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Also
Known as: Hyperactivity Disorder (Hyperkinetic Disorders)
ADHD or
ADD is characterized by a majority of the following symptoms
being present in either category (inattention or hyperactivity).
These symptoms need to manifest themselves in a manner and degree
which is inconsistent with the child's current developmental
level. That is, the child's behavior is significantly more inattentive
or hyperactive than that of his or her peers of a similar age:
Persisting for at least 6 months to a degree that is maladaptive
and immature, the patient has either inattention or hyperactivity-impulsivity
(or both) as shown by:
Inattention. At least 6
of the following often apply:
Fails
to pay close attention to details or makes careless errors
in schoolwork, work or other activities.
Has trouble keeping attention on tasks or play.
Doesn't appear to listen when being told something.
Neither follows through on instructions nor completes chores,
schoolwork, or jobs (not due to oppositional behavior or failure
to understand).
Has trouble organizing activities and tasks.
Dislikes or avoids tasks that involve sustained mental effort
(homework, schoolwork).
Loses materials needed for activities (assignments, books,
pencils, tools, toys).
Easily distracted by extraneous stimuli.
Forgetful.
Hyperactivity-Impulsivity.
At least 6 of the following often apply:
Squirms
in seat or fidgets.
Inappropriately leaves seat.
Inappropriately runs or climbs (in adolescents or adults,
the may be only a subjective feeling of restlessness).
Has trouble quietly playing or engaging in leisure activity.
Appears driven or "on the go".
Talks excessively.
Impulsivity
Answers
questions before they have been completely asked.
Has trouble or awaiting turn.
Interrupts or intrudes on others.
Begins before age 7.
Symptoms must be present in at least 2 types of situations,
such as school, work, home.
The disorder impairs school, social or occupational functioning.
The symptoms do not occur solely during a Pervasive
Developmental Disorder or any psychotic disorder including
Schizophrenia.
The symptoms are not explained better by a Mood,
Anxiety, Dissociative
or Personality
Disorder.
Associated
Features:
Learning
Problem.
Hyperactivity.
Differential
Diagnosis:
Some disorders have similar symptoms. The clinician, therefore,
in his diagnostic attempt has to differentiate against the following
disorders which need to be ruled out to establish a precise
diagnosis. The clinician, therefore, in his diagnostic attempt
has to differentiate against the following disorders which need
to be ruled out to establish a precise diagnosis.
Age-appropriate
Behaviors in Active Children;
Mental Retardation;
Understimulating Environments;
Oppositional Behavior;
Another Mental Disorder;
Pervasive
Developmental Disorder;
Psychotic Disorder;
Other
Substance-Related Disorder Not Otherwise Specified.
Cause:
ADHD is
not caused by poor parenting or family problems. One early theory
was that attention disorders were caused by minor head injuries
or damage to the brain, and thus for many years ADHD was called
"minimal brain damage" or "minimal brain dysfunction."
The vast majority of people with ADHD however have no history
of head injury or evidence of brain damage however.
ADHD is likely to be caused by biological factors which influence
neurotransmitter activity in certain parts of the brain, and
which have a strong genetic basis. Studies have shown a link
between a person's ability to pay continued attention and the
level of activity in the brain. Specifically researchers measured
the level of glucose used by the areas of the brain that inhibit
impulses and control attention. In people with ADHD, the brain
areas that control attention used less glucose, indicating that
they were less active. It appears from this research that a
lower level of activity in some parts of the brain may cause
inattention and other ADHD symptoms.
Treatment:
A wide variety
of treatments have been used for ADHD including, but not limited
to, various psychotropic medications, psychosocial treatment,
dietary management, herbal and homeopathic treatments, biofeedback,
meditation, and perceptual stimulation/training. Of these treatment
strategies, stimulant medications and psychosocial interventions
have been the major foci of research. Overall, these studies
support the efficacy of stimulants and psychosocial treatments
for ADHD and the superiority of stimulants relative to psychosocial
treatments. However, there are no long-term studies testing
stimulants or psychosocial treatments lasting several years.
Counseling
and Psychotherapy [ See
Therapy Section ]:
Psychosocial
treatment of ADHD has included a number of behavioral strategies
such as contingency management such as those utilising; point/token
reward systems, timeout, response cost. Clinical behavior therapy
(parent, teacher, or both are taught to use contingency management
procedures), and cognitive-behavioral treatment (e.g., self-monitoring,
verbal self-instruction, problem-solving strategies, self-reinforcement).
Cognitive-behavioral treatment has not been found to yield beneficial
effects in children with ADHD. In contrast, clinical behavior
therapy, parent training, and contingency management have produced
beneficial effects.
Pharmacotherapy
[ See
Psychopharmacology Section ] :
Methylphenidate
(MPH).
Desipramine.
Dextroamphetamine.
Pemoline.
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Read
the following article:
Non-Medical
Treatment of
Attention Deficit Hyperactivity Disorder (ADHD)
By Preeti Gupta, Clinical Psychologist
Click here to read
Attention-Deficit
Disorder
By Jef Gazley, M.S.
ADD
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