What is ADHD?
Attention-deficit hyperactivity disorder, or ADHD, is a very common brain-based disorder that affects the abilities to pay attention and control impulsive behavior. It is one of the most common neurodevelopmental disorders found in children, and usually continues into adulthood. ADHD can interfere with all aspects of life. With children, it can lead to difficulties in school, as they may struggle to pay attention in the classroom, or to focus on completing a homework assignment. It can also lead to behavioral problems, as hyperactive children may become restless and have difficulty controlling their behavior, especially when they are required to sit still and keep quiet for extended periods of time throughout the school day.
The causes of ADHD are not entirely known, although there are some factors that are linked to it. For example, it is believed that genetic factors play a role. Additionally, the DSM-III mentions lead as a causative factor toward ADHD, with studies showing that lead exposure leads to ADHD symptoms. Unhealthy dietary patterns, including high intake of refined sugar or saturated fat, may also increase the risk of ADHD, and sleep problems have also been shown to contribute to attention issues. Many other things can contribute to attention deficit problems, including head injuries, other illnesses, and even chemotherapy treatment. As such, it’s important to note that ADHD is a spectrum of attention problems that can have many different sources and causes. Being able to identify the specific source or cause of symptoms is therefore not always possible, and will vary from one person to the next.
ADHD is extremely common, with the percentage of children affected rising every year. In 2003, 7% of children in the US, and 9% of children in Georgia, were diagnosed with ADHD. By 2019, that number had risen to 10% nationally, and 13% in Georgia. Given how common this has become, it is important to detect and diagnose symptoms early on and begin treatment as soon as possible.
ADHD vs. ADD: What’s the Difference?
You’ve probably heard of both ADD and ADHD, and it’s likely you aren’t quite sure what the difference is between them. The truth is, there is no real difference between ADD and ADHD. Originally, ADD, or attention deficit disorder, was the only diagnosis for people exhibiting symptoms related to attention and hyperactivity deficits. In the 1980s, hyperactivity was added to the name, leading to what we now know as ADHD.
As of 1994, doctors essentially merged ADD and ADHD together under ADHD, making ADD an outdated term. All forms of attention deficit disorder now fall under the umbrella term of ADHD. Some people still use the term ADD today, and while it is technically no longer correct, it is often used interchangeably with ADHD. The bottom line: for all intents and purposes, ADD and ADHD are now one and the same.
Common Signs & Symptoms of ADHD
You’re likely familiar with the general signs and symptoms of ADHD: easily distracted, difficulty paying attention, daydreaming, fidgeting. In more official terms, ADHD symptoms are broken down into four main categories:
Sustainable attention deficits: This refers to things like daydreaming, and presents as difficulty concentrating and staying on task. It may also present as being very disorganized.
Selective attention deficits: This refers to being overly focused on external events with difficulty prioritizing salience of some things over others, meaning people become easily distracted by things that are irrelevant or not important. This is often linked to sensory processing disorders in children.
Impulsivity: This refers to impulsive decision making without considering long term consequences. People with impulsivity focus on the short-term reward over the long term effects of their actions. A common sign of impulsivity is frequently interrupting people when they are talking.
Hyperactivity: Hyperactivity presents as fidgeting, tapping hands or feet, and a general inability to sit still, especially in inappropriate situations.
Diagnosing 3 Types of ADHD
Based on the signs and symptoms listed above, the Diagnostic and Statistical Manual of Mental Disorders (DSM) categorizes ADHD into three general types:
- Predominantly Inattentive Type Presentation
- Predominantly Hyperactive-Impulsive Type Presentation
- Combination Type Presentation (inattentive and hyperactive-impulsive)
Diagnosing ADHD is not done through a single test, but rather through a multistep process. ADHD is a complex disorder, and is further complicated by its many symptoms that overlap with other mental health disorders such as anxiety, depression, and some learning disabilities. It can also be a co-existing set of symptoms following head injuries or neurological conditions like early stage dementia. Diagnoses will often involve medical exams, symptom checklists, and sometimes computer administered performance tests called Continuous Performance Tests. Recently, new techniques have emerged evaluating a child in a virtual classroom to get a better idea of what in the classroom affects them or an adult in an aquarium while being asked to focus on certain things. There are even tests of brain function that have been published and developed that can help confirm these brain based problems. We’ve outlined below each of the three major types as defined by the DSM:
Inattentive Type: Children are not hyperactive with this presentation. They are often seen shy and even quiet, as they are usually daydreaming and in their own world. Since they are not hyperactive, they are often dismissed as just daydreamers, so diagnosis in these children is sometimes overlooked. Inattentive ADHD is diagnosed in children under 16 if they have 6 or more of the following symptoms:
- Trouble paying attention
- Avoids long mental tasks, such as homework
- Trouble staying on task. This can be in school, at home, or playing
- Forgetful and disorganized
- Doesn't listen when spoken to directly
- Doesn’t pay close attention to details
- Loses things often
- Makes careless mistakes
- Struggles to follow directions
Hyperactive-Impulsive Type: Children with hyperactive-impulsive ADHD are very high energy and have trouble sitting still. Whether they are fidgeting, running around, or interrupting you, this type of ADHD is much more noticeable and more commonly diagnosed than the inattentive type. Children under 16 are diagnosed if they have 6 of the following symptoms:
- Blurting out answers before someone finishes asking a question
- Interrupting others frequently
- Difficulty waiting their turn to speak
- Talking too much
- Constant fidgeting, tapping hands or feet, or squirming
- Stands up at inappropriate times. For example, while teacher is teaching
- Running or climbing when and where they shouldn’t be
- Inability to play quietly
- High energy - always on the go
Combined Type: Children with combined ADHD will present with symptoms of both inattentive and hyperactive-impulsive ADHD
ADHD Treatment Options
ADHD is generally treated with a choice of medications and/or behavioral therapies. Behavioral therapy is often recommended before trying medications, especially with younger children, due to the common concerns of side effects or the concerns of long-time use on brain development. Treatment plans may vary depending on the child and the severity of their symptoms, as well as how they respond to different types of treatments. It's best to speak with your child’s doctor to determine the best course of action if they have been diagnosed with ADHD.
ADHD Treatment with Mind & Motion
Mind & Motion offers a range of treatment options for children with ADHD, including state of the art therapies such as neurofeedback and if appropriate based on test findings, sensory de-sensitivity training. We’ll get you started with extensive psychological testing to help pinpoint the issue and diagnose your child in order to get them on the best path toward feeling better. Get in touch with us today to learn more about our services and how we can help you and your child.