encourage behavior changes, and to improve their interactions with their children through family and marital therapy.

A parent's active participation is essential in all types of therapy for children and teens with ADHD. In order to manage ADHD symptoms and behavior, parenting sessions alone are not effective (without parent involvement). Anxiety and depression symptoms may be treated more effectively with this type of treatment.

Why is ADHD Awareness Month Important?

People with ADHD often feel stigmatized because of the myth that ADHD is "not a real disorder." Our collective efforts can help break through this stigma. In the right environment and with the right treatment, people with ADHD are able to live a happy and successful life.

“Because ADHD has a range of presentations and a wide range of severity, ADHD is often difficult to understand,” says CHADD CEO Bob Cattoi. “The key is to understand that it is a neurodevelopmental issue. There are resources to help individuals affected by ADHD and those who support them. We’re here to help them move beyond the self-criticism that is often associated with ADHD, and to appreciate the strengths—creativity, curiosity, generosity—that individuals with ADHD bring to our society.”

How to Observe ADHD Awareness Month

For starters, discover the difference between ADD and ADHD. Also, understand that we all struggle to concentrate sometimes. It doesn't mean we have attention deficit disorder or hyperactivity disorder.

It is possible, however, to test for this condition if you or your child are experiencing persistent or severe symptoms. Remember, there are a variety of resources available for help. To learn more, visit add.org or addrc.org to learn more.

We also need to dispel the myth that children with ADD and ADHD are just looking for attention or misbehaving. There is a difference in the wiring in their brains. In the classroom, at home, and in everyday life, share coping skills and ways to help children.

In order for the public to understand ADHD on a human level, the American Deficit Disorder Association invites people with ADHD to share their stories. By sharing their stories, those who have been challenged by stigma can reduce it.