ADHD: Attention Deficit Hyperactivity Disorder
Basic Information

(ADHD) Attention Deficit Hyperactivity Disorder Online Resources

The purpose of this paper is to provide a detailed description of Attention Deficit Hyperactivity Disorder (ADHD), its causes, symptoms and treatments. ADHD is a neurological disorder that develops during childhood and can persist into adulthood. Although adult ADHD is more common than initially thought, not all children who have these symptoms will go on to have the adult version of the disorder. Childhood symptoms may also change across the lifespan; some fade (e.g., blatant hyperactivity) while others may be expressed differently (e.g., chronic disorganization may result in getting fired from jobs). Because ADHD often "looks" different in kids and adults, the adult version of the disorder will be discussed in its own section later in the paper.

ADHD is one of the most common childhood disorders. Approximately 3-7% of school-aged children have the disorder. Prevalence rates seem to vary by community, with some research indicating that larger cities may have ...

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What is ADHD?

  • Attention Deficit Hyperactivity Disorder (ADHD) is a non-curable neurological disorder that develops during childhood and that can persist into adulthood.
  • It creates information processing challenges among those individuals affected by it. In other words, those with ADHD think differently and, at times, less clearly than other people without ADHD.
  • ADHD is one of the most common childhood disorders.
  • Approximately 3-7% of school-aged children have the disorder.
  • ADHD develops in childhood, with at least some symptoms present prior to age 7.
  • ADHD has always been considered a children's disorder, but increasingly in the last 25 years, adults have been diagnosed and medicated for this problem.
  • This disorder cannot appear suddenly in adults. If an adult is newly diagnosed with ADHD, the condition is viewed as the adult component of a childhood disorder that was never diagnosed.
  • Estimates of children whose symptoms continue into adulthood range up to 60%.
  • Prevalence rates for adults with ADHD are not as clear as they are for children, but estimates suggest that 1 to 5% of American adults have some form of the disorder.

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For more information about ADHD in Adulthood

What are the symptoms of ADHD?

Common symptoms of ADHD in children include:

  • Failure to pay attention or a failure to retain learned information
  • Fidgeting or restless behavior
  • Excessive activity or talking
  • The appearance of being physically driven or compelled to constantly move
  • Inability to sit quietly, even when motivated to do so
  • Engaging in activity without thinking before hand
  • Constantly interrupting or changing the subject
  • Poor peer relationships
  • Difficulty sustaining focused attention
  • Distractibility
  • Forgetfulness or absentmindedness
  • Continual impatience
  • Low frustration tolerance
  • When focused attention is required, it is experienced as unpleasant
  • Frequent shifts from one activity to another
  • Careless or messy approach to assignments or tasks
  • Failure to complete activities
  • Difficulty organizing or prioritizing activities or possessions

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Common symptoms of ADHD in adults include:

  • A history of poor school performance - lower grades, criticism from teachers, as well as parents, and sometimes, the need to repeat a grade.
  • Career difficulties - problems with concentration and task completion that affect school performance continue to be problems in a job setting.
  • Adults with ADHD will likely benefit from predictable, consistent work routines, flexible deadlines, and projects that allow for creative involvement. One surprising research finding regarding this group is that they appear to be more likely to own their own small business.
  • As a result of various ongoing problems, adults with untreated ADHD tend to have a lower socioeconomic status, and money is often a serious concern. Frequent job changes and poor job performance may leave the finances of many ADHD adults in disarray.
  • Individuals with adult ADHD may appear as one of two extremes: withdrawn and antisocial, preferring to spend their time alone; or overly social and unable to easily endure even brief periods of solitude.
  • Relationships of all kinds are difficult for the adult with ADHD. Impulsive comments and behaviors in combination with a notoriously short temper can cause extreme problems.

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What are the causes of ADHD?

  • The exact cause of ADHD is not yet known.
  • Research suggests that ADHD is primarily a brain-based disorder that is either present at birth, or that develops early on in childhood.
  • Environmental factors can play a role in increasing the severity of a person's symptoms, but the environment does not seem to be the primary cause of the disorder.
  • Genes play a powerful role in the development of symptoms found in ADHD. The estimated heritability (the proportion of variance in a trait that can be attributed to genetics) of ADHD ranges from 75 to 91%.
  • Studies suggest that people with ADHD have brains that are about 4% smaller than normal. The reduction in size occurs in areas of the brain that could produce the symptoms seen in ADHD.

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How is ADHD diagnosed?

Diagnosing ADHD in Children:

  • The first step is to make an appointment with a child psychiatrist, psychologist, developmental/behavioral pediatrician, behavioral neurologist, or clinical social worker who is trained to recognize the symptoms and pattern of onset with ADHD.
  • Although a pediatrician or general medical practitioner is often consulted first when families or individuals are seeking help, it is important to remember that these individuals are trained in medicine and do not typically have expertise in psychological disorders.
  • A medical evaluation to rule out other possible medical causes for the symptoms can be an important first step in the diagnostic process.
  • Self-report instruments are commonly used to help identify ADHD in both children and adults. Self-report instruments are generally a series of questions to which a person responds about their own symptoms, thoughts, and feelings.
  • Further steps of the process will also include the professional interviewing the parents and teachers, as well as the child before a final diagnosis can be made.

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Diagnosing ADHD in Adults:

  • Diagnostic criteria for ADHD in adults are identical to those for children.
  • Clinicians must first verify the presence of ADHD symptoms in childhood by administering questionnaires and gathering a developmental history consistent with ADHD that would include evidence of problems with peers; problems such as bed wetting, school failure, and suspensions; and special interventions such as sitting in front of the class, etc.
  • A physical exam may be done to rule out medical or other causes for the symptoms (e.g., hyperthyroidism, hearing loss, bipolar disorder, substance abuse, depression, etc).
  • Brain scans or brain imaging techniques (e.g., EEG, CT, or MRI) may be done to rule out brain abnormalities (that are not consistent with ADHD).
  • Psychoeducational testing (e.g., IQ tests and/or achievement tests) may be done if a learning disability or other cognitive deficit is suspected.

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What are the common treatments for ADHD?

Common treatments for ADHD in Childhood:

  • The largest study to date of ADHD treatment found that combining medication and psychosocial interventions is the best strategy for helping individuals deal with their symptoms.
  • Psychosocial interventions are ones that relates to the child's psychological development in, and interaction with their social environment.
  • Stimulant medications are usually the first line of treatment. These drugs are not a cure for ADHD. Instead, they can help minimize the negative impact of ADHD symptoms on an individual's life.
  • Ritalin is the most common medication prescribed for ADHD.
  • Techniques such as changing the environment to reinforce (increase) desirable behaviors while punishing (diminishing) undesirable behaviors are a common treatment method that is used at home and in school settings. This generally involves both teachers and parents immediately praising the child's efforts to use appropriate social skills and also providing an immediate negative consequence for aggressive behaviors.
  • Parent and child education, individual therapy, and family therapy, can also be used to treat ADHD.

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Common Treatments for ADHD in Adulthood:

  • As with treating ADHD in children, the combination of medication and other psychotherapeutic strategies produces the most positive outcome.
  • Almost 70% of adults with ADHD benefit from stimulant medication treatment.
  • Adults may benefit from a different medication dosing schedule. For example, adults may use medications to relax in the evening, instead of using them to increase focus during the day.
  • Longer-acting medications tend to be more effective with adults, because many individuals forget to take the second or third dose of the day.
  • The most successful psychotherapeutic strategies for adult ADHD are based on cognitive behavioral theories (CBT), and will focus on changing unhelpful thoughts and increasing positive thoughts regarding oneself and the future.
  • Adults with ADHD will also likely need therapy to address other specific issues such as employment problems and difficulties in family and interpersonal relationships.
  • Group therapy can often be extremely helpful for addressing interpersonal skills deficits.

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How can I help a child with ADHD at home and school?

  • Remember, ADHD is not the child's fault, and rather than assign blame, parents must provide support and encouragement as children struggle to improve their self-management skills.
  • Maintain a positive attitude, and a sense of humor can decrease the likelihood that the child will respond negatively to parental requests.
  • Manage the child in positive ways, to encourage them to use their assets and strengths to their advantage, and to guide them to achieve their potential.
  • Children with ADHD, even those with high intelligence, typically do less well than their peers in school. Often, ADHD symptoms lead to other associated problems that may result in the resentment of both school and authority figures in general.
  • A child with ADHD may tend to perform better in certain extracurricular activities such as individual sports (e.g., martial arts, swimming, golf, biking, etc) rather than team sports (e.g., soccer, baseball).

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What are some ways to live with ADHD as an adult?

  • Learn techniques to control impulsive behavior.
  • Minimize distractions when trying to focus.
  • Find constructive outlets (e.g., scheduling regular physical exercise) for nervous energy and feelings of restlessness.
  • Maintain a sense of humor to avoid becoming discouraged or increasingly depressed.
  • Avoid, reduce, or eliminate alcohol or drug use altogether. This can create a mental state that is more conducive to learning and change.
  • Make a commitment to adhere to treatment recommendations (both medication and psychotherapy), finish tasks and improve organization.
  • Enlist a friend or family member to help finish tasks, remember important details and commitments. This person can also provide feedback which can help the individual manage the new demands and changes in his or her life.
  • Ask for help, when needed.
  • Appreciate the support given by family and friends.

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