ADHD: The Basics


ADHD


Written by Corry Hawkins, Clinical Director for KPS


Attention-Deficit/Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder, often diagnosed in childhood. Some children grow out of ADHD as they age, while others continue to experience symptoms in adulthood. While all children struggle to pay attention or control their impulses, children with ADHD struggle almost constantly. This can be exhausting and frustrating for the child, their parents, their friends, and their teachers.


Risk Factors


Causes and risk factors of ADHD are still uncertain, although it is strongly believed to be influenced by genetics. It is generally accepted that an ADHD brain does not function quite like a neurotypical brain. The front of the brain, responsible for regulation and impulse control, tends to be smaller and lacking in certain chemicals in children and adults with ADHD. This results in the symptoms of inattention and hyperactivity described below.


There are some risk factors associated with the development of ADHD, such as brain injury or the exposure of a child in utero to substances such as lead, alcohol, and tobacco. Premature delivery and low birth weight are also often correlated with the development of ADHD.


Symptoms


Symptoms of ADHD can vary depending on the individual and other social and environmental factors. There is often some confusion for people about the differences between “ADD” and “ADHD.” However, these are generic terms that don’t always clearly describe the diagnosis you or your child may have.


There are three subtypes of an Attention-Deficit/Hyperactivity Disorder diagnosis: (1) Inattentive, (2) hyperactive/impulsive, and (3) combined. The symptoms of each type are described below. Please keep in mind that these symptoms only indicate the presence of ADHD if they are developmentally inappropriate and if other possible explanations for those symptoms have been ruled out. For instance, anxiety and ADHD share many symptoms, and many children with a history of trauma present with concentration and behavioral problems.


Predominantly Inattentive Type: Individuals with this set of ADHD symptoms have difficulty paying attention and are easily distracted, especially at school or when doing things that don’t hold their interest. Adults may wonder if children have a hearing problem because they don’t appear to hear instructions the first time.


This subtype of ADHD includes children who present with 6 or more of the following, or adolescents and adults with 5 or more of the following symptoms:

  • Overlooks, makes careless mistakes, or misses details

  • Struggles to sustain attention, such as remaining focused in conversation or reading

  • Does not seem to listen when spoken to directly

  • Does not follow through on instructions and fails to finish tasks

  • Has difficulty organizing tasks and activities, including problems keeping belongings in order and poor time management

  • Avoids or dislikes tasks that require sustained mental effort

  • Loses things necessary for tasks or activities

  • Easily distracted by extraneous stimuli

  • Often forgetful in daily activities

Predominantly Hyperactive/Impulsive Type: Individuals who are predominantly hyperactive or impulsive struggle to stay put, blurt out answers or interrupt others, and often get in trouble for unintentional behaviors.


This subtype of ADHD includes children who present with 6 or more of the following, or adolescents and adults with 5 or more of the following symptoms:

  • Fidgets with hands or feet, or squirms in seat

  • Leaves seat in situations when remaining seated is expected

  • Runs or climbs in situations were it is inappropriate

  • Struggles to play or engage in leisure activities quietly

  • Seems “on the go” or acts as if “driven by a motor”

  • Talks excessively

  • Blurts out answers before a question has been completed

  • Has difficulty waiting his or her turn

  • Interrupts or intrudes on others or uses their property without asking permission

Combined Presentation: Children with combined symptoms exhibit 6 or more inattentive symptoms and 6 or more hyperactive/impulsive symptoms. They struggle with paying attention, focusing, staying still, and impulsive behaviors.


Treatment


Due to the problems experienced in the front of the brain, children with ADHD are more likely to have co-occurring behavioral disorders and develop anxiety or depression in childhood. Learning disorders and difficulties with social skills are also common. It’s important to have a thorough psychiatric or psychological evaluation to assess the need for medication and therapy to treat both symptoms of ADHD and any related concerns.


Typically, it is recommended that children under the age of 6 receive behavior therapy with additional support and training for parents. After 6 years old, a combination of medication (if deemed appropriate by the child’s medical provider) and behavioral therapy is generally best. Many also decide to also support themselves or their children with changes in lifestyle, as this can support brain development and overall functioning. For example, adequate amounts of sleep and exercise may improve focus and attention. A healthy diet supports a developing child and emotional regulation. Work with your physician or your child’s pediatrician to determine the best steps.


What’s Next?


It is best to talk with your physician or make an appointment for a psychological evaluation if you have concerns about you or your child. A proper ADHD evaluation will involve more than asking you to complete a simple checklist. Working with your medical providers can help you decide where to start.


It’s important to remember that an ADHD brain is not broken, just different. People with ADHD tend to be highly creative, fast thinkers, and engaging. Thinking differently has never stopped anyone from achieving their dreams. Understanding how your brain works is just the first step!


References

Centers for Disease Control and Prevention. (2021, September 23). What is ADHD? Centers for Disease Control and Prevention. Retrieved February 4, 2022, from https://www.cdc.gov/ncbddd/adhd/facts.html

“Attention-Deficit/Hyperactivity Disorder (ADHD).” National Institute of Mental Health, U.S. Department of Health and Human Services, https://www.nimh.nih.gov/health/statistics/attention-deficit-hyperactivity-disorder-adhd.

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