What Is Attention-Deficit/ Hyperactivity Disorder?
Attention-deficit/hyperactivity disorder (ADHD) is an illness characterized by inattention, hyperactivity, and impulsivity. The most commonly diagnosed behavior disorder in young persons, ADHD affects an estimated three percent to five percent of school-age children.
Although ADHD is usually diagnosed in childhood, it is not a disorder limited to children-ADHD often persists into adolescence and adulthood and is frequently not diagnosed until later years. Those with the predominantly inattentive type often: fail to pay close attention to details or make careless mistakes in schoolwork, work, or other activities; have difficulty sustaining attention to tasks or leisure activities; do not seem to listen when spoken to directly; do not follow through on instructions and fail to finish schoolwork, chores, or duties in the workplace; have difficulty organizing tasks and activities; avoid, dislike, or are reluctant to engage in tasks that require sustained mental effort; lose things necessary for tasks or activities; are easily distracted by extraneous stimuli; are forgetful in daily activities.
Those with the predominantly hyperactive/impulsive types often fidget with their hands or feet or squirm in their seat; leave their seat in situations in which remaining seating is expected; move excessively or feel restless during situations in which such behavior is inappropriate; have difficulty engaging in leisure activities quietly; are “on the go” or act as if “driven by a motor”; talk excessively; blurt out answers before questions have been completed; have difficulty awaiting their turn; interrupt or intrude on others .
Those with the combined type, the most common type of ADHD, have a combination of the inattentive and hyperactive impulsive symptoms.
What is needed to make a diagnosis of ADHD?
A diagnosis of ADHD is made when an individual displays at least six symptoms from either of the above lists, with some symptoms having started before age seven. Clear impairment in at least two settings, such as home and school or work, must also exist. Additionally, there must be clear evidence of clinically significant impairment in social, academic, or occupational functioning behavior.
What Causes ADHD?
First of all, it is important to realize that ADHD is not caused by dysfunctional parenting, and those with ADHD do not merely lack intelligence or discipline.
Strong scientific evidence supports the conclusion that ADHD is a biologically based disorder. Recently, National Institute of Mental Health researchers using PET scans have observed significantly lower metabolic activity in regions of the brain controlling attention, social judgment, and movement in those with ADHD than in those without the disorder. Biological studies also suggest that children with ADHD may have lower levels of the neurotransmitter dopamine in critical regions of the brain.
Other theories suggest that cigarette, alcohol, and drug use during pregnancy or exposure to environmental toxins such as lead may be linked to the development of ADHD. Research also suggests a genetic basis to ADHD-the disorder tends to run in families.
While early theories suggested that ADHD may be caused by minor head injuries or brain damage resulting from infections or complications at birth, research found this hypothesis to lack substantial supportive evidence. Furthermore, scientific studies have not verified dietary factors, another widely discussed possible influence for the development of ADHD, as a main cause of the disorder.
Stimulants are the most widely used drugs for treating attention- deficit/ hyperactivity disorder. The four most commonly used stimulants are methylphenidate (Ritalin), dextroamphetamine (Dexedrine, Desoxyn), amphetamine and dextroamphetamine (Adderal ) and Pemoline (Cylert).
These drugs increase activity in parts of the brain that are underactive in those with ADHD, improving attention and reducing impulsiveness, hyperactivity and/or aggressive behavior. Antidepressants, major tranquilizers, and the antihypertensive clonidine (Catapres) have also proven helpful in some cases. Some common side effects of stimulant medications include weight loss, decreased appetite, trouble sleeping, and, in children, a temporary slowness in growth; however, these reactions can often be controlled by dosage adjustments. Medication has proven effective in the short-term treatment of more than 76 percent of individuals with ADHD.
Treatment strategies such as rewarding positive behavior changes and communicating clear expectations of those with ADHD have also proven effective. Additionally, it is extremely important for family members and teachers or employers to remain patient and understanding.
Children with ADHD can additionally benefit from caregivers paying close attention to their progress, adapting classroom environments to accommodate their needs, and using positive reinforcers.