Attention-deficit hyperactivity disorder (ADHD) is one of the most commonly diagnosed childhood neurodevelopmental disorders that often lasts into adulthood. People with ADHD can have trouble focusing and be easily distracted. They can also be overly active and speak or move impulsively.
ADHD can be treated with a combination of behavioral and pharmacological treatments.
Overview
ADHD often presents during childhood. Parents, educators, or health providers may notice behaviors that cause difficulty at home, in school, or with friends.
According to the CDC, about 9.4% of children 17 and younger are diagnosed with ADHD. When isolated by gender, boys account for more diagnoses compared to girls. Boys are more than twice as likely to be diagnosed with ADHD.
Data from recent years indicates that diagnoses of ADHD are increasing. It is unclear whether this is a result of more children having ADHD or simply more children being recognized as having ADHD.
Although ADHD is usually diagnosed during childhood, symptoms can last into adulthood.
Individuals with ADHD may have trouble controlling behavior, struggle to pay attention and be overly active.
ADHD often occurs simultaneously with other disorders. A multifaceted treatment approach is found to be most effective for people with ADHD.
Types
ADHD is divided into three types:
- Predominantly inattentive/distractible: This is where the person has difficulty concentrating and is easily distracted. Hyperactivity is absent.
- Predominantly impulsive/hyperactive: This type is characterized by restlessness and hyperactive behaviors without inattention. This is the least common type.
- Combined: The most common type of ADHD is the presence of both inattentiveness and hyperactivity.
Causes
ADHD is a highly researched disorder, however, the exact cause is still unknown. It is known that individuals with symptoms of ADHD tend to have lower levels of dopamine, a neurotransmitter.
Certain risk factors have been identified for developing ADHD:
- Family history of the disorder
- Substance abuse during pregnancy
- Exposure to environmental toxins such as lead
- Premature birth
Claims that ADHD is caused by eating too much sugar or watching too much television have not been supported by research. Also, differences in parenting styles are not found to cause ADHD.
Research shows that brain differences that result in ADHD are usually present at birth.
Symptoms
ADHD presentation can vary from person to person. The symptoms fall into three categories that correspond to the types of ADHD.
There is no universal test for diagnosing ADHD. Doctors often use a checklist and ratings for symptoms of the disorder.
The American Academy of Family Physicians recommends the use of the DSM-5 criteria for diagnosis. Using this tool, a patient must have 6 or more symptoms if under the age of 17.
Patients 18 or older only need to have 5 symptoms present.
Symptoms can also be classified as mild, moderate, or severe.
Some symptoms of inattentive or distractible include:
- Forgetting daily activities
- Poor listening skills
- Short attention span
- Unable to complete schoolwork or other assignments
Some symptoms of hyperactivity include:
- Fidgeting or squirming when seated
- Overly talkative
- Difficulty waiting for a turn
- Interrupting others or blurting out responses
If a patient has 6 or more symptoms from both categories, they are likely to be diagnosed as having the Combined type of ADHD.
Since children with ADHD often have additional cognitive or behavioral disorders, it is important to have a medical professional complete a formal evaluation.
Some other disorders that may mimic the presentation of ADHD include:
- Autism spectrum disorder
- Brain injury
- Visual or hearing impairments
More than 75 percent of children diagnosed continue to experience symptoms into adulthood. In adulthood, symptoms may present slightly differently.
ADHD may present alongside a mood disorder, depression, or substance abuse. Individuals may have difficulties being consistent at work.
They may have difficulty completing daily responsibilities and experience relationship problems.
Feelings of extreme restlessness, frustration, or guilt may be present.
Treatments
Since ADHD is so prevalent, much research has been done and many therapies have been identified.
ADHD treatment often involves a combination of therapies. This comprehensive approach looks at the disorder from a medical, educational, behavioral, and psychological perspective.
Different interventions can be used to support the patient. For instance, parents and patients can receive education about the disorder.
Behavioral therapy may be used to try to manage the behaviors that are disrupting everyday life.
If appropriate, an ADHD prescription may be used and will be monitored by a medical professional. It may be necessary to adjust the medication dosing.
In the educational environment, the patient can be supported through tutoring, 504 plans, and special education programs.
Alternative treatments may also be considered. These might include supplementing with omega-3 oils and vitamins.
Another form of alternative treatment is yoga and meditation. These can help the patient relax and learn to focus more effectively.
By providing a well-rounded treatment plan, the patient’s social, physical, and mental needs are supported.
Medications
Medication is often used to help address the symptoms of ADHD. They can be divided into stimulants (methylphenidate or amphetamine-based) and non-stimulants that include atomoxetine and alpha agonists.
Some examples of drugs approved by the FDA for the treatment of ADHD include:
Methylphenidate:
Amphetamine:
Atomoxetine:
Alpha Agonists:
Sources:
- Centers for Disease Control. What is ADHD? September 23, 2021. Available at CDC.gov.
- Centers for Disease Control. Data and statistics about ADHD. September 23, 2021. Available at CDC.gov.
- Centers for Disease Control. ADHD Throughout the Years. September 23, 2021. Available at CDC.gov.
- Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD). About ADHD-Overview. Accessed on April 21, 2022. Available at CHADD.org.
- Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD). ADHD Medications Approved by the US FDA. July 2021. Available at CHADD.org.
- Johns Hopkins Medicine. Attention-deficit/ hyperactivity disorder (ADHD) in children. Accessed April 21, 2022. Available at HopkinsMedicine.org.
- Mayo Clinic. Attention-deficit/hyperactivity disorder (ADHD) in children. June 25, 2019. Available at MayoClinic.org.
- American Academy of Family Physicians (AAFP). DSM-5 Diagnostic Criteria for ADHD. Accessed April 21, 2022. Available at AAFP.org.
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