OverviewWhat is Attention-Deficit/Hyperactivity Disorder (ADHD)?Does your child fail to sustain attention, behave within appropriate limits at home and in public, or sit quietly when they’re expected to do so? Not being able to stay within limits or sit quietly is normal childhood behavior if it happens at different ages and from time to time, but if this behavior occurs frequently and interferes with your child’s daily life, they may have ADHD. Show
ADHD is a neurodevelopmental condition that can affect family life. The word “neurodevelopmental” refers to the nervous system, which includes the brain as it develops across the lifespan. ADHD behavior usually appears by age 7, though difficult behavior may show up before this. With ADHD, children can have trouble with impulsivity, hyperactivity, distractedness, following instructions and completing tasks. But ADHD is treatable. When symptoms of Attention-Deficit Hyperactivity Disorder occur in childhood, they tend to persist into adulthood in about half of all cases. Adults with ADHD often find it difficult to follow directions, remember information, and concentrate on or organize tasks. Without proper acknowledgement and management of these behaviors, ADHD can result in behavioral, emotional, academic, vocational and social problems that decrease the quality of life. What is the difference between ADHD and ADD (Attention-Deficit Disorder)?ADHD is the only term assigned to this diagnosis but there are different presentations of ADHD — ADHD Inattentive Presentation, ADHD Hyperactive/Impulsive Presentation, ADHD Combined Presentation (both inattention and H/I behavior) and a fourth type called Unspecified ADHD, a diagnosis used when symptoms are unclear. How common is ADHD?About 11% of children between the ages of four and 17 have ADHD. Symptoms of ADHD typically first appear between the ages of three and six years old. The average age of ADHD diagnosis is seven years old. In children, it’s three times more common in young boys than girls. ADHD isn’t just a childhood disorder. About 4% of American adults over the age of 18 contend with ADHD behaviors on a daily basis. In adulthood, it’s diagnosed equally between males and females. Is ADHD a mental illness?By definition, ADHD is better referred to as a neurodevelopmental disorder, not a “mental illness.” The term “mental illness” is a very broad term for any type of condition that affects mood, behavior or thinking. ADHD is better described as a pattern of behavior — something different in the way a person does things — rather than describing it as something “wrong” with people. Evidence indicates that ADHD is associated with neural pathways in brain functioning (the default mode and the task positive mode). This functioning yields problematic behavioral at certain ages (stages of development) — thus the term neurodevelopmental disorder is a better broad category name for the problem of ADHD. Is ADHD a form of autism?No, although they are both neurodevelopmental disorders. Except, many children with autism have ADHD. But the two conditions are by expression and definition quite different. Is ADHD a learning disability?ADHD is not a learning disability, though it certainly can impair learning. About 30% to 40% of children with ADHD also have a learning disability. Like those with a learning disability, children with ADHD are eligible to receive special education services. Symptoms and CausesWhat are the symptoms of ADHD?Children, teenagers and adults with ADHD have an ongoing pattern of three types of core behaviors:
Children, teens and adults with ADHD are diagnosed by the behavior pattern that is most actively present. The three most common ADHD presentations are Predominantly Inattentive, Predominantly Hyperactive/Impulsive and the combination of these types. ADHD Predominantly Inattentive Presentation is defined by the following nine behaviors:
Behaviors of the ADHD Predominantly Hyperactivity/Impulsive type include:
What are the risk factors of ADHD?ADHD is largely a hereditary condition. If one or both parents have been diagnosed with ADHD, their children are more likely to have it as well. Although the exact etiology (i.e., origins) of ADHD are ill-defined, healthcare providers report other associated risk factors:
What makes ADHD symptoms worse?Certain behaviors are expected depending on the age of a person. Because the brain doesn’t develop at the same rate in everyone, cognitive functions may be poor in some people and not in others. A child 10 years old, for example, might only have the abilities of a younger child 8 years old rather than his or her same age peers. Therefore, as you or your child get older, the problem is not that ADHD gets worse, it’s that the child’s abilities are not developing synchronized with age. Although ADHD doesn’t get “worse,” the tasks expected of the person become more complicated with age and circumstances, such as increased demands in school, therefore, the problematic behaviors (such as completing things on time) become more problematic. For example, as the child may get a lower grade for turning in late work. Examples of other complications include:
Diagnosis and TestsHow is ADHD diagnosed in children, teens and adults?To diagnose a child, the healthcare provider must perform three tasks. The healthcare provider must: 1) identify the presence of ADHD symptom criteria, 2) rule out alternative causes of symptoms, and 3) identify comorbid conditions (other conditions such as depression or anxiety). But, the job is not yet done. Certain conditions must also be met. First, the symptom behaviors must be present in two or more settings such as at home and in school. Second, the symptoms must be impairing. It’s not just that they occur as everyone engages in these behaviors sometimes. Third, symptom behaviors must have been present in childhood, typically before the age of 12 years. Last, the symptoms cannot be corollaries to another disorder that is not ADHD. For example, sometimes, when a person is depressed or anxious, inattentive behaviors may occur. The clinician will identify ADHD symptoms by asking you questions about your child’s behavior s at home and school (that is, behaviors your child’s teachers shared with you). Next, your provider will rule out other possible conditions that share some similar symptoms. These conditions include:
A sudden life change (such as divorce, death in the family, or moving to a new home) may also result in behaviors that could be confused with ADHD). Sometimes, an adult will recognize the behaviors of ADHD in himself or herself when a son or daughter is diagnosed. Other times, adults will seek professional help for themselves and find that their depression or anxiety is related to ADHD. The American Psychological Association has guidelines to help healthcare providers make the diagnosis. To be diagnosed with ADHD, children must have six or more symptoms in one of the two (or both) main categories — 1) inattention and/or 2) hyperactivity/impulsivity (see the symptom section) — of ADHD over the last six months. To be diagnosed with ADHD as an adult, you must have five or more of the established ADHD behaviors in either of these categories for at least six months and there must be evidence such as recall of school experiences that indicates symptoms were present in childhood. To reiterate, in addition to having ADHD behaviors, children, teens and adults must meet the following criteria:
Based on review of the collected information, your healthcare provider may diagnose an adult or child with one of types of ADHD:
Keep in mind that symptoms can change over time and therefore so can the diagnosis of the type of ADHD. How should I prepare for my child’s appointment to discuss ADHD?If you think your child has a problem with attention, hyperactivity or impulsivity, and it seems that his or her behavior at home and performance at school are being affected, your next step is to see your pediatrician. If the symptoms are affecting your child’s schoolwork, contact the school and request an evaluation. When making this request, be as specific as possible about the type of educational or behavioral difficulties your child is having. Schools are required to evaluate children (ages three to 21) if there’s evidence of a disability that affects their learning. This evaluation is free and must, by law, include appropriate standardized tests. School testing can lead to accommodations in the classroom. The school will not diagnose ADHD, but will take note of the symptoms and will often assign a designation of “Other Health Impaired” (OHI). Get a copy of the school’s report and bring it with you to the appointment with the pediatrician. If necessary, the family provider may suggest you take your child to a professional who specializes in ADHD and other developmental, behavioral or mental health concerns. Management and TreatmentHow is pharmacotherapy used to treat ADHD?A group of drugs called psychostimulants are an effective treatment for ADHD. The two most commonly used medicines in this class are methylphenidates (often known as Ritalin) and dextroamphetamines (similar to Adderall). These medicines help people with ADHD focus their thoughts and ignore distractions. Stimulant medicines are effective in 70% to 90% of patients with ADHD. New medicines are also being developed. Examples of short-acting (immediate-release), intermediate-acting and long-acting forms of these medications include: Methylphenidates
D-Amphetamines
Non-stimulant medicines include atomoxetine (Strattera®,) guanfacine (Intuniv®), and clonidine (Kapvay®). They are often used as additional treatment, or can be used on their own if the healthcare provider approves. New nonstimulant formulations are in the pipeline of several pharmaceutical companies. There’s no way to really know which medicine(s) and dosage level(s) will work best for you or your child until you try it out. Your healthcare provider may need to prescribe several different formulations and see how you your or your child react. Typically the physician will “start low (in dose) and go slow.” The most common side effects of ADHD medications include decreased appetite, trouble sleeping and irritability. Fortunately, side effects are often mild and short-lived and usually happen early in treatment. If they continue or interfere with you or your child’s daily life, your provider will probably change your medication or lower the dose. The most important question to ask is, “Does the benefit of the medicine outweigh the side effect?” The most effective treatment is medicine combined with behavioral therapy. What behavioral treatments are used to treat childhood and adult ADHD?The best prevention for ADHD, supported by substantial research, is to use a combined approach of both behavioral intervention and pharmacotherapy. Medicines are not enough to treat you or your child’s ADHD. The old adage — pills don’t teach skills — is certainly appropriate here. Thus it’s best to combine medical treatments with behavioral treatments. Behavioral treatments for childhood ADHD include:
Behavioral treatments in adults help you navigate the demand of jobs, relationships and educational opportunities. ADHD coaches are trained and certified to assist adults with ADHD to manage the various difficulties of their lives. Behavioral treatments for adults with ADHD include:
What happens if ADHD is left untreated?Symptoms will continue if ADHD is left untreated and people are left to manage them on their own. Children may struggle at school, home and in social situations, and adults may struggle with work, education, interactions with friends and family and more. Untreated ADHD makes life harder than it has to be. PreventionHow can I prevent ADHD?There are certain risk factor categories for the development of ADHD, some of which can be changed, some that can’t. They are:
If you or your parents have ADHD, there is a higher probability that your children will, too. Unfortunately, there’s nothing that can be done to prevent the genetics from ADHD expression. The same goes for biologic factors. People can be born with chemical imbalances or they can have adequately functioning neurotransmitters. Environmental toxins have been linked to ADHD in children. Parents may have their home tested for lead, for example, to prevent lead poisoning which increases the risk of ADHD. Another way to help reduce the risk of ADHD is to avoid smoking, alcohol and drugs while pregnant with your child. Outlook / PrognosisWhat can I expect if I or my child has ADHD?ADHD is a complicated condition with various symptom expressions. If you or your child have ADHD, educate yourself as much as possible about the behaviors that make life difficult. Consider medicines and behavioral treatments. Your healthcare provider will help you with these. He or she will sum up the results of the ADHD evaluation and will recommend appropriate treatment. A combination of pharmacotherapy and behavioral treatment, is generally recommended. A trained behavioral health clinician can give general guidelines for managing your own or your child’s ADHD and these can be tailored to your family’s needs and your child’s strengths and weaknesses. Also, it is always useful to have appropriate expectations for yourself and your child. Don’t expect your child to get out of bed the first time you wake them up, and don’t be too hard on yourself if making progress is difficult. It is always best to have your partner and friends help with tasks like organizing and time management. Stay in contact with your healthcare provider, especially if there is a change in you or your child’s behaviors, or there is a reaction to prescribed medications. Two important questions to ask yourself are: 1) "Am I moving forward in the world of action or am I living in my head? 2) "Am I moving closer to my values or am I moving away from what I value?" How long will I have ADHD?ADHD does not go away but many people learn to manage it successfully in their adult lives. ADHD is a lifelong condition, and behaviors are often successfully managed with medicine and behavioral treatment. Living WithA child with ADHD typically may become hyper focused with activities of interest. For example, children can spend hours in front of a screen playing video games, but they may have trouble finishing even simple homework assignments, or they may throw tantrums and refuse to do chores or schoolwork at home. Your child uses a certain kind of attention — called automatic attention — when doing something that is of interest to them. However, things that require effort, such as homework, require a different type of attention — called directed or effortful attention — which is harder to use and requires much more effort. What are some additional strategies for managing my child’s ADHD at home?You may find the following strategies helpful for managing ADHD in the home: Behavior:
Organization:
Homework time:
What strategies can parents with ADHD use to resolve conflicts with children with ADHD?
In addition to the formal symptoms used to diagnose ADHD in children and adults, are there other easy to identify behaviors and problems that indicate an adult may have ADHD?Yes. The following behaviors and problems might stem directly from ADHD or might be the result of related adjustment difficulties in adults:
What strategies can help an adult with ADHD succeed in the workplace?If you struggle at your job, it may be because your job requires strong organization, focus and decision-making skills—the very skills that people with ADHD struggle with. Your healthcare provider can help. Ask your provider for referral to other professionals, such as a professional ADHD Coach, who can offer the following tactics that can help you thrive at your job:
What questions should I ask my child’s healthcare provider about ADHD?
What questions should I ask my healthcare provider about ADHD?
A note from Cleveland Clinic Attention-deficit hyperactivity disorder (ADHD) is a common, lifelong condition that affects children, teens and adults. Although it can negatively affect behavior, thinking, and attention, it is nevertheless treatable with behavior therapy and medication. Behavioral treatments and support from friends, family and teachers are always helpful. Stay in contact with your healthcare provider. Be open and honest about all of the behavior you find problematic. Together, come up with a plan. There may seem like there’s a lot to do for your child between dealing with school and healthcare providers and monitoring homework. If you also have ADHD, there’s even more to do like attending therapy sessions, taking your own medicines and monitoring your children. There are long to-do lists, and they are especially complicated if you have ADHD and may give a sense of feeling overwhelmed like your child often feels. However, it is possible to have things work far better than they are and it is helpful to follow the tips in this article. And so doing you can drastically improve your child’s life and your own. Never hesitate to contact your healthcare providers with any questions or concerns about you or your child’s ADHD. They are there to help you! Which of the following terms is defined as the ability to use information gained by one sense to guide another?The ability to use information gained from one sense to guide another is called: cross-modal transfer.
What refers to the focusing of mental resources on select information?Attention. Definition. The focusing of mental resources on select information.
What is Piaget's concept of grouping isolated behaviors into a higherassimilation. Piagetian concept of using existing schemes to fit new information or experiences. accomodation. Piaget's concept of grouping isolated behaviors and thoughts into a higher-order, more smoothly functioning cognitive system. organization.
Which of the following indicates a significant problem in an infant's communication system quizlet?Lack of pointing in an infant is a significant indicator of problems in the infant's communication system. Long before infants begin to learn words, they can make fine distinctions among the sounds of the language.
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