ADHD & LD

Attention Deficit Hyperactivity Disorder (ADHD) is a biologically-based behavioral condition. It is not a new disorder, though it has had increasing publicity in the popular press over the last 10 years. The main characteristics of this disorder are difficulties in attention/distractibility and/or overactivity/impulsivity. Patients with ADHD tend to fluctuate in their ability to sustain attention and control behavior over time and in boring, repetitive situations. It is not uncommon for them to be able to focus on a favorite TV show or activity, but be unable to sustain attention or control behavior during more mundane activities such as chores or work projects. These symptoms MUST be present prior to age 7 (though the patient may not be properly diagnosed until much later) and MUST be present in two or more situations (e.g., school, home, work, etc.) to qualify for the disorder. If there is a sudden onset of these symptoms later in childhood or even in adulthood or if they are present only in one situation or setting, then it is likely that some other behavioral process or disorder is occurring. There are three forms of the disorder: Inattentive Subtype, Hyperactive/Impulsive Subtype, or Combined Subtype.

Children or adults with ADHD-Inattentive Subtype have at least 6 of the following characteristics:

  1. Often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities
  2. Often has difficulty sustaining attention in tasks or play activities.
  3. Often does not seem to listen when spoken to directly
  4. Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand spoken directions).
  5. Often has difficulty organizing tasks and activities
  6. Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort such as schoolwork or homework
  7. Often loses things necessary for tasks or activities
  8. Often easily distracted by extraneous stimuli (noises, pictures, other activity in the room)
  9. Often forgetful in daily activities.

Children or adults with ADHD-Hyperactive/Impulsive Subtype have at least 6 of the following characteristics:

  1. Often fidgets with hands or feet or squirms in seat
  2. Often leaves seat in classroom or in other situations in which remaining seated is expected.
  3. Often runs about or climbs excessively in situations in which it is inappropriate.
  4. Often has difficulty playing or engaging in leisure activities quietly
  5. Is often "on the go" or often acts as if "driven by a motor"
  6. Often talks excessively
  7. Often blurts out answers before questions have been completed.
  8. Often has difficulty awaiting turn
  9. Often interrupts or intrudes on others, such as butting into conversations or games.

Children or adults with ADHD-Combined Subtype have symptoms in both of the above categories.

Children or adults with ADHD do not outgrow their symptoms, though how they cope with their symptoms can change as they grow. Most patients find that symptoms continue to be problematic throughout their life if untreated, though a few show a reduction in symptoms by late adolescence and early adulthood.

Children and adults with ADHD are at higher risk for the following difficulties: poor academic performance (and possibly having a Learning Disability in addition to ADHD), behavioral problems and oppositionality, social rejection due to impulsive or disruptive behaviors, and emotional problems such as depression, low self-esteem, and anxiety.

There are several MYTHS about ADHD. Research does NOT suggest that ADHD is caused by: food allergies, too much sugar, poor parenting, poor school setting, or too much TV or video games. ADHD is a biologically-based disorder that children are born with and must cope with throughout the lifespan.

A comprehensive evaluation is key to detecting ADHD and any of these associated difficulties, and for designing an appropriate treatment plan. There is no cure for ADHD. However, research suggests that the best way to deal with symptoms of ADHD is to work with health care providers that can provide education about the disorder and any co-occuring difficulties, teach behavioral interventions for the family and for the child, and provide appropriate medication interventions. A combined treatment approach is often the most effective.

For information about local support groups and information about ADHD: Children and Adults with Attention Deficit Disorder (CHADD), National Headquarters, 499 N. W. 70th Avenue, Suite 109, Plantation FL 33317, 305 587-3700.