Adhd
ADHD stands for Attention deficit hyperactivity disorder. ADHD is one of the most common neurodevelopmental disorders affecting children. It’s a condition that causes trouble paying attention, hyperactivity, and impulsive behavior. It is often first recognized in early childhood, and the symptoms of ADHD usually improve with age, but many adults who were diagnosed with the condition at a young age continue to experience problems.
| Author: | Doctor Anny Palencia |
| Reviewed by: | Ana Codallo, CTO |
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ADHD can affect a child's thinking, performance in school, behavior, feelings, and relationships with others, and it often continues into adulthood. Additionally, it is more commonly diagnosed among boys than girls, not because boys are more likely to have ADHD but because they tend to present with hyperactivity and girls with inactivity.
Aside from the typical symptoms of hyperactivity/impulsivity and inattention, people with ADHD may also have problems such as sleep, anxiety, and mood disorders.
Looking after a child with ADHD can be difficult, but parents, caregivers, and teachers must remember that these children cannot help their behavior.
ADHD Symptoms
ADHD has two categories of core symptoms: hyperactivity/impulsivity and inattention.
Hyperactive and impulsive symptoms typically are observed by the time the child is four years old and increase during the next three to four years, peaking in severity at seven to eight years old. Some of these symptoms include excessive fidgetiness (e.g., tapping the hands or feet), difficulty remaining seated when sitting is required, feelings of restlessness (in adolescents) or inappropriate running around or climbing in younger children, problem playing quietly, excessive talking, difficulty waiting for turns, blurting out answers too quickly, interruption or intrusion of others, among others.
Inattention symptoms tend only to be evident once the child is eight to nine years old. These include failure to provide close attention to detail, difficulty maintaining attention in play, school, or home activities, seeming like they’re not listening, failure to follow through (e.g., homework), difficulty organizing tasks, activities, and belongings, avoiding tasks that require consistent mental effort, loses things, easily distracted, among others.
Symptoms of ADHD in adults are different from those in children. At this stage, the symptoms are more characterized by inattention, impulsiveness, restlessness, executive dysfunction, and emotional dysregulation. Symptoms of hyperactivity or impulsivity are less evident than those of inattention in adults.
An impairment in function in academic, social, or occupational activities is necessary to be able to diagnose ADHD. For example, children with inattention may have difficulty attending to social cues needed for effective social interaction, making it difficult to form friendships.
Types of ADHD
Predominantly inattentive
The predominantly inattentive subtype of ADHD is difficulty focusing, following instructions, organizing, and staying on task. These children frequently appear to be daydreaming. Some experts believe many of these cases are underdiagnosed because these children don’t tend to disrupt the learning environment. Some of the symptoms are:
- Doesn’t pay close attention to detail or makes careless mistakes
- Has problems staying focused on tasks or activities
- They don’t seem to listen when spoken to
- Does not follow through on instructions and doesn’t complete schoolwork, chores, or job duties (may start tasks but quickly loses focus)
- Has problems organizing tasks and work (for instance, does not manage time well)
- Avoids or dislikes tasks that require sustained mental effort
- Often loses things
- Is easily distracted
- Forgets daily tasks
Predominantly hyperactive-impulsive type
Children with a predominantly hyperactive-impulsive subtype of ADHD are unable to sit still, have excessive energy, and fidget. Symptoms that occur frequently are:
- Fidgets with or taps hands or feet, or squirms in seat
- Not able to stay seated (in the classroom, workplace)
- Runs about or climbs where it is inappropriate
- Unable to play or do leisure activities quietly
- Constantly “on the go,” as if driven by a motor
- Talks too much
- Blurts out an answer before the teacher finishes the question
- Has difficulty waiting for their turn
- Interrupts or intrudes on others
Combined hyperactive-impulsive and inattentive type
Doctors diagnose this type of ADHD when the criteria for both inattentive and hyperactive/impulse types are met. They must exhibit six of the nine symptoms identified for each sub-type to make the diagnosis.
What Causes ADHD?
The exact cause of ADHD is unknown, but there are certain factors that scientists believe contribute to its development. There is evidence of a change in the brain structure of people diagnosed with ADHD. However, no single area of the brain is different in all patients with this condition. Genetics also seem to have an important role to play, but scientists have not identified a specific gene as the culprit. And finally, some non-genetic factors are likely involved, such as low birth weight, premature birth (before the 37th week of pregnancy), and smoking, alcohol, or drug abuse during pregnancy.
ADHD Diagnosis and Testing
Doctors should initiate the evaluation for ADHD in children ≥4 years old who have symptoms of inattention, hyperactivity, or impulsivity or who have complaints frequently associated with ADHD; it includes comprehensive medical, developmental, educational, and psychosocial assessments, and it might require several office visits.
The doctor will do a thorough medical history and a basic physical examination, conduct a behavioral assessment and history and ask parents and teachers to complete a behavior rating scale. Teachers can have an essential role in the diagnosis.
Aside from the assessment done by the physician, the American Psychiatric Association has a defined set of criteria for diagnosing ADHD. They publish them in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). For children <17 years ≥6 symptoms of hyperactivity and impulsivity or≥6 symptoms of inattention are required. For adolescents ≥17 years and adults, ≥5 symptoms of hyperactivity and impulsivity or ≥5 symptoms of inattention are required.
ADHD Treatment
Most experts agree that unrecognized and untreated ADHD can have serious negative consequences. Treatment can help a child have better relationships, perform better in school and follow the rules.
There are two types of treatment: cognitive-behavioral therapy and medication. The best treatment is usually a combination of both. Parent-Child Interaction Therapy (PCIT) is an evidence-based therapy to help young children with ADHD and oppositional defiant disorder.
ADHD medication
Psychostimulants (amphetamines and methylphenidate) are first-line pharmacological treatments for managing ADHD. There are many new FDA-approved medications of this type. Clonidine, guanfacine, and atomoxetine are the other FDA-approved options for treating ADHD.
Children can have varying degrees of tolerability and efficacy with all of the above options, so it can be a good idea to alternate between them. The ultimate goal is to improve symptoms and restore appropriate function in the child’s life.
ADD vs. ADHD
Both are essentially the same thing. ADD, or attention deficit disorder is simply an outdated name for ADHD and is typically used to describe inattentive-type ADHD. ADHD is the official medical term for the condition.
Adults and ADHD
ADHD in adulthood is associated with significant impairment in occupational, academic, and social functioning. One of three things happens regarding ADHD in adults:
- Children diagnosed with ADHD continue to meet the criteria for the disorder later in life.
- The diagnosis went unrecognized by parents, teachers, and physicians during childhood.
- They never had it during childhood and present symptoms for the first time as adults.
Adults with ADHD have higher rates of occupational difficulties (such as unemployment), criminal activity, substance abuse problems, traffic accidents, and motor vehicle citations than adults without ADHD. They also seem to have a higher mortality rate, with accidents being the most common cause of death.
Many adults with ADHD do not realize they have the disorder. A physician, usually a psychiatrist, does a comprehensive evaluation, including a review of past and current symptoms, a medical exam and history, and uses adult rating scales or checklists. Like in children, treatment includes therapy, medication, or a combination.
Coexisting Conditions
It’s critical to recognize that ADHD can present with several coexisting conditions. Many of them are related to mental health problems affecting children and adults. These include mood disorders like depression, anxiety, and substance use disorders. Many use substances to cope with the symptoms they experience from having ADHD, leading to substance abuse. Compared to the general population, suicide is more common in people with ADHD.
ADHD is not inherently a learning disability. However, 20 to 50% of children with ADHD have a learning disorder and may have difficulty with performance in school. It’s a good idea to consult with the child's teacher or school counselor if they have difficulty with reading, spelling, or arithmetic.
Benefits of ADHD
Even though ADHD can have negative consequences if left untreated, recognizing the strengths of people with ADHD is also essential. They can be energetic, spontaneous, hyperfocused, creative, and innovative. Several studies have shown that adults with ADHD tend to be out-of-the-box thinkers. They might even be better during a crisis than an average person. A recent study found that the ADHD brain produces more Theta waves than the average brain; these waves indicate a state of deep relaxation.
Sometimes, all a person with ADHD needs is some assistance to harness these traits and use them to their benefit. Of course, the most crucial first step is recognizing that a child, adolescent, or adult has or could have ADHD and providing proper treatment.
Dr. Stephen v Faraone: KOL #1 for Adhd
According to KOL's technology, Dr. Stephen V Faraone is the top ranking Key Opinion Leader (worldwide) for Adhd. You can see Dr. Stephen V Faraone's KOL resume and other concepts for which they rank #1 worldwide.
Stephen Vincent Faraone (born July 27, 1956) is an American psychologist. He has worked mainly on attention-deficit hyperactivity disorder and related disorders and is considered one of the most influential psychologists in the world.
Faraone graduated in 1978 from the State University of New York at Stony Brook with a BA in Psychology. He then went to the University of Iowa where he obtained his Master of Arts and Doctor of Philosophy. Faraone completed a postdoctoral clinical psychology internship and a research fellowship at Brown University.
Biography courtesy of: https://www.upstate.edu/psych/faculty.php?empID=faraones
Who are the top experts researching treatments for adhd?
The top experts researching adhd are: Hannah L. R. Checkley, Yan Huang and Yan-Yan Liu.
What are the top concepts researched in studies about adhd?
The most researched concepts in studies of adhd are: ADHD, ADD, adhd symptoms and adhd children.
What are some of the top places that specialize in adhd?
Recommended institutions that specialize in adhd:
- Mind Health Institute, Pasadena200 E Del Mar Blvd Suite 200, Pasadena, CA 91105 Phone: +16267233099
- Dr. Melissa Welby99 Cherry St unit d, Milford, CT 06460 Phone: +12039066294
- The London Psychiatry Centre72 Harley St, London W1G 7HG, United Kingdom Phone: +442075804224
- Yamamotoaki Mental ClinicYamamotoaki Mental Clinic Phone: +81332300002
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