Attention-deficit/hyperactivity disorder, or ADHD, is a chronic condition that affects millions of children and adults. The problems caused by ADHD are persistent and include difficulty paying attention, being overactive, or exhibiting impulsive behavior. October is a time to learn more about ADHD and discover resources that may help you or your child manage the disorder.
What Is ADHD?
ADHD is a common neurodevelopmental disorder usually first diagnosed in childhood and often lasting into adulthood. The Centers for Disease Control and Prevention (CDC) estimates that 6.1 million children have ever been diagnosed with ADHD. Children experiencing ADHD may be hyperactive and have difficulty paying attention and controlling impulsive behaviors.
The signs and symptoms of ADHD in children include:
- daydreaming a lot
- forgetting things or losing them often
- squirming or fidgeting
- talking too much
- making careless mistakes or taking unnecessary risks
- having a hard time resisting temptation
- having trouble taking turns
- having difficulty getting along with others
Types of ADHD
The three main types of ADHD are:
- Mainly impulsive-hyperactive: A person with impulsive-hyperactive ADHD fidgets a lot, talks a lot, and has a hard time sitting still for long. Smaller children feel restless and display a need to run, jump, or climb constantly. Impulsivity is a problem, and the person may interrupt others often, grab things from others, or speak at awkward times. A person with impulsiveness has difficulty waiting for his or her turn or listening to directions and can experience more accidents and injuries than other people their age.
- Mainly inattentive: In this type of ADHD, it is hard for the individual to stay on task or finish a task, pay attention to details, or follow verbal or written instructions and conversations. Inattentive people are easily distracted and forget details of daily routines.
- Combined: Symptoms of both impulsive-hyperactive and inattentive behaviors are present.
There is no single test to determine if a child has ADHD. Rather, a process of several steps needs to be taken for an accurate diagnosis. A family history, an interview, and a medical exam, including hearing and vision tests, are needed to rule out other problems whose symptoms are similar to ADHD’s, such as depression, anxiety, sleep problems, and learning disabilities.
According to the Diagnostic and Statistical Manual of Mental Health, 5th Edition (DSM-5), for someone to be diagnosed with ADHD, six or more symptoms of inattention and/or hyperactivity and impulsivity need to be present in children up to age 16 and five or more symptoms of each need to be present in people age 17 or older.
The DSM-5’s list of symptoms for inattention includes:
- Often failing to give close attention to details or making careless mistakes in schoolwork, at work, or in other activities
- Often having trouble holding attention on tasks or at play
- Often seeming not to listen when spoken to
- Often not following through on instructions and failing to finish schoolwork, chores, or work duties
- Often avoiding, disliking, or being reluctant to do tasks that require mental effort over long periods of time
- Often losing things necessary for tasks and activities, such as school materials, wallets, keys, and eyeglasses
- Often being easily distracted
- Often forgetting daily activities
The list of symptoms for impulsivity and hyperactivity includes:
- Often fidgeting, tapping hands and feet, or squirming in a seat
- Often leaving a seat when remaining seated is expected
- Often running or climbing when inappropriate (children) or often feeling restless (adolescents and adults)
- Often being unable to play or take part in leisure activities quietly
- Often being “on the go”
- Often talking excessively
- Often blurting out an answer before a question is asked completely
- Often having trouble waiting for a turn
- Often interrupting or intruding on others
These additional conditions must also be met:
- Several inattentive or hyperactive-impulsive symptoms were present before age 12
- Several symptoms are present in two or more settings
- Clear evidence that symptoms interfere with or reduce the quality of functions at school, in social settings, or at work
- Symptoms are not better explained by another mental disorder, such as mood disorder, anxiety, personality disorder, or dissociative disorder, and do not happen only during psychotic disorder episodes.
Adults with ADHD may exhibit other age-appropriate symptoms such as mood swings and difficulty maintaining relationships and employment.
Boys versus Girls
Boys are more likely to be diagnosed with ADHD than girls, with a 12.9 percent versus 5.6 percent rate of occurrence. Signs of ADHD also are different when comparing children of both sexes. Boys are more likely to exhibit hyperactivity, be aggressive, and struggle with self-control, while girls tend to adapt better in school but exhibit restlessness and excessive talking in a classroom setting. They also may be considered overly emotional and be disciplined for daydreaming.
The fact that girls’ symptoms are less noticeable than boys may account for the disparity in the percentage of diagnoses. Girls’ less aggressive symptoms may also account for the average age of diagnosis being later in girls (12 years old) than in boys (7 years old).
Causes of ADHD
Although science is still studying ADHD to determine risk factors for the disorder, current research has discovered that ADHD runs in families and, therefore, a genetic link may be the cause.
Other possible causes and risk factors include:
- Brain injury
- Exposure to environmental factors, including lead in paint, in utero or during early childhood
- A mother’s alcohol and tobacco use while pregnant
- Premature birth
- Low birth weight
Because ADHD can delay normal development, parents are advised to seek help for a child as soon as a pattern of symptoms develops. A screening will be performed to include a physical exam and an interview. Follow-ups for children will focus on more interviews or questionnaires, behavioral tests, and psychological tests.
As advised by the American Academy of Pediatrics (AAP), treatment should include a combination of medicine and behavioral therapy. In children younger than 6, parent training in behavior management is the first line of treatment. Medication may be prescribed for children older than 6 and its use should be closely monitored. Stimulants, such as Adderall, Ritalin, and Concerta, are the most widely used ADHD medications and typically improve symptoms in 70 to 80 percent of children who use them. (Parents concerned that ADHD drugs and their addictive properties can consult the AAP’s HealthyChildren.org website for more information.)
Nonstimulants were approved to treat ADHD in 2003 and may be appropriate for children diagnosed with ADHD and certain coexisting conditions, such as Tourette Syndrome, because they can treat more than one disorder. Nonstimulants do not work as quickly as stimulants but can have long-lasting effects. Doses may be altered, medication schedules may change, and different medications may be tried to find what works best.
Nonmedical lifestyle changes that may help alleviate symptoms of ADHD in adults and children include:
- mindfulness training
- relaxation techniques
- proper sleep
- a healthy diet
- cutting back on sugar and caffeine
Herrick Library Resources on ADHD
The following books and DVDs can be requested and checked out from Herrick Library via curbside pickup or online through OverDrive, where indicated*:
- ADHD: The Ultimate Teen Guide, by John Aspromonte: A guide filled with up-to-date, reliable information for teenagers with ADHD.
- ADHD: What Every Parent Needs to Know, by Mark Wolraich and Joseph Hagan Jr.: The American Academy of Pediatrics’ fully updated, comprehensive guide on ADHD.
- ADHD Nation: Children, Doctors, Big Pharma, and the Making of an American Epidemic, by Alan Schwarz: This book takes the approach that ADHD is overly misdiagnosed and has resulted in serious effects on children, adults, and society.
- Focused: ADHD & ADD Parenting Strategies for Children with Attention Deficit Disorder, by Blythe Grossberg: Essential information on ADHD to empower parents to help their children improve functioning, support emotional development, and promote positive behavior.
- The Healthy Brain Book* , by William Sears and Vincent Fortanasce: Renowned family doctor Sears and neurologist Fortanasce present an accessible, all-ages guide to optimum brain health, including for those with ADHD.
- The Kids We Lose: This award-winning documentary explores what life is like for children with behavioral challenges and the struggles encountered by their parents, educators, and mental health clinicians.
- Parenting Your Child with ADHD: A No-Nonsense Guide for Nurturing Self-Reliance and Cooperation, by Craig Wiener: A guide for parents wishing to treat their child’s ADHD without medication.
- Raised on Ritalin: A Personal Story of ADHD, Medication, and Modern Psychiatry, by Tyler Page: A graphic novel offering a personal account of the effects the ADHD drug Ritalin has had on the author.
- Taking Charge of Adult ADHD, by Russell Barkley and Christine Benton: Coping strategies for adults with ADHD who have problems with attention, planning, problem solving, and controlling emotions.
- What Is Mindfulness?*, ; by Tamara Russell: The daily practice of mindfulness is explored as a way to alleviate symptoms of many disorders, including ADHD.
- Working Around ADHD: How to Take Control, One Obstacle at a Time, by Bill Rolfe: For adults with ADHD who want to gain greater control of their life.
Sources: Centers for Disease Control and Prevention (CDC), Attention-Deficit/Hyperactivity Disorder (ADHD), Data and Statistics, https://www.cdc.gov/ncbddd/adhd/data.html#:~:text=Boys%20are%20more%20likely%20to,12.9%25%20compared%20to%205.6%25);. Symptoms and Diagnosis, https://www.cdc.gov/ncbddd/adhd/diagnosis.html; CDC, Attention-Deficit/Hyperactivity Disorder (ADHD), What Is ADHD?, https://www.cdc.gov/ncbddd/adhd/facts.html; HealthyChildren.org, Non-Stimulant Medications Available for ADHD Treatment, https://www.healthychildren.org/English/health-issues/conditions/adhd/Pages/Non-Stimulant-Medications-Available-for-ADHD-Treatment.aspx; Help Guide International, Treatment for Adult ADHD, https://www.helpguide.org/articles/add-adhd/treatment-for-adult-adhd-attention-deficit-disorder.htm; Mayo Clinic, Adult Attention-Deficit/Hyperactivity Disorder (ADHD), https://www.mayoclinic.org/diseases-conditions/adult-adhd/symptoms-causes/syc-20350878; Mayo Clinic, Attention-Deficit/Hyperactivity Disorder (ADHD) in Children, https://www.mayoclinic.org/diseases-conditions/adhd/symptoms-causes/syc-20350889; MedlinePlus, ADHD Screening, https://medlineplus.gov/lab-tests/adhd-screening/; Understood.org, Do Boys and Girls Show the Same Signs of ADHD, https://www.understood.org/en/learning-thinking-differences/child-learning-disabilities/add-adhd/do-boys-and-girls-show-same-adhd-symptoms
Graphics: ADD.org, https://add.org/adhd-awareness/; CHADD.org, https://chadd.org/weekly-editions/adhd-weekly-october-42018/; KidsHealth.org, https://kidshealth.org/en/parents/adhd.html