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ADHD: Attention Deficit Hyperactivity Disorder

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Introduction to Attention Deficit Hyperactivity Disorder (ADHD)Symptoms of ADHDHistorical Development of ADHDThe ADHD DiagnosisOnset and Prevalence of ADHDADHD ComorbidityControversies Surrounding ADHD

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Introduction to Attention Deficit Hyperactivity Disorder (ADHD)

Margaret Austin, Ph.D., Natalie Staats Reiss, Ph.D., and Laura Burgdorf, Ph.D. Updated: Nov 5th 2007

The purpose of this paper is to provide a detailed description of Attention Deficit Hyperactivity Disorder (ADHD), its causes, symptoms and treatments. ADHD is a neurological disorder that develops during childhood and can persist into adulthood. Although adult ADHD is more common than initially thought, not all children who have these symptoms will go on to have the adult version of the disorder. Childhood symptoms may also change across the lifespan; some fade (e.g., blatant hyperactivity) while others may be expressed differently (e.g., chronic disorganization may result in getting fired from jobs). Because ADHD often "looks" different in kids and adults, the adult version of the disorder will be discussed in its own section later in the paper.

ADHD is one of the most common childhood disorders. Approximately 3-7% of school-aged children have the disorder. Prevalence rates seem to vary by community, with some research indicating that larger cities may have rates as high as 10-15%.

ADHD produces symptoms that are characterized by distractibility, hyperactivity, poor impulse control, and forgetfulness. The "attention deficit" component of ADHD refers to inattention, or difficulty focusing for long periods and being easily distractible. The "hyperactivity" portion of ADHD is used to describe behavior that is restless, agitated, and difficult to resist. Hyperactive individuals often appear as if they NEED to move. They are in almost constant motion, and frequently make excessive noise. Although impulsivity is not included in the diagnositic label, it is also considered a behavior characteristic of this disorder. When impulsivity is paired with hyperactivity, the person appears to act without prior thought or intention. Impulsive behaviors are often intrusive, rude, and dangerous, sometimes resulting in accidents. For example, children may not think about landing when they jump off a ledge to catch a ball.

Given that all children tend to exhibit some of the behaviors characteristic of ADHD, such as daydreaming, restlessness, or thoughtlessness, it is important to understand the difference between normal behaviors and a true disorder. True ADHD symptoms are long-term and severe enough to impair someone's every day functioning. Moreover, symptoms must occur in more than one environment. For example, in children, this means that the ADHD symptoms interfere with success in school and relationships with parents, siblings, or peers. For adults, ADHD interferes with both work and family functioning.

Experts consider ADHD to be a chronic condition that has no cure. However, individuals with this disorder should not give up hope. There are many different treatment options that can help people successfully manage ADHD symptoms and move forward in their lives.

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Reply to ADHD article - Norm - Nov 15th 2009

After perusing this article, I offer this information: At least two countries, the U.K. and Australia, are moving to ban products containing synthetic food & beverage dyes from their shelves, thought to cause problems in children, including symptoms of ADHD, plus other health concerns in adolescents and adults.

One U.S. company, a Minnesota-based firm, has developed an all-natural, non-GM alternative to the petroleum-based dyes that for years have been used in foods, beverages, cosmetics and other products put on or in our bodies.

High in antioxidants, this new product, now catching the eye of large U.S. food/beverage manufacturers, is derived from a specially developed 'purple' corn hybrid. Once the natural dyes are extracted, the starches, proteins and oils in the corn are sustained for continued use along the food chain. To learn more, go to www.suntava.com.

They'd label my son if I let them - Allan N. Schwartz, PhD - Nov 15th 2009

Hello Mom,

I know that you mean well for your son but you really need to think more prudently than you are at this moment. Here is why:

1. The problem has nothing to do with "labeling" but with removing any obstacle to learning he may have. The fact that he is extremely bright has nothing to with ADHD. I have met medical doctors, lawyers, dentists and all types of professionals who have this problem.

2. Yes, love and nurturing are extremely important but parents sometimes need to do more. If your son does have ADHD then it would serve his interests and his future well if he got help now.

3. Help now for ADHD does NOT have to do with medication. There are psychologists who are expert in providing the kind and types of training that helps children and adults with this problem, learn to compensate so they can progress.

4. Are there dangers to doing nothing if he has ADHD? Yes. All the evidence shows that untreated children with ADHD run the risk of coming to feel alienate by adolescence and aligning themselves with delinquent types of kids. That brings with it drug abuse and other problems.

5. Finally, I have no way of knowing if your child has ADHD or not. However, if teachers are hinting at that I would suggest that you have him evaluated. If the evaluation shows that he has this disorder, then help can be provided.

Please know that medication is not the only or even the best treatment except in very, very severe cases where a child is uncontrollable and that does happen.

Please, keep your mind and options open.

Dr. Schwartz

ADHD - jglennon - Nov 15th 2009

As a former elementary school principal, I am quite aware that attention difficulties are just the tip of the iceberg. ADHD children can't filter out distractions, finish tasks on-time, use their memory optimally, etc. A pill doesn't teach these skills.

My wife and I opted to use cognitive training for our son, Alex. We used Play Attention (www.playattention.com) and ADHD Nanny (www.adhdnanny.com). We've been very successful with these approaches. We also changed our parenting skills with great success.

It's just important to know that medicine teaches nothing. Parents and teachers must actively participate to help change a child's life.

Dr. Dombeck's Note: An absolutely true observation. As is the case with many 'mental' issues, there are multiple ways to approach the problem(s). Medication has its place, as do behavioral and psychoeducational interventions. No single approach will address every aspect of the issue(s) needing to be addressed, and the manifestation of the issue(s) will vary with each child. Where one child may respond well to a single approach, another may require a different approach or mutiple approaches offered at once or in series. Not all professionals are aware of or good at offering all the various approaches so any given professional may not tell you about other approaches that may be helpful.

There are multiple levels of funnction - CCRN1993 - Nov 15th 2009

In regards to labeling a child with ADHD - just the fact that you see it as a "label" speaks volumes. We all must remember there are so many levels of severity and different manifestations. Structure at home is a big benefit to children with ADHD, they tend to thrive in structure/routine especially with supportive parents. The problem is that many children do not have that, either the home is dysfunctional or simply one where both parents have to work and no routine can be established. Also, so much focus has been on medicating, a quick fix, medicine only helps the child behave / perform IF THEY WANT TO, it does not make them behave - it gives the ability to choose, a bigger focus here is the importance of counseling. For those in which the impulsivity is expressed to the point that it interferes with relationships and success, counseling can help teach / guide them to develop those behaviors that seem innate to non ADHD suffers. It teaches them how to bring out their strengths, how to handle their weaknesses and how to develop habits will help them succeed throughout their life.

They'd label my son if I'd let them - - Nov 14th 2009

My six-year-old is extremely talkative (verbal diarrhea), constantly moving, and disruptive at home and at school. I'm not the best parent, but neither am I the worst. We provide for him, love him, discipline him. On that front, sometimes I lose patience and yell — God help me he is a handful — and when I do he tells me I don't need to yell because he is just a little boy and that makes me feel like poo. I have educated myself on ADHD so that whenever a teacher makes a subtle hint in this direction, I can cut them off at the knees. My son is reading a couple of grade levels above his age, he can concentrate for long periods of time on his many, many interests (building, basketball, chasing our cats, etc.), he does his homework pronto with the promise of a cookie when it's done, his brain is firing on all cylinders. My quiet bright bookworm daughter tells me she wants to be a teacher. I think she will be a very good one. My crazy, wild, hyper son tells me he wants to be a scientist. I think he will make a great one. What might he discover? He will not be labelled or druged as long as I have a breath left in my body. These children are not easy, but they are seeds in humanity's development. We must nurture them as best we can.

Stop traying to portray persons with the so called ADHD as abnormal - Elena - Nov 9th 2009

Stop trying to portray persons with the so called ADHD as abnormal, what is normal any ways. I have ADHD and I can focus and I can pay attention, but only to those things and situations that really interest me. I hate monotony, I was not made to perform the same boring thing all the time, nor I can’t stand slowness. May be that is because my mind works as fast as the speed of light.

We, persons with ADHD are not ABNORMAL, wed just learn differently and function differently. For example, office work is not suitable for a person with ADHD, but movie actor or any other profession that involves lots of action and excitement will be perfect.

Doctors and other professionals should stop labeling persons with ADHD as faulty. The only faulty thing is the society we are living in.

Wondering - - Sep 7th 2009

I am 50 years old, and have wondered if I have ADHD.

I have had many jobs over the years and have been fired from all of them for one reason or another. My mind works very fast - ( I am told). I play online scrabble games of 3 to 4 minutes. My interpersonal skills are less than wonderful. I only have one really close friend, and lots of acquaintance.

Anyone able to give me some insights?

Resources - Stephanie Fiamengo - Aug 6th 2009

All of your information has been so helpful as I am researching a presentation on ADHD. I need to cite sources and I was wondering if you had a works cited page for where you get your information from. Thanks!

Editor's Note: Please find selected resources, readings and references here and here.

No to Methamphetamines - Allan N. Schwartz, PhD - Jul 29th 2009

Hello Bear Bear,

I very, very stronly urge you, plead with you and even beg you to stop your use of methamphetamine. It is higly dangerous, addictive and will cause you to lose control of your life. This is not my opinion, this is fact.

At your age you should be seeking Cognitive Behavioral Psychotherapy with a properly trained clinical psychologist in this set of techniques. ADHD is something you can LEARN to manage.

Dr. Schwartz

48 yrs with ADHD - Bear Bear - Jul 29th 2009

i was diagnosed by a psychiatrist with ADHD approx 6 yrs ago. I was prescribed Stratterra and Depacote. The depacote made me upset and I have tried several mood modifiyers since, but the Stratterra has been tremendously successful. I started using methamphatime about the same time. It struck me as feeling a strong dose of Stratterra and have been on them both since. It's very confusing, but I feel better than I did before.

Good luck to all with this disorder. It's a rough road!

Comment regarding medical marijuana and adhd - Rahul - Jun 21st 2009

I was just browsing and thought I'd post a question/comment regarding the previous comment about someone using marijuana to help with adhd.

I am 29 years old and received a medical marijuana license about 9 months ago. I have been using cannabis regularly for the past 3 years. I also used a little bit when I was 17 (and occasionally in college), but not on a regular basis. I stopped for the most part, because it brought on paranoia. However in the last few years I found that I get less paranoid and it helps with anxiety, depression, stress, headaches (I used to get migraines as a kid), and muscle tension. I am continually seeking alternatives to remain healthy such as yoga.

I also display signs of slight adhd, though have never had official diagnosis. My question is this: Although weed helps reduce anxiety (thereby allowing one to focus), it also can scatter my mind so that I find myself starting many projects but only finishing few. So it also de-focuses people. I don't want to go on ritalin or adderall, but does anyone know the best treatment for ADHD?

Also, I learned in graduate school that in the new DSM, there will be a new diagnosis that will have a blend of anxiety and depression. My teacher told me that therapists have known about this blended diagnosis for a long time and have been treating patients using this knowledge, but this new official diagnosis will help people better understand the issue.

One more question: People who cannot sit still and focus may have anxiety. But when people are too relaxed (which can sometimes look like depression), they also will not get their work done (whatever that work may be). So, do people still need to go on two different medications?

A cure - - May 26th 2009

I am currently 18 years old and have a medical marijuana license. I also happen to have been diagnosed with ADHD and it has been a problem for me in the past as i have been expelled form 2 school in 2 years because of my impulses. i have found the most effective cure other than pills is to smoke weed as it calms me down and really makes me think about things before acting.

It is ok - - May 1st 2009

I am 13 years old and I have had ADHD my whole life. I have gotten into trouble and had trouble making friends. But since the 5th grade I have been out of trouble and tons of friends. The only way I was able to do this was with the love and support from my family, therapists, and many adults who knew I could do it. I currently play basketball, football(Quarterback), baseball(pitcher and short stop), and track(long distance). My grades are A's and B's and my life is really good. I still take weekly therapist.

ADHD - - Mar 25th 2009

My son is now 13 he was diagnosed with adhd when he was little and they tried to medicate him when he started school and at first i refused because i thought we could manage but by the time he was in 1st grade it was soo hard for him i agreed and in 2006 his doc sent him for a random ekg because new studies showed the meds caused heart problems and his ekg came back abnormal he had to go see a ped cardiologist and continues to see him now because these meds casued his left ventrical of his heart to be enlarged and it just devestated me i thought i was doin the right thing for him and i hurt him he can have reagular activity but the doc said he has to know when to stop so he wont over work his heart and possible have a heart attack or anything it just scares me because he dont know when to stop he has all the symptoms of adhd excessive noises not doing well in school because he cant focus and hes constantly moving ect.. he has seen phycologist and doc and nothing helps i took him off the meds as soon as the ekg but its so hard for him he dont have friends we dont have good family time together it just makes me sad i wish i new what to do i want him to have a good life any suggestions my email is maryc792003@yahoo.com

look at me now - B-money - Mar 13th 2009

hello every one i am a 16 year old who has adhd and i would like to say to every one that this is a very beatable problem i was just like ever other kid with adhd but now im in a great place im very well in the mental health system and you would think that im in it but no in fact im on the board of a whole non-profit comp. im very happy that i have learned many ways to deal with this and i would like to say that if any one would like to know any more about me and my story of growing up with adhd and beating it i will leave my e-mail

i would also like to know from some one it did say that forgetfullness what a part of this but i really have some probelms with that i some times more then less forget my friends names and if i have home work to do i have many things to do i go around Oregon supporting youth and what they want to do with there mental health and i some times forget to go to meetings so i would like to know if there is any way i can imporve my memery some how

i would like to say thanks to the people who really care

ADD and Successful Coping - Allan N Schwartz - Feb 27th 2009

Hi Mrs. Beautiful Brown,

Congratulations. You are doing an excellent job of successfully coping with your ADD. Yes, I agree with you that others with this problem should get help with it. They can see a clinical psychologist whose focus is adult add because they can help clients learn the very techniques you taught yourself. There is no reason why add needs to keep anyone back. You made a wonderful career choice and it works well for you. Keep on with the great work you are doing.

Dr. Schwartz

8th Grade Teacher with ADHD - Mrs. Beautiful Brown - Feb 26th 2009

I have suffered with ADD for so long until I found and made up every coping skill possible. I knew from a very early age that college wasn't an option. I hated to read. I can't stand being bored, I'm impatient and I loose everything. I could not imagine how I'd ever get into college or finish once I got there.

I am now a 45 year old . I teach 8th grade, I've been teaching for 20 years. My class is the fun and activities change often because I can't stand being bored. This is real and very serious. Anyone who suffers with ADHD really should get some help.

ADD and ADHD are real illnesses - - Feb 1st 2009

My 3 children are now grown. They all have ADD or ADHD. To me it is an inability to focus in on tasks (the worse the ADD, the more tasks this applies to). They procrastinate, but a deadline gets them to get the task done--at the last moment. They cannot do jobs which require them to initiate the work. The work must be coming at them--such as asnwering incoming calls, customers waiting in line to be helped. One things I have not read about that I see associated with their ADD is that they go beyond disorganized or forgetful--their apartments, cars, and even their personal hygiene definitely are affected--things are gross, slovenly, not just cluttered. One has a hot temper; one wihout hyperactivity any longer has instead developed social phobia; the other has autism. This is definitely a neurological problem which needs much more research and much better medicines. Gross motor skills, hand/eye coordination and learning disabilities such as dyslexia also run in the family. Please support more research--these are bright minds we cannot afford to lose, and they are also young people who are suffering.

- - Jan 6th 2009
my neice has adhd,odd, an bi polar disorder. she was kicked out of pre-k for bitting the teacher an thats when we first found out she was diagnosed with these disorders

- - Dec 17th 2008

Any parent with a child with adhd please be careful while they are young. My son was dx at the age of 6 and was placed on ritlan in high doses, he was kicked out of school in kindergarden and they refused to allow him in school unless he was on medication.

He is now 32, his adhd never improved, the experts now say its because of the medication. As they get older some go to street drugs because they are looking for that normal feeling again they had with the medication when they were younger. Some become worse, develop drug induced bipolar disorder which causes them a life time of hell and hard to get good help for because they can not keep a job or insurance.

Fight for your kids while they are young, and make sure they follow up into their adulthood for their sake and yours.

Training - Allan N Schwartz - Nov 11th 2008

Just to let people know that medication is not the only way to treat ADHD for either children or adults. A psychologist trained in it can do Coaching, and that is training in specific behaviors to help overcome the symptoms of ADHD, such as: learning refrain from interrupting people, keeping yourself organized, making eye contact, listening skills, etc. It works. Medicine can sometimes be helpful but, with or without medicine, it is important to get the training.

Dr. Schwartz

this is not rubbish - DJ - Nov 11th 2008

hey mike those things you said are true but this article does not says anything like that it just shows common charecteristics of adhd children i know i have been diagnosed with it as well and i have these exact problems anyway your probably not a kid unlike me so why are you saying its rubbish

53 with adhd - sandi - Oct 19th 2008

i was diagnosed approx 2 yrs ago. i need help i have had the symtoms since childhood. 2 years ago i was also diagnosed bi-polar. im on several meds now staterra, ziprexa,prozac. the meds help some what. any ideas that might help me come to grips with this illness. i only learned tonight that it is not curable. thats pretty frightening.

alot of this is rubish - mike - Oct 11th 2008

alot of this is rubish like anythnig you can find on adhd im 25 and am one of the most extream cases in uk iv herd so much crap from ppl that no know more then wot tv or there dr has told them full blown adhd really adhd is not nice people if you kid is actin like a brat that is not adha if thay go nut when there not ment to that is not adhd lots of people now blame anything thay can on adhd it makes life hard for thos how have it it is so much more then bein hyper or not doin as your told one day the world will change its way of thinkin .. but for me stupid people and tv shows make my life hard as if it wasnt already every time i see some brat on tv usein it as a get out of trouble card i think there perants should be locked up and stoped from havein kids thay are lazy and wont to blam something for being bad parants

the bigest problem tho is the dr's sellin any drug thay can to make cash mum's and dad dont give them to your kid i was on ritalin for years b for i was told wot it had don to me your kid anger and mad actin is as a result of this like a coke addict on a come down thats wot your putin your kids thru docs will tell you differnt but i spent 14 years on it thay sold it i think i know wot it dose to someone give them good food exersize and get them in to something like acting thay will make you proud .. dont try and change them thay will fight it teach them to usew there extra power to be better faster and smarter do this and you will do well .

Coffee - Rachel - Sep 24th 2008

If you are short on money or find it difficult to buy or locate the medication your child needs. You may have a cheap alternative in your home. Caffine.

Not all children react the same to caffine. For some, it makes them calm and helps them concentrate. In other cases, it makes the child hyperactive.

You can do a simple test at home, give the child caffine, and see how they react. If it boosts their hyperactivity and makes it worse, oh well, it was worth a try. But if it makes them concentrate better, Great!

It's cheap and has it's flaws but it may just get you through.

good luck!

Medication - Montana - Sep 24th 2008

Ok so, my name is Rachel i'm fourteen and I have ADHD inattentive subtype. I have no idea if anyone even knows what that is. But I have been on two kinds of medication and so far the Adderall XR is the one that works best.

I was on Strattera since 3rd grade, it started out fine till I kept getting violent stomach aches. They got worse as I continued to take the medication. Eventually I told my mother that flat-out refused to take it. I found out later from a few friends in my school that they had had the same problem. (one of them even progressed to vomiting)

So throughout most of 7th grade I didn't have medication. I did OK in school, but i could have done better. Eventually my mom took me to see the doctor and they put me on the Adderall. (which is a lot like riddlin) It has been perfect. The only minor flaws it has is that:

1. it curbs your appetite (children who are skinny already may need to drink things like ensure or boost to keep thier weight up)

2. it is an anphetamine, so if it isn't taken with care it could make you high, and/or addicted.

3. even if you do take it with care, on days when you forget to take it you may experience minor withdrawl symptoms. (irritability, drowzyness, mood swings)

4. it causes some sort of slight B vitamin deficiency. (I just take multivitamins and i'm fine)

other than those it is a great way to control your ADHD.

now some people say that riddlin (adderall) gives you "ticks" (twitches) but the truth is, it only gives you ticks if the dose is too high.

Anyway, that's about all i have to say on the medication part.... one more thing tho, HERBAL MEDS DO NOT WORK! so yeah that's it.

mother's concern - carnel san jose - Jul 8th 2008
i have a son who has adhd but i heard that the medication is expensive that stopped me to go to a hospital specializing adhd.do you have other options for me to help my son overcome this disorder.i am a mother from a third world country.thank you so much and God speed.

medication - Duke - May 20th 2008

Strattera has worked very well for me. When I took ritilan it gave me twiches. Ask your doctor. Good Luck.

Duke

my life whit adhd - nate - Feb 18th 2008
i have had adhd for 7 years now and it is just so had to find help so if u all have somthing to tell me that will help it woud be nice

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