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Information on ADD & ADHD

from CHADD- Children & Adults with Attention Deficit/Hyperactivity  Disorder

http://www.chadd.org/AM/Template.cfm?Section=Understanding

What is AD/HD?

We may all occasionally have difficulty sitting still, paying attention, or controlling impulsive behavior. But for some children and adults, the problem is so pervasive and persistent that it interferes with their daily lives at home, at school, at work, and in social settings.

Attention-deficit/hyperactivity disorder (AD/HD) is a neurobiological disorder. It is characterized by developmentally inappropriate impulsivity, inattention, and in some cases, hyperactivity. Although individuals with AD/HD can be very successful in life, without appropriate identification and treatment, AD/HD can have serious consequences. These consequences may include school failure, depression, conduct disorder, failed relationships, and substance abuse. Early identification and treatment are extremely important.

Until recent years, it was believed that children outgrew AD/HD in adolescence. This is because hyperactivity often diminishes during the teen years. However, it is now known that many symptoms continue into adulthood. If the disorder goes undiagnosed or untreated during adulthood, individuals may have trouble at work and in relationships, as well as emotional difficulties such as anxiety and depression.

What causes AD/HD?

Research has demonstrated that AD/HD has a very strong neurobiological basis. Although precise causes have not yet been identified, there is little question that heredity makes the largest contribution to the expression of the disorder in the population.

In instances where heredity does not seem to be a factor, difficulties during pregnancy, prenatal exposure to alcohol and tobacco, premature delivery, significantly low birth weight, excessively high body lead levels, and postnatal injury to the prefrontal regions of the brain have all been found to contribute to the risk for AD/HD to varying degrees.

What are the symptoms of AD/HD?

AD/HD symptoms usually arise in early childhood. Current diagnostic criteria indicate that the disorder is marked by behaviors that are long lasting and evident for at least six months, with onset before age seven. There are three primary subtypes, each associated with different symptoms.

AD/HD - Primarily Inattentive Type:
• Fails to give close attention to details or makes careless mistakes.
• Has difficulty sustaining attention.
• Does not appear to listen.
• Struggles to follow through on instructions.
• Has difficulty with organization.
• Avoids or dislikes tasks requiring sustained mental effort.
• Is easily distracted.
• Is forgetful in daily activities.

AD/HD - Primarily Hyperactive/Impulsive Type:
• Fidgets with hands or feet or squirms in chair.
• Has difficulty remaining seated.
• Runs around or climbs excessively.
• Has difficulty engaging in activities quietly.
• Acts as if driven by a motor.
• Talks excessively.
• Blurts out answers before questions have been completed.
• Has difficulty waiting or taking turns.
• Interrupts or intrudes upon others.

AD/HD - Combined Type:
• Meets both inattentive and hyperactive/impulsive criteria.

Because everyone shows signs of these behaviors at one time or another, the guidelines for determining whether a person has AD/HD are very specific. In children, the symptoms must be more frequent or severe than in other children of the same age. In adults, the symptoms must be present since childhood and affect one’s ability to function in daily life. These behaviors must create significant difficulty in at least two areas of life, such as home, social settings, school, or work.

How is AD/HD diagnosed?

Children and Teens
Determining if a child has AD/HD takes many steps. There is no single test to diagnose the disorder. As a result, a comprehensive evaluation is necessary to establish the diagnosis, rule out other causes, and determine the presence or absence of coexisting conditions. Such an evaluation requires time and effort. It should include a clinical assessment of the child’s school, social, and emotional functioning and developmental level. A careful history should be taken from parents, teachers, and the child when appropriate.

Teens with AD/HD present a special challenge, as academic and organizational demands increase. In addition, they face typical adolescent issues: discovering their identity, establishing independence, and dealing with peer pressure. Several types of professionals can diagnose AD/HD, including pediatricians, psychologists, social workers, nurse practitioners, psychiatrists, and other medical doctors. A thorough medical exam by a physician is important. Only medical doctors can prescribe medication if it is indicated. Regardless of who does the evaluation, use of the most current diagnostic criteria according to established professional standards of diagnosis is essential. The evaluating professional will also provide parents and other adults in the child’s life, including teachers, with symptom checklists or other feedback forms when gathering information in this evaluation process. 

Adults
Growing up with undiagnosed AD/HD can have devastating effects, with adults often thinking of themselves as "lazy," "crazy," or "stupid." As a result, proper diagnosis can be profoundly healing, putting present difficulties into perspective and making sense of lifelong symptoms. A comprehensive evaluation for AD/HD is best made by clinicians with experience in the disorder. This may include a behavioral neurologist, psychiatrist, clinical or educational psychologist, nurse practitioner, or clinical social worker. A comprehensive evaluation should focus on past and present AD/HD symptoms; the person’s developmental and medical history and school, work, and psychiatric history, including medications, social adjustment, and general ability to meet the demands of daily life. Ideally, the exam should include several sources of information, such as a parent or significant other.