Attention Deficit Hyperactivity Disorder and Attention Deficit Disorder
En Español (Spanish Version)More InDepth Information on This ConditionAttention deficit hyperactivity disorder (ADHD) is a chronic behavioral disorder. It is behavior that is hyperactive, impulsive, and/or inattentive. These must persist for at least six months and be present in two environments (home, work, or school). ADHD affects children, adolescents, and adults.
The cause of ADHD is unknown. It most likely is caused by a chemical imbalance in the brain. There also appears to be a genetic factor since ADHD can run in families.
Child's Brain
A chemical imbalance in the brain may be responsible for ADHD.
© 2009 Nucleus Medical Media, Inc.
These risk factors may increase your chances of developing ADHD:
- Being a first-born boy
- Having a parent or sibling (especially an identical twin) with ADHD
- Having a mother who smoked cigarettes and/or drank alcohol during pregnancy
- Having a parent with certain conditions (eg, alcoholism, conversion disorder)
- Being born prematurely
All children display some of the symptoms of ADHD. Children with ADHD have symptoms that are more severe and consistent. They often have difficulty in school and with their family and peers.
ADHD can last into adulthood. It can cause problems with relationships, job performance, and job retention.
There are three types of ADHD:
- Inattentive (classic "ADD")
- Hyperactive-impulsive
- Combined
- Easily distracted by sights and sounds
- Doesn't pay attention to detail
- Doesn't seem to listen when spoken to
- Makes careless mistakes
- Doesn't follow through on instructions or tasks
- Avoids or dislikes activities that require longer periods of mental effort
- Loses or forgets items necessary for tasks
- Is forgetful in day-to-day activities
- Is restless, fidgets, and squirms
- Runs and climbs and is not able to stay seated
- Blurts out answers before hearing the entire question
- Has difficulty playing quietly
- Talks excessively
- Interrupts others
- Has difficulty waiting in line or waiting for a turn
Combined ADHD is the most common type.
- Has a combination of the above symptoms
People with ADHD can also have:
There is no standard test to diagnose ADHD. It is done by a trained mental health professional. Family and teachers are involved, as well.
The American Academy of Pediatrics recommends that the following guidelines be used for diagnosis in children 6-12 years of age:
-
Diagnosis should be initiated if a child shows signs of difficulty in:
- School
- Academic achievement
- Relationships with peers and family
-
During diagnosis, the following information should be gathered directly from parents, caregivers, teachers, or other school professionals:
- Assessment of symptoms of ADHD in different settings (home and school)
- Age at which symptoms started
- How much the behavior affects the child's ability to function
-
The professional should examine the child for:
- Other conditions that might be causing or aggravating symptoms
- Learning and language problems
- Aggression
- Disruptive behavior
- Depression or anxiety
- Psychotic symptoms
- Personality disorder
-
For a diagnosis of ADHD to be made, symptoms must:
- Be present in two or more of the child's settings
- Interfere with the child's ability to function for at least six months
-
Fit a list of symptoms detailed in the most recent version of the
Diagnostic and Statistical Manual (DSM)
of the American Psychiatric Association
The goal is to improve the child's ability to function. Doctors should work together with parents and school staff. Together, they can set realistic goals and evaluate the child's response.
Treatments include:
Children who do not sleep enough may suffer from worse behavior problems. A key part of treatment is to ensure that children with ADHD get plenty of sleep.
Medications can help control behavior and increase attention span. Stimulants are the most common choice for ADHD. They increase activity in parts of the brain that appear to be less active in children with ADHD. Stimulant medications include:
Talk to your doctor if you have any questions about ADHD medication. There are possible risks with these medications, including cardiovascular events (eg,
stroke
,
heart attack
) and psychiatric problems (eg, hearing voices, becoming manic).
Because of the rare risk of serious heart problems, the American Heart Association suggests that children have an
electrocardiogram
(ECG) before starting stimulant medication for ADHD.
Children who take medication and go to therapy do better than those who just use medication. Therapy sessions focus on practicing social and problem-solving skills. Counselors will also teach parents and teachers to help the child through positive reinforcement. This could involve changes in the classroom, as well as in parenting style. Often, daily report cards are exchanged between parents and teachers.
Other tools, like the Disc'O'Sit cushion, may be helpful in improving children's attention in class. The Disc'O'Sit is a dome-shaped cushion filled with air that the child balances on.
ADHD coaching can also be helpful. These coaches work with individuals to help them organize and strategize so that they can be more efficient and successful.
There are no guidelines for preventing ADHD because the cause is unknown. Proper treatment can prevent problems later in life.
Attention Deficit Disorder Association
Attention Deficit Disorder Resources
Children and Adults With Attention-Deficit/Hyperactivity Disorder (CHADD)
Canadian Psychiatric Association
American Psychiatric Association.
Diagnostic and Statistical Manual of Mental Disorders
. 4th ed. Text Revision. Washington, DC: American Psychiatric Association;2000.
Children's Health Topics.
American Academy of Pediatrics website. Available at:
http://www.aap.org/
. Accessed June 24, 2008.
Fact sheet ADHD.
The National Mental Health Association website. Available at:
http://www.nmha.org/
. Accessed June 24, 2008.
Rappley M. Attention deficit-hyperactivity disorder.
NEJM
. 2005;352:165-173.
The Truth About Diagnosing and Treating ADHD.
American Psychiatric Association website. Available at:
http://www.psych.org/
.
Accessed June 24, 2008.
Your child—ADHD. American Academy of Child and Adolescent Psychiatry website. Available at:
http://www.aacap.org/
.
Accessed June 24, 2008.
4/30/2008 DynaMed Systematic Literature Surveillance
DynaMed's Systematic Literature Surveillance
: Pfeiffer B, Henry A, Miller S, Witherell S. Effectiveness of Disc 'O' Sit cushions on attention to task in second-grade students with attention difficulties.
Am J Occup Ther.
2008;62:274-281.
7/6/2009 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed/what.php
: Paavonen EJ, Räikkönen K, Lahti J, et al. Short sleep duration and behavioral symptoms of attention-deficit/hyperactivity disorder in healthy 7- to 8-year-old children.
Pediatrics.
2009;123:e857-864.
10/12/2009 DynaMed Systematic Literature Surveillance
DynaMed's Systematic Literature Surveillance
: Cortese S, Faraone SV, Konofal E, Lecendreux M. Sleep in children with attention-deficit/hyperactivity disorder: meta-analysis of subjective and objective studies.
J Am Acad Child Adolesc Psychiatry.
2009;48:894-908.
10/16/2009 DynaMed Systematic Literature Surveillance
DynaMed's Systematic Literature Surveillance
: Wilens TE, Vitulano M, Upadhyaya H, et al. Cigarette smoking associated with attention deficit hyperactivity disorder.
J Pediatr.
2008;153:414-419.
1/8/2010 DynaMed Systematic Literature Surveillance
DynaMed's Systematic Literature Surveillance: Froehlich TE, Lanphear BP, Auinger P, et al. Association of tobacco and lead exposures with attention-deficit/hyperactivity disorder.
Pediatrics. 2009;124:1054-1063.
2/4/2010 DynaMed's Systematic Literature Surveillance
DynaMed's Systematic Literature Surveillance: Froehlich TE, Lanphear BP, Auinger P, et al. Association of tobacco and lead exposures with attention-deficit/hyperactivity disorder.
Pediatrics. 2009;124(6):e1054-1063.
Last Reviewed November 2009