Attention Deficit Hyperactivity
Disorder (ADHD)

Many people are unable to sit still, plan ahead, finish tasks or be fully aware of what is going on around them.  To their family, classmates or coworkers they seem to exist in a whirlwind of disorganized or frenzied activity.  On some days and in certain situations they seem fine, often leading others to believe they can control this behavior.  The disorder can adversely affect relationships with others in addition to disrupting their daily life, consuming energy and diminishing self-esteem.

Incidence

ADHD, once called hyperkinesis or minimal brain dysfunction, is a common mental disorder among children.  It affects some 3-5% of all children - perhaps as many as 2 million American children.  Two to three times more boys than girls are affected.  On average, at least one child in every classroom in the United States needs help for the disorder.

Signs and Symptoms

At present, ADHD is a diagnosis applied to children and adults who consistently display certain characteristic behaviors over a period of time.  The most common behaviors fall into three categories: inattention, hyperactivity and impulsivity.  ADD (Attention Deficit/Deficiency Disorder) occurs when hyperactivity is not present.

Diagnosis and Tests

Not everyone who is overly hyperactive, inattentive or impulsive has an attention disorder.  Are these behaviors excessive, long-term and pervasive, occurring more often than in most others the same age? Are they a continuous problem, not just a response to a temporary situation? Do the behaviors occur in several settings or only in one specific place such as the playground or the office?

According to the Diagnostic and Statistical Manual of Mental Disorders, there are three patterns of behavior that indicate ADHD, and someone may have one or more.

Signs of inattention include:

• becoming easily distracted by irrelevant sights and sounds
• failing to pay attention to details and making careless mistakes
• rarely following instructions carefully and completely
• losing or forgetting things such as toys, or pencils, books and tools needed for a task.

Some signs of hyperactivity and impulsivity are:

• feeling restless, often fidgeting with hands or feet, or squirming
• running, climbing or leaving a seat in situations where sitting or quiet behavior is expected
• blurting out answers before hearing the whole question
• having difficulty waiting in line or for a turn.

To be considered ADHD, the behaviors must have appeared before age 7 and continued for at least 6 months.  In children they must be more frequent or severe than in most others of the same age.  Above all, the behaviors must create a real handicap in at least two areas of a person's life, such as school, home, work or social settings.  Someone whose work or friendships are not impaired by these behaviors would not be diagnosed with ADHD, nor would a child who seems overly active at school but functions well elsewhere.

Other conditions may produce similar symptoms resulting in an incorrect diagnosis.  Anything from chronic fear to mild seizures can make a child seem overactive, quarrelsome, impulsive or inattentive.  For example, a formerly cooperative child who becomes overactive and easily distracted after a parent's death is dealing with an emotional problem, not ADHD.  A chronic middle ear infection can also make a child seem distracted and uncooperative.  Living with family members who are physically abusive or addicted to drugs or alcohol can produce effects that may resemble ADHD, but are not.

In other children, ADHD-like behaviors may be their response to a defeating classroom situation.  Perhaps the child has a learning disability and is not developmentally ready to learn to read and write at the time these are taught.  Perhaps the work is too hard or too easy, leaving the child frustrated or bored.

It's also important to realize that during certain stages of development, the majority of young children tend to be inattentive, hyperactive or impulsive, and yet do not have ADHD.  Preschoolers have lots of energy and run everywhere they go, but this doesn't mean they are hyperactive.  Many teenagers go through a phase when they are messy, disorganized and reject authority but it doesn't mean they will have a lifelong problem controlling their impulses.

Treatment and Prevention

ADHD is a serious diagnosis that may require long-term treatment with counseling and medication.  Medication-free methods should receive a trial before immediately beginning drug use.  Identifying the problem can help people understand why they behave in these ways.  This understanding can be an important part of coping with the disorder.

Prognosis

ADHD often continues into adolescence and adulthood, and can cause a lifetime of frustrated dreams and emotional pain.

While it was previousely thought that Attention Deficit was primarily a childhood problem, it is now believed that only one-third of this population grows out of it.

References and Further Information

Two books that could appear on any suggested reading list include:

• ADHD: A Path to Success - A Revolutionary Theory and New Innovation in Drug-Free Therapy (1998) by Lawrence Weathers and Kelsey Loughlin presents a revolutionary theory that helps parents see through their ADHD child's eyes.  Their high rate of success is based on learning how your child's ADHD is not a deficit, but a highly refined skill that helps them survive.
• Driven to Distraction - Recognizing and coping with Attention deficit Disorder from Childhood through Adulthood (1995) by Edward Hallowell, MD and John Ratey, MD is a readable and helpful paperback.