What is ADHD?
Attention-deficit/hyperactivity disorder (ADHD) is one of the most common mental disorders affecting children. ADHD symptoms include:Inattention.Hyperactivity is excessive movement, which does not fit the context.Impulsivity: Hasty actions that are performed without thinking. Adults with ADHD can experience low self-esteem, increased self-criticism and sensitivity to criticism. This may be due to higher levels of criticism in their lives This page is devoted to children.Estimates show that 2.5% of adults and 8.4% of children have ADHD . ADHD is usually first diagnosed in children who are school-aged when there is disruption in the class or difficulty with schoolwork. Due to the differences in symptoms, it is more common among boys. This does not mean that boys are more prone to ADHD. Boys are more likely to show hyperactivity or other externalizing symptoms than girls.
Diagnosis and Symptoms
Children may have difficulty waiting for their turn, paying close attention, fidgeting and acting impulsively. Children who are diagnosed with ADHD have symptoms that are more severe than normal for their age and developmental level. These include hyperactivity, impulsivity, inattention, and organization. These symptoms can cause serious problems and suffering at home, in school, work and relationships. These symptoms are not caused by a person being defiant, or incapable of understanding tasks or instructions.
There are three types of ADHD:
A presentation that is primarily inattentive.
Predominantly hyperactive/impulsive presentation.
Combined presentation.
The diagnosis is made based on symptoms that persist over time, and have been noticeable in the last six months. ADHD is a disorder that can be diagnosed at any time, but it usually begins in childhood. The symptoms must be present and causing problems in more than just one place before the age of 12 to be considered for diagnosis. The symptoms may not occur only at home.
Inattentive type
Inattentive is a term used to describe difficulties with staying focused, organizing, and staying on task. This type of ADHD is diagnosed when six symptoms (or five if the individual is older than 17) are present frequently.
Makes careless errors or does not pay attention to detail in school or at work.
Needs assistance staying focused during activities or tasks, such as lectures, conversations or extended reading.
Doesn’t listen to you when you speak (i.e. seems to be somewhere else).
Doesn’t follow instructions or complete tasks (or may start but lose focus quickly).
Needs assistance in organizing work and tasks (for example, has a messy, unorganized work environment; misses deadlines).
Does not like or avoids doing tasks that require sustained mental efforts, such as writing reports and filling out forms.
You often lose things that you need for your daily life, like school papers, books and keys. Also, you may forget to take out your wallet, mobile phone or eyeglasses.
He easily gets distracted.
Do not forget daily tasks such as chores or errands. Adults and older teens may have to remember to pay bills, return phone calls and keep appointments.
Hyperactive/impulsive type
Hyperactivity is excessive movement such as fidgeting or excessive energy. It can also be described as not being able to sit still and talking excessively. Impulsivity is the act of making decisions or taking actions without considering their consequences. This type of ADHD is diagnosed when six symptoms (or five if the individual is older than 17) are present frequently.
Squirms or fidgets while sitting.
Need assistance to remain seated in a classroom or workplace.
Climbs or runs about in an inappropriate place.
Unable to play or do leisure activities quietly.
As if being driven by a motor,
Talks too much.
Has a tendency to blurt out an answer without waiting for the question to be finished.
Has trouble waiting for their turn, as when waiting in line.
Intrudes or interrupts others (for example, cutting into conversations, games or activities, or using other people’s items without permission). Adults and older teens may try to take over other people’s activities.
Combination type
Type 1 ADHD is diagnosed if the criteria of inattentiveness and hyperactivity/impulsivity are met.
ADHD is usually diagnosed by mental health professionals or primary care physicians. The psychiatric assessment will consist of a patient’s description of symptoms, completed questionnaires by caregivers and teachers, as well as a complete medical and psychiatric history. A referral to a medical evaluation may be made in order to rule out any other medical conditions.
The following conditions may mimic ADHD: learning disorders, mood disorders and anxiety, as well as head injuries, thyroid disorders and certain medications like steroids. ADHD can also coexist with other mental conditions such as conduct disorder, oppositional defiant disorders or conduct disorders, anxiety disorders and learning disorders (Austerman 2015). A complete psychiatric assessment is therefore essential. For ADHD, there are no routine blood tests or imaging. Patients may undergo additional psychological tests (such as psychoeducational or neuropsychological testing) or computer-based assessments to determine the severity of their symptoms.
Causes of ADHD
Scientists still haven’t identified the exact causes of ADHD. There is increasing evidence that genetics can contribute to ADHD. Several genes have been associated with the disorder. However, no particular gene or combination of genes has been identified. It is important to remember that many relatives of people with ADHD also suffer from the condition. Anatomical differences between children with ADHD and children without the disorder have been observed. Children with ADHD, for example, have a reduced volume of grey and white matter in the brain and show different activation patterns during certain tasks . Further studies have indicated that the frontal lobes, caudate nucleus, and cerebellar vermis of the brain are affected by ADHD (. Several non-genetic factors have also been linked to the disorder, such as low birth weight, premature birth, exposure to toxins (alcohol, smoking, lead, etc.) during pregnancy, and extreme stress.
Treatment
ADHD treatment usually encompasses a combination of therapy and medication intervention. The recommended first-line approach in preschool-age and younger children includes behavioral strategies in parent management training and school intervention. Parent-Child Interaction Therapy (PCIT) is an evidence-based therapy to help young children with ADHD and oppositional defiant disorder.According to current guidelines, psychostimulants (amphetamines and methylphenidate) are first-line pharmacological treatments for managing ADHD In preschool-aged patients with ADHD, amphetamines are the only FDA-approved medication, although guidelines suggest that methylphenidate rather than amphetamines may be helpful if behavioral interventions prove insufficient. Alpha agonists (clonidine and guanfacine) and the selective norepinephrine reuptake inhibitor atomoxetine are the other FDA-approved options for treating ADHD. There are newer FDA-approved medications for ADHD treatment, including Jornay (methylphenidate extended-release), which is taken at night and starts the medication effect the following day; Xelstrym (dextroamphetamine) which is an amphetamine patch; Qelbree (viloxazine) which is a non-stimulant, Adhansia (methylphenidate hydrochloride), Dyanavel (amphetamine extended-release oral suspension), Mydayis (mixed salts amphetamine product), and Cotempla (methylphenidate extended-release orally disintegrating tablets).Many children and families can alternate between various medication options depending on the efficacy of treatment and tolerability of the medication. The goal of treatment is to improve symptoms to restore functioning at home and school.
ADHD and School-Aged Children
Teachers and school staff can provide parents and doctors with information to help evaluate behavior and learning problems and assist with behavioral training. However, school staff cannot diagnose ADHD, make treatment decisions, or require that a student take medication to attend school. Only parents and guardians can make those decisions with the child’s healthcare clinician.Students whose ADHD impairs their learning may qualify for special education under the Individuals with Disabilities Education Act or for a Section 504 plan (for children who do not require special education) under the Rehabilitation Act of 1973. Children with ADHD can benefit from study skills instruction, changes to the classroom setup, alternative teaching techniques, and a modified curriculum.
ADHD and Adults
Many children diagnosed with ADHD will continue to meet the criteria for the disorder later in life and may show impairments requiring ongoing treatment (Pliszka, 2007). However, sometimes a diagnosis of ADHD is missed during childhood. Many adults with ADHD do not realize they have the disorder. A comprehensive evaluation typically includes a review of past and current symptoms, a medical exam and history, and the use of adult rating scales or checklists. Adults with ADHD are treated with medication, psychotherapy, or a combination. BehaviorManagement strategies, such as minimizing distractions, increasing structure and organization, and support from immediate family members, can also be helpful.ADHD is a protected disability under the Rehabilitation Act of 1973 and the Americans with Disabilities Act (ADA). This means that institutions receiving federal funding cannot discriminate against those with disabilities. Individuals whose symptoms of ADHD cause impairment in the work setting may qualify for reasonable work accommodations under the ADA.
Related Conditions
Autism spectrum disorder
Social communication disorder
Specific learning disorder