Deficit- Hyperactivity Disorder (ADHD)

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Attention-deficit/hyperactivity disorder(ADHD)

http://www.nimh.nih.gov/health/publications/adhd/nimhadhdpub.pdf

Definition

Attention-deficit/hyperactivity disorder (ADHD) is a chronic disorder that affectsmillions of American children, and it can persist into adulthood.Problems generally associated with ADHD include inattention, hyperactivity andimpulsive behavior. They can affect nearly every aspect of life. Children andadults with ADHD often struggle with low self-esteem, troubled personalrelationships and poor performance in school or at work.The best treatment for ADHD is a matter of debate. Currently, psychostimulantdrugs are the most commonly prescribed medications for treating ADHD. Butalthough these drugs can relieve many symptoms, they don't cure ADHD, andthey can sometimes cause troubling side effects. Counseling, specialaccommodations in the classroom, and family and community support are otherkey parts of treatment.

Symptoms

At various times, ADHD has been called attention-deficit disorder (ADD),hyperactivity, and even minimal brain dysfunction. But ADHD is the preferredterm because it more accurately describes all aspects of the condition. Mostdoctors believe that a child shouldn't receive a diagnosis of ADHD unless thecore symptoms of ADHD appear early in life and create significant problems athome and at school on an ongoing basis.ADHD symptoms fall into two broad categories:

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Inattention

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Hyperactivity-impulsive behavior

In general, children are said to have ADHD if they show six or more signs orsymptoms from each category for at least six months. These symptoms mustsignificantly affect a child's ability to function in at least two areas of life —typically at home and at school. This helps ensure that the problem isn't with onlya particular teacher or with only parents. Children who have problems in schoolbut get along well at home or with friends are not considered to have ADHD. Thesame is true of children who are hyperactive or inattentive only at home butwhose schoolwork and friendships aren't affected by their behavior.In most children diagnosed with ADHD, signs and symptoms appear before theage of 7, although they sometimes may occur even earlier.

Inattention

Signs and symptoms of inattention may include:

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Often fails to pay close attention to details or makes careless mistakes inschoolwork or other activities

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Often has trouble sustaining attention during tasks or play

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Seems not to listen even when spoken to directly

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Has difficulty following through on instructions and often fails to finishschoolwork, chores or other tasks

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Often has problems organizing tasks or activities

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Avoids or dislikes tasks that require sustained mental effort, such asschoolwork or homework

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Frequently loses needed items, such as books, pencils, toys or tools

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Can be easily distracted

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Forgetful often

Hyperactivity-impulsiveness

Signs and symptoms of hyperactivity-impulsive behavior may include:

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Fidgets or squirms frequently

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Often leaves his or her seat in the classroom or in other situations whenremaining seated is expected

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Often runs or climbs excessively when it's not appropriate or, if anadolescent, might constantly feel restless

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Frequently has difficulty playing quietly

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Always seems on the go

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Talks excessively

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Blurts out the answers before questions have been completely asked

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Frequently has difficulty waiting for his or her turn

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Often interrupts or intrudes on others' conversations or gamesMost healthy children exhibit many of these behaviors at one time or another. Forinstance, parents may worry that a 3-year-old who can't listen to a story frombeginning to end or finish a drawing may have ADHD. But preschoolers normally

have a short attention span and aren't able to stick with one activity for long. Thisdoesn't mean they're inattentive — it simply means they're normal preschoolers.Even in older children and adolescents, attention span often depends on thelevel of interest in a particular activity. Most teenagers can listen to music or talkto their friends for hours but may be a lot less focused about homework.The same is true of hyperactivity. Young children are naturally energetic — theyoften wear their parents out long before they're tired. And they may become evenmore active when they're tired, hungry, anxious or in a new environment. Inaddition, some children just naturally have a higher activity level than others.Every child is unique. Children should never be classified as having ADHD justbecause they're different from their friends or siblings.Most children with ADHD don't have all the signs and symptoms of the disorder,and they may be different in boys and girls. Boys are more likely to behyperactive, and girls tend to be inattentive. In addition, girls who have troublepaying attention often daydream, but inattentive boys are more likely to play orfiddle aimlessly. Boys also tend to be less compliant with teachers and otheradults, so their behavior is often more conspicuous.

Symptoms of ADHD in adults

ADHD always begins in childhood, but it may persist into adult life. The coresigns and symptoms of distractibility, hyperactivity and impulsive behavior arethe same for adults as for children, but they often manifest themselves differentlyand far more subtly in adults. Hyperactivity, in particular, is generally less overt inadults. Children may race around madly; adults are more likely to be restless andto have trouble relaxing.On the other hand, problems with organization and concentration often increaseas people get older when their lives become more complicated and demanding.Adults diagnosed with ADHD often say that their biggest frustration is theirinability to focus and to prioritize, leading not only to missed deadlines but also toforgotten meetings and social engagements.As difficult as this is, the impulsive behavior of some adults with ADHD can beeven more problematic. The inability to control impulses, which some experts saymay be the defining characteristic of ADHD, can range from impatience waitingin line or driving in heavy traffic to mood swings, intense outbursts of anger,blurting out rude remarks and having troubled relationships.One set of guidelines used to diagnose adult ADHD, called the Utah criteria, liststhe following as characteristic of adults with the disorder:

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A childhood history of ADHD

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Hyperactivity and poor concentration

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