ATTENTION DEFICIT HYPERACTIVITY DISORDER
The following discussion is for general informational purposes only and is not meant to provide the reader with specific medical advice. Please consult with your personal physician, or with a neurologist, for specific advice, guidance and information regarding your particular circumstances.
Attention Deficit Hyperactivity Disorder (ADHD) is a common condition, affecting up to 10% of school aged children. The most common features are distractibility, impulsivity and hyperactivity. It is three times more common in boys than girls but it is probably underdiagnosed in girls. ADHD is believed to be a biological condition, due to alterations in neurochemistry and neurotransmitters in certain parts of the brain. Sophisticated brain imaging studies have shown abnormalities in function of areas known as the basal ganglia and the frontal lobe. ADHD tends to run in families as well. The impact of this condition in children is primarily noted in school, with impaired learning and academic achievement. However, children may exhibit symptoms at home as well. It is also now known that ADHD is a lifelong condition, so it is not surprising that many parents of children with ADHD are themselves being identified as having the same condition.
ADHD symptoms always begin in childhood, by definition before age 7. The hallmark symptoms include distractibility, impulsivity and hyperactivity. Boys initially tend to have more “hyperactive” ADHD, and girls tend to have more “inattentive” ADHD. These symptoms may lead to poor school performance, either because patients have difficulty maintaining attention or “focus” in class, or because of impulsive, sometimes disruptive behaviors. Social functioning in class and at home may be affected as well. Difficulty with the ability to initiate, sustain and complete tasks, so called “executive dysfunction”, is very common in ADHD.
The diagnosis is made through a careful medical and family history as well as examination. Various criteria have been developed and used to correctly identify patients with ADHD. Input from teachers as well as parents is important. It is vital to identify other conditions, which may co-exist with ADHD, such as specific learning disabilities. In addition, other conditions such as anxiety or primary emotional disturbances may co-exist or even be confused with ADHD. Psycho-educational testing is often helpful. Other neurological testing is rarely necessary.
The treatment of ADHD involves 3 main areas: 1) academic accommodations and adaptations, 2) behavioral therapy, and 3) medication. It is well known that the combination of all of these types of treatment is superior to any single type alone. A multidisciplinary approach involving the patient, parents, teachers, and doctors works best.