Attention Deficit Hyperactivity Disorder and Attention Deficit Disorder

Attention deficit hyperactivity disorder (ADHD) is a disorder that affects behavior. It can cause hyperactive and impulsive behavior, and/or make it difficult to pay attention. Most people have some of these behavioral issues at some time. However with ADHD, these behavioral problems continue over a long period of time. To be considered ADHD, these behaviors must last for at least six months and be present in two environments (home, work, or school). ADHD affects children, adolescents, and adults. There are three types of ADHD:

  • Causes

    The cause of ADHD is unknown. It most likely is caused by a chemical imbalance in the brain. There also appears to be a genetic factor since ADHD can run in families.

    Child's Brain
    Child Brain
    A chemical imbalance in the brain may be responsible for ADHD.
    Copyright © Nucleus Medical Media, Inc.

  • Definition

    Attention deficit hyperactivity disorder (ADHD) is a disorder that affects behavior. It can cause hyperactive and impulsive behavior, and/or make it difficult to pay attention. Most people have some of these behavioral issues at some time. However with ADHD, these behavioral problems continue over a long period of time. To be considered ADHD, these behaviors must last for at least six months and be present in two environments (home, work, or school). ADHD affects children, adolescents, and adults.

    There are three types of ADHD:

    • Inattentive (classic "ADD")
    • Hyperactive-impulsive
    • Combined—the most common type

  • Diagnosis

    There is no standard test to diagnose ADHD. It is done by a trained mental health professional. The diagnosis will also be based on feedback from family and teachers.

    The American Academy of Pediatrics (AAP) recommends that the following guidelines be used for diagnosis in children 4-18 years of age:


    • Evaluation should be initiated if a child shows signs of:

      • Inattention
      • Hyperactivity
      • Impulsivity
      • Poor school performance
      • Behavior problems

    • During diagnosis, the following information should be gathered directly from parents, caregivers, teachers, or other school professionals:

      • Assessment of symptoms of ADHD in different settings (home and school)
      • Age at which symptoms started
      • How much the behavior affects the child's ability to function

    • The professional should examine the child for other conditions that might be causing or aggravating symptoms, such as:

      • Certain health conditions
      • Learning or language disorders
      • Aggression
      • Disruptive behavior
      • Depression or anxiety
      • Psychotic symptoms
      • Personality disorder

    • For a diagnosis of ADHD to be made, symptoms must:

      • Be present in two or more of the child's settings
      • Interfere with the child's ability to function for at least six months

      • Fit a list of symptoms detailed in the most recent version of the
        Diagnostic and Statistical Manual (DSM)
        of the American Psychiatric Association

  • Prevention

    There are no guidelines for preventing ADHD because the cause is unknown. Proper treatment can prevent problems later in life.

  • Risk Factors

    Factors that increase your chance of developing ADHD include:

    • Being a first-born boy
    • Premature birth
    • Having a parent or sibling (especially an identical twin) with ADHD

    • Having a mother who
      smoked cigarettes
      and/or drank alcohol, had a urinary tract infection, or had preterm labor during pregnancy

    • Having a parent with certain conditions (such as,
      alcoholism
      ,
      conversion disorder
      )

    • Being born
      prematurely

    • Other possible risk factors, such as:

      • Head injury
        at a young age (less than two years old)
      • Being born with a serious heart condition

      • Having
        Turner syndrome
        (a genetic condition)
      • Being exposed to certain pesticides
      • Spending over two hours a day watching TV or playing video games when young

  • Symptoms

    All children display some of the symptoms of ADHD. Children with ADHD have symptoms that are more severe and consistent. They often have difficulty in school and with their family and peers.

    ADHD can last into adulthood. It can cause problems with relationships, job performance, and job retention. Symptoms can vary according to the type of ADHD:


    • Inattentive (classic "ADD")

      • Easily distracted by sights and sounds
      • Doesn't pay attention to detail
      • Doesn't seem to listen when spoken to
      • Makes careless mistakes
      • Doesn't follow through on instructions or tasks
      • Avoids or dislikes activities that require longer periods of mental effort
      • Loses or forgets lis necessary for tasks
      • Is forgetful in day-to-day activities

    • Hyperactive-Impulsive

      • Is restless, fidgets, and squirms
      • Runs and climbs; not able to stay seated
      • Blurts out answers before hearing the entire question
      • Has difficulty playing quietly
      • Talks excessively
      • Interrupts others
      • Has difficulty waiting in line or waiting for a turn
    • Combined ADHD—Combination of the symptoms above.

    People with ADHD may also have:

    • Depression
    • Anxiety
    • Conduct disorder
      —difficulty following social rules
    • Oppositional defiant disorder
      —negative, angry, and defiant behaviors
    • Learning and language disorders

    • Physical conditions such as
      sleep apnea
    • Substance abuse
    • Trouble sleeping
    • Cigarette use

  • Treatment

    The goal is to improve the child's ability to function. Doctors should work together with parents and school staff. Together, they can set realistic goals and evaluate the child's response.

    Treatments include: