ADD / ADHD

ADHD stands for attention deficit hyperactivity [HI-per-ak-TIV-i-tee] disorder. It’s a biological disorder that affects how the brain functions and works. People with ADHD often have trouble paying attention, sitting still, and controlling their behavior. Symptoms start in childhood, and often continue into adulthood. Attention deficit disorder (ADD) is an older term for ADHD.

There are 3 main types of ADHD:

• Inattentive type. People with this type of ADHD consistently have trouble paying attention, resisting distractions, and staying focused.
• Hyperactive-impulsive type. People with this type of ADHD are too active (hyperactive) and tend to act without much thought or control (impulsive).
• Combined type. People with this type of ADHD show all 3 types of symptoms: inattention, hyperactivity, and impulsivity. More than half of people with ADHD have this type.

Many people have behaviors that are like ADHD symptoms, especially children. The difference is that people with ADHD have these symptoms for a long time, and they interfere with daily life. For example, people with ADHD often have trouble at school or work. They may also struggle to learn from past mistakes or predict how their choices will affect the future. Their personal relationships can suffer. And as a result, they may feel anxious, unsure of themselves, and depressed.

ADHD is a serious condition that affects up to 1 in 10 children, and it often persists into adulthood. Right now, there’s no cure for ADHD. But with early and proper treatment, most people with ADHD can enjoy better relationships and self-esteem — and have a much better chance of reaching their full potential.

Your child’s symptoms will depend on the type of ADHD your child has.

If your child has the inattentive type of ADHD, they might:

• Be distracted and make careless mistakes • Have trouble focusing and organizing • Not follow through with tasks • Often forget and lose things

If your child has hyperactive-impulsive type of ADHD, they might:

• Fidget, squirm, or feel restless much of the time • Run about or climb too much, and seem “driven by a motor” • Have trouble being quiet • Interrupt others • Have trouble taking turns or waiting in line • Blurt out answers before hearing the whole question

If your child has the combined type of ADHD, they may have symptoms from both other types of ADHD.

If you notice any of the symptoms of ADHD in your child, make an appointment to see your child’s healthcare provider. They can help determine if your child does have ADHD and, if so, create a treatment plan. Treating ADHD can help make your child have more confidence, more success at school, and better relationships.

ADHD affects the brain’s executive function system. The executive function system controls behavior, thoughts, and emotions. Weaknesses in executive function can make it hard to control one’s emotions, start and finish tasks, keep track of items, use long-term memory, solve problems, and work toward a goal.

Scientists don’t know exactly what causes ADHD, but they do know that it can run in families — many people with ADHD have a parent or other relative with the disorder. Symptoms of ADHD are also seen in patients who have had brain injuries.

It’s important for parents to know that ADHD is not caused by child-rearing methods or the family environment. This is a biological condition. Environment can affect behaviors, but it doesn’t cause them.

There’s no blood test or brain scan to find out if you have ADHD. Healthcare providers diagnose ADHD the same way they diagnose a lot of other conditions: by gathering different kinds of information and comparing it to a medical definition of the condition. Some of the tools they use are described below:

• Forms. There are several standard forms (questionnaires) used to check for ADHD and other mental health problems. The forms ask about symptoms in different settings. They also ask about stress levels and coping styles. For a school-aged child, forms will also be used to gather information about the child’s classroom behavior and school performance. 
• Medical history. The healthcare provider asks about past and present illnesses, personality and development, and family history. 
• Physical exam. A thorough exam helps a healthcare provider know if symptoms come from a condition other than ADHD. (Some conditions can also make ADHD worse.)

Guidelines for diagnosis. Using information from the sources described above, a healthcare provider diagnoses ADHD if the following are true:

• The symptoms generally were present by age 12
• The symptoms interfere with performance in two or more settings — for example, at school, home, work, or in personal relationships
• The symptoms have lasted 6 months or longer

ADHD is treated with strategies that aim at reducing symptoms. Treatment also includes giving people with ADHD and their families new behaviors and skills to help manage ADHD and live well with the condition. Treatment strategies might be tried one by one or in combination. Healthcare providers, patients, families, and teachers usually discuss options together. Common effective strategies are described below:

• Medicine. Medicine is a common part of treatment, and studies show that it works well for most children. ADHD medicines work by helping the brain’s chemical message carriers (neurotransmitters) function better. Medicine cannot cure ADHD or teach new behaviors or skills, but it can help focus attention and decrease activity and impulsivity. There are several options for treating ADHD with medicine.
  • Stimulants such as Ritalin (methylphenidate) have been used for decades.
  • Non-stimulant medicines — such as Wellbutrin (bupropion) or Strattera (atomoxetine) — are being used for some patients.
  • Watch for side effects and whether the medicine is helping with attention and behavior. If a medicine causes troublesome side effects — or if the medicine or dosage doesn’t seem to help — contact your healthcare provider. 
• Education, training, and support groups. The more you know about ADHD, the better you can cope with it. This goes for family members and teachers, as well as for the person with ADHD. Here are a few ways to get good information:
  • Community ADHD classes. Learn about ADHD, how it impacts families, and strategies to manage it at home, school, and work. 
  • Books and websites. These can give you more information about living with ADHD.
  • Support groups. Connect with and learn from people who share your challenges and concerns.
  • Parent skills training. Learn about tools and techniques for managing a child with ADHD. 
• Family counseling and/or education. People with ADHD may need counseling to improve their self-esteem and help them express their feelings better. And because ADHD affects the whole family, parents, siblings, and spouses may also benefit from counseling. Counseling can help undo some of the frustration and anger that often come from with living with a person with untreated ADHD. 
• Behavioral therapy. Behavioral therapy helps the person focus on current behaviors and learn more effective habits, skills, and responses. It can also be helpful if other health conditions cause specific behavior problems. Behavioral therapy often involves working with a child to set behavior goals, then tracking progress toward goals.
  Consequences and rewards — used in a non-punishing way — help motivate changes. For example, a child might have a goal of sitting for 15 minutes at a time to do school work. Each day, parents or teachers record whether the child reached the goal. And from time to time, they can review the child’s progress and offer feedback.

It’s common to have different goals for different settings (for example, home and school) and in different areas (such as relationships or tasks). But each part of the plan supports the others. Each part gives more structure to daily life and sets clear expectations for behavior.

While there are many theories, scientists don’t know exactly what causes ADHD. As scientists do not know the exact cause of ADHD, there is no known prevention at this time.

CHADD.org Children and adults with attention deficit hyperactivity disorder.

www.help4adhd.org National Resource Center of ADHD

www.nami.org National Alliance on Mental Illness

ADHD is a biological disorder that affects how the brain functions and works. People with ADHD often have trouble paying attention, sitting still, and controlling their behavior.