Definition: Defining the Meaning of ADHD and ADD
ADHD - Attention deficit hyperactivity disorder - Similar to hyperkinetic disorder in the ICD-10) is a developmental neuropsychiatric disorder in which there are significant problems with executive functions (e.g., attentional control and inhibitory control) that cause attention deficits, hyperactivity, or impulsiveness which is not appropriate for a person's age. These symptoms must begin by age six to twelve and persist for more than six months for a diagnosis to be made. In school-aged individuals inattention symptoms often result in poor school performance.
ADD - Attention deficit hyperactivity disorder predominantly inattentive (ADHD-PI), formerly attention deficit disorder (ADD), is one of the two types of attention deficit hyperactivity disorder (ADHD). The term was formally changed in 1994 in the new Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV), to "ADHD predominantly inattentive" (ADHD-PI or ADHD-I)
There are two types of attention deficit disorder (ADD and ADHD) H-standing for Hyperactivity. ADD - is Attention Deficit Disorder Inattentive Type without hyperactivity.
Attention-Deficit/Hyperactivity Disorder (AD/HD, often abbreviated as ADHD) is usually considered to be a neuro-behavioral developmental disorder. It affects about 3 - 5% of children with symptoms starting before seven years of age. It is characterized by a persistent pattern of impulsiveness and inattention, with or without a component of hyperactivity.
ADHD occurs twice as commonly in boys as in girls.
ADHD is generally a chronic disorder with 10 to 40% of individuals diagnosed in childhood continuing to meet diagnostic criteria in adulthood. As they mature, adolescents and adults with ADHD are likely to develop coping mechanisms to compensate for their impairment.
The most common symptoms of ADHD are:
- Impulsiveness: acting before thinking of consequences, jumping from one activity to another, disorganization, tendency to interrupt during conversations.
- Hyperactivity: restlessness, often characterized by an inability to sit still, fidgeting, squirming, climbing on things, restless sleep.
- Inattention: easily distracted, zoning out, not finishing work, difficulty listening.
Children who have symptoms of inattention may:
- Struggle to follow instructions.
- Not seem to listen when spoken to
- Have difficulty focusing on one thing
- Daydream, become easily confused, and move slowly
- Have difficulty processing information as quickly and accurately as others
- Become bored with a task after only a few minutes, unless they are doing something enjoyable
- Be easily distracted, miss details, forget things, and frequently switch from one activity to another
- Have difficulty focusing attention on organizing and completing a task or learning something new
- Have trouble completing or turning in homework assignments, often losing things (e.g., pencils, toys, assignments) needed to complete tasks or activities
Children who have symptoms of hyperactivity may:
- Talk nonstop
- Be constantly in motion
- Fidget and squirm in their seats
- Have difficulty doing quiet tasks or activities.
- Have trouble sitting still during dinner, school, and story time
- Dash around, touching or playing with anything and everything in sight
Children who have symptoms of impulsivity may:
- Be very impatient
- Often interrupt conversations or others' activities.
- Have difficulty waiting for things they want or waiting their turns in games
- Blurt out inappropriate comments, show their emotions without restraint, and act without regard for consequences
If you suspect your child might have ADHD, see your family doctor or pediatrician. Your child's vision, hearing, and anything else that may contribute to inattention should also be checked. The doctor may diagnose ADHD or refer your child to a mental health specialist for evaluation.
Methods of treatment usually involve some combination of medications, behavior modifications, life-style changes, and counseling. The American Academy of Pediatrics states that stimulant medications and/or behavior therapy are appropriate and generally safe treatments for ADHD.
Many people today believe ADHD is a "condition" that did not exist in the days of good parental discipline and in the days when schools were allowed to apply discipline. The controversies have involved clinicians, teachers, policymakers, parents, and the media, with opinions regarding ADHD that range from not believing it exists at all to believing there are genetic and physiological bases for the condition, and also include disagreement about the use of stimulant medications such as Ritalin used in treatments.
FDA has approved two types of medications--stimulants and non-stimulants--to help reduce the symptoms of ADHD and improve functioning in children as young as age 6.
Despite their name, stimulants, which contain various forms of methylphenidate and amphetamine, actually have a calming effect on hyperactive children with ADHD. They are believed to increase brain levels of dopamine--a neurotransmitter associated with motivation, attention, and movement.
FDA has also approved three non-stimulants to treat the symptoms of ADHD: Strattera (atomoxetine), Intuniv (guanfacine), and Kapvay (clonidine). These provide a useful alternative for children who do not tolerate stimulants well.
In addition to medication, some children with ADHD receive behavioral therapy to help manage symptoms and provide added coping skills. Moreover, concerned parents can reach out to their children's schools and community support groups for information and guidance on how to cope with ADHD behavior. "It's helpful to engage with the different individuals who are involved in a child's life when managing the disorder.
Adults and ADHD
Studies suggest that about 4% of adults may have ADHD. For adults, the symptoms are the same as those in children but might show up somewhat differently. Adults with ADHD may have poor time management skills and trouble with multitasking, become restless with downtime, and avoid activities that require sustained concentration.
A diagnosis of ADHD in an adult is given only when it's known that some of the symptoms were present early in childhood, usually under the age of seven.
For some adults, a diagnosis of ADHD can bring a sense of relief. Receiving a diagnosis allows adults to understand the reasons for their problems, and treatment can help them to deal with challenges more effectively.
Study estimates ADHD symptom persistence into adulthood
60% of children with ADHD in a recent study demonstrated persistence of symptoms into their mid-20's, and 41 percent had both symptoms and impairment as young adults.
Investigators noted that rates of ADHD persistence into adulthood have varied greatly in earlier studies, depending on how information is collected and analyzed. In a 16-year follow-up of the Multimodal Treatment Study of Children with ADHD (the "MTA"), they found that a combination of parent and self-reports plus a symptom threshold that is adjusted for adulthood (rather than based on traditional childhood definitions of ADHD) may be optimal.
There has been a lot of recent controversy over whether children with ADHD continue to experience symptoms into adulthood. This study found that the way you diagnose ADHD can lead to different conclusions about whether or not an adult still has the disorder that started in childhood. First, if you ask the adult about their continued symptoms, they will often be unaware of them; however, family members or others who know them well often confirm that they still observe significant symptoms in the adult. If the classic childhood definition of ADHD is used when diagnosing adults, many cases will be missed because symptom presentation changes in adulthood. By asking a family member about the adult's symptoms and using adult-based definitions of the disorder, you typically find that around half of children with moderate to severe ADHD still show significant signs of the disorder in adulthood.
ADHD Awareness Information
The orange colored ribbon signifies awareness of both child and adult ADHD, and October has been declared ADHD Awareness Month. In 2012 FEAADAH formally requested from the World Health Organization (WHO) the declaration of an annual ADHD World Awareness Day.
Quick Facts: ADHD
- The average age of ADHD diagnosis is 7 years old.
- Symptoms of ADHD typically first appear between the ages of 3 and 6.
- Males are almost three times more likely to be diagnosed with ADHD than females.
- ADHD isn't just a childhood disorder. Today, about 4 percent of American adults over the age of 18 deal with ADHD on a daily basis.
- During their lifetimes, 12.9 percent of men will be diagnosed with the attention disorder. Just 4.9 percent of women will be diagnosed.
Children are also diagnosed at different ages.
- 8 years old: average age of diagnosis for children with mild ADHD
- 7 years old: average age of diagnosis for children with moderate ADHD
- 5 years old: average age of diagnosis for children with severe ADHD
Studies show the number of children being diagnosed with ADHD continues to increase, according to the Centers for Disease Control and Prevention (CDC). About 11% of children ages 4 to 17 (6.4 million kids) have been diagnosed with ADHD as of 2011, up from 7.8% in 2003, according to the CDC. Child psychiatrist Tiffany R. Farchione, M.D., who reviews drugs at the U.S. Food and Drug Administration (FDA) to treat ADHD, says that increase might be because of greater public awareness of the disorder and psychiatric illnesses in general.
Boys (13.2%) were more likely than girls (5.6%) to have ever been diagnosed with ADHD. Boys also are more likely to have the hyperactive-impulsive type, which is easier to spot than the quieter child who is inattentive, says Farchione.
- Rates of diagnosis and treatment have increased in both the United Kingdom and the United States since the 1970s.
- ADHD is estimated to affect about 6 - 7% of people aged 18 and under when diagnosed via the DSM-IV criteria. When diagnosed via the ICD-10 criteria rates in this age group are estimated at 1 - 2%.
- Children in North America appear to have a higher rate of ADHD than children in Africa and the Middle East; this is believed to be due to differing methods of diagnosis rather than a difference in underlying frequency.
- ADHD is diagnosed approximately three times more often in boys than in girls. This difference between sexes may reflect either a difference in susceptibility or that females with ADHD are less likely to be diagnosed than males.