ADHD
Q: What are the differences between ADD and ADHD?
A: Both Attention Deficit Disorder and Attention Deficit Hyperactivity Disorder are conditions that tend to be the center of many discussions these days. Many people do understand the basic components that signify the conditions; however, they do not realize that ADD and ADHD are different. While they do share some similarities, understanding the differences between them is very important. ADD is difficult to distinguish from ADHD because it generally has the same meaning as one type of ADHD (ADHD, inattentive type). Essentially, both of these conditions refer to struggles with paying attention or remaining focused, but the causes, manifestations, and signs can all be different.
ADHD is a disorder defined by inattention, impulsivity, and/or hyperactivity that affects functioning and development. Attention Deficit Disorder (ADD) is a specific expression of Attention Deficit Hyperactivity Disorder (ADHD), a neurological condition which, according to estimates by the National Institute of Mental Health, affects between three and five percent of all children. While ADD may be the most widely-known and common term for this type of ADHD, the official medical name is ADHD-Predominantly Inattentive. ADD causes a variety of problems, usually relating to the ability to concentrate.
The following symptoms are typical for the “Inattentive” type of ADHD.
- Takes an excessive amount of time completing tasks, especially without supervision.
- Often fails to give close attention to details or makes careless mistakes in schoolwork.
- Often has difficulty sustaining attention and remaining focused in tasks or play activities.
- Often does not seem to listen when spoken to directly (i.e., mind seems elsewhere).
- Often does not follow through on instructions and fails to finish schoolwork or chores.
- Starts tasks but quickly loses focus and is easily distracted.
- Has difficulty organizing tasks and activities. Difficulty keeping materials and belongings in order; messy, disorganized work; poor time management.
- Avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort.
- Often loses things necessary for tasks or activities.
- Is often easily distracted by extraneous stimuli, especially auditory stimuli.
- Is often forgetful in daily activities.
The following symptoms are typical for the “Hyperactive-impulsive” type of ADHD.
- Often fidgets with or taps hands or feet or squirms in seat.
- Often leaves seat in situation when remaining seated is expected.
- Often runs about or climbs in situation where it is inappropriate (feeling restless).
- Difficulty playing or engaging in leisure activities quietly.
- Is often “on the go” acting as if “driven by a motor”
- May be uncomfortable being still for extended time, as in restaurants.
- Often talks excessively, interrupts, or blurts out an answer.
- Has difficulty waiting his or her turn.
- Is touchy, easily annoyed by others, fearful, anxious, nervous, or worried.
The following symptoms are typical for the “Combined” type of ADHD.
- Shows signs of both inattentive and hyperactive-impulsive types.
Q: What causes ADHD?
A: The scientific community is unsure what exactly causes ADHD. Most research focuses on the brain, with experts agreeing that it is likely caused by a neurotransmitter imbalance. This imbalance can, in turn, be created by a variety of factors. There are a number of different ADHD causes, though there is still a significant amount of research being done to see if there are any other issues. Some of the top causes include altered brain function and anatomy, which can be as a result of maternal smoking, drug use, or even exposure to toxins. Children who are also exposed to these types of toxins also have a greater chance of being diagnosed with ADHD. Studies have also shown that ADHD causes are hereditary and several genes may actually be associated with it. It is also believed that food additives can lead to ADHD symptoms. This includes certain artificial colorings and preservatives. While researchers may be unable to pinpoint exact ADD causes, they have been able to develop several ways of treating the condition.
Q: Why is my child so disorganized?
A: Children with ADHD often have difficulty with Executive Functioning. This is the ability to: plan and take action, organization, internal regulation, flexibility, initiating, and orchestrating what’s going on, evaluating (is this working?), monitoring, focusing and maintain attention, adapting strategies when somethings not working. It is the ability to analyze situations, plan and take action, focus and maintain attention, and adjust actions as needed and when needed to get the job done. Your child may have difficulty following multiple step directions, making plans, time management, making connections with what you know, keeping track of one thing at a time, evaluating ideas, reflecting on your ideas, flexibility, asking for help or knowing when it’s time seeking for more information, and difficulty engaging in group dynamics or waiting to talk.
Q: What are the different treatment options for ADHD?
A: There is no cure for ADHD, but there are treatments that can help improve symptoms. There are a significant number of ADHD treatments and which ones are used depend upon the actual symptoms that are being treated. Among the top treatments are medications, as well as behavioral modification activities and psychosocial therapy. Medications can be used for any type to treat symptoms related to both hyperactivity and inattention. Behavioral therapy is often the first treatment option for those diagnosed with ADHD, especially for younger children. Parents or other loved ones are often brought in to interact with the person struggling with ADHD symptoms. Addressing the diet can also help suppress certain ADHD symptoms as well. Social skill training for specific situations is also seen as helpful. Extracurricular activities can also be a good way to help children with ADHD. These structured activities can be productive and creative outlets that can become positive rewards to help encourage and develop self-discipline. For instance, art and music classes may be helpful for children who express the ADD or ADHD-Inattentive symptoms of daydreaming and distractedness. Dance, swim, gymnastics, karate, or other high energy activities may be helpful for children exhibiting symptoms related to the ADHD Hyperactive-Impulsive or Combined types.
The most popular pharmaceutical treatments are stimulants, with Ritalin being the best-known brand name. Stimulants can be short-acting (work for 4 to 6 hours) or long-acting (work for 8 to 12 hours). Children and teens usually tolerate these medicines well. They can be taken by mouth or through a skin patch. There are several different types of stimulants available. Your doctor may need to try several to find one that works best for your child. Stimulants help with ADHD symptoms by increasing the release of the defective neurotransmitters which are thought to be the condition’s root cause. This form of treatment has its critics, with many arguing that the potential risks to children using stimulants is greater than any benefit they can provide. A few studies found that all stimulants seem to improve ADHD symptoms in children 6 and older for months to years at a time with few side effects, but there is not enough research to know for certain. The stimulant methylphenidate (Ritalin® and Concerta®, among others) works well and is generally safe for treating ADHD symptoms, but there is not enough research to know if it is safe for preschool children (under age 6) for longer than 1 year. The most common side effects of stimulants is loss of appetite and difficulty going to sleep.
Q: When can my child be diagnosed with ADHD?
A: Children may first develop ADHD symptoms at an early age (between 3 and 6 years old). However, ADHD is most often found and treated in elementary school (between 7 and 9 years old). ADHD symptoms like hyperactivity my get better as a child gets older. However, symptoms may not disappear completely and may continue into adulthood.
Q: How is ADHD diagnosed?
A: There is no one medical or physical test that tells if someone has ADHD. Usually, a parent, teacher, or other adult tells the doctor about the behaviors they see. Your pediatrician or family doctor may suggest you take your child to see a psychologist or psychiatrist. It is important to find a specialist whom you trust and connect with. Sometimes a child may have ADHD at the same time as other problems, such as anxiety, a learning disability, oppositional defiant disorder (a condition where children or teens argue, talk back, disobey, and defy parents, teachers, and other adults). The doctor may check for other medical problems that might explain your child’s symptoms.
Q: What can I do to help my child?
Because many children who suffer from ADHD also struggle with low self-esteem, it can be helpful for the child to keep an “accomplishment” journal in their room and write down something that they’re proud of accomplishing each day.
Homework can be a struggle for children to initiate and complete in a reasonable amount of time, especially when left to complete independently. You can help your child write down all homework assignments on a white board, reduce environmental distractions, and consider the possibility of hiring a tutor.
Prior to giving directions, make sure that you have your child’s his eye contact and ask him/her to repeat the direction back to you before following it.
If your child struggles sitting down for dinner, allow him/her to stand up or set a timer for the expected amount of seated time. Provide choices for your child and avoid giving empty threats for punishment.
For more information on ADHD, contact your pediatrician or psychiatrist to determine the need for medication and/or behavioral therapy. www.help4adhd.org 1-800-233-4050