Attention Deficit Hyperactive Disorder (ADHD)

What are ADHD and ADD?
ADHD is a biological condition which makes the child hard to sit still and concentrate on the given task. They might be so restless that one can recognize easily

ADD or Attention Deficit Disorder is also a biological condition that makes it hard for many children to pay proper attention during a task. Its means a person shows enough symptoms of inattention but isn't hyperactive or impulsive. They are mostly shy in nature

Is ADD and ADHD same?
No. ADD, is a type of ADHD. Predominantly Inattentive Type ADHD is also called attention deficit disorder (ADD).
While ADD generally seen in adult but ADHD is common in both children and adult.
The acronyms ADD is not being nowadays as it is a sub type of ADHD only

How common ADHD is?
The American Psychiatric Association says that 5 percent of American children have ADHD. According to CDC the prevalence is 11 percent of American children, in the age group 4 yrs to 17 yrs. In India, the prevalence is more or less same. Some surveys have observed it is between 2% to 17%.

What are the symptoms of ADHD?

If you are concern, that your child may have ADHD, look for the following symptoms / signs and note these symptoms should be present at least for past six months.
Signs and symptoms related to Inattention

  • The child forgets things, mostly confused and appears to not be listening
  • The child finds it hard to concentrate and jumps quickly from one activity to another
  • The child gets easily bored with an activity unless it’s very enjoyable
  • The child struggles to get organized and finish tasks in time
  • The child has difficulty learning new things and following directions
  • The child is smart but he doesn’t understand or “get” things you expect

Signs and symptoms related to Impulsivity

  • The child is impatient and has trouble waiting for a turn
  • The child interrupts people and bursts out inappropriately
  • The child shows overreaction to feelings and emotional situations
  • The child doesn’t understand the consequences of his actions

Signs and Symptoms related to Hyperactivity

  • He talks almost constantly
  • He moves nonstop even when sitting down
  • He moves from place to place quickly and frequently
  • He fidgets and has to pick up everything and play with it
  • He has trouble sitting still for meals and other quiet activities

What skills / activities may be affected due to ADHD?
If a child has ADHD, he might be getting problems with

  • Social skills
  • Self-control
  • Organization, planning and learning
  • Understanding directions
  • Thinking things through
  • Paying attention to new information
  • Applying knowledge from one area to a different one
  • Staying focused without getting bored
  • Being aware of one’s own thought processes (the opposite of daydreaming)

What are the different types of ADHD? 
There are three types of ADHD

  • Predominantly hyperactive-impulsive type
  • Predominantly inattentive type
  • Combined type

What are the causes of ADHD?

  • We don’t know the exact cause of ADHD. But we have identified factors showing it’s a brain-based biological condition. The possible causes of ADHD include:
  • Genes and heredity 
  • Differences in the brain
  • Environmental factors
  • Brain injury

How ADHD is diagnosed?
There’s no single test that can confirm that a child has ADHD. Using the DSM5 is the standard protocol to make the diagnosis and knowing the severity of the condition
DSM-5TM medical classification system for ADHD
A persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development

For children, six or more of the symptoms have persisted for at least 6 months to a degree that is inconsistent with developmental level, and that negatively impacts directly on social and academic/occupational activities. 

For older adolescents and adults (age 17 and older), five or more symptoms are required
- Several inattentive or hyperactive-impulsive symptoms present prior to age 12 years1
- Several inattentive or hyperactive-impulsive symptoms present in two or more settings (e.g. at home, school or work; with friends or relatives; in other activities)1
- Clear evidence that the symptoms interfere with, or reduce the quality of, social, academic or occupational functioning1
- Symptoms do not occur exclusively during the course of schizophrenia or another psychotic disorder, and are not better explained by another mental disorder (e.g. mood disorder, anxiety disorder, dissociate disorder, personality disorder, substance intoxication or withdrawal).

 

Symptoms of inattention

  • Often fails to give close attention to detail or makes mistakes
  • Often has difficulty sustaining attention in tasks or activities
  • Often does not seem to listen when spoken to directly
  • Often does not follow through on instructions and fails to finish schoolwork or workplace duties
  • Often has difficulty organizing tasks and activities
  • Often avoids, dislikes or is reluctant to engage in tasks that require sustained mental effort

Often loses things necessary for tasks or activities
Is easily distracted by extraneous stimuli
Is often forgetful in daily activities

Symptoms of hyperactivity and impulsivity

  • Often fidgets with or taps hands and feet, or squirms in seat
  • Often leaves seat in situations when remaining seated is expected
  • Often runs and climbs in situations where it is inappropriate (in adolescents or adults, may be limited to feeling restless)
  • Often unable to play or engage in leisure activities quietly
  • Is often ‘on the go’, acting as if ‘driven by a motor’
  • Often talks excessively
  • Often blurts out answers before a question has been completed
  • Often has difficulty waiting their turn
  • Often interrupts or intrudes on others

1
The current severityof ADHD should also be specified:
Mild few, if any, symptoms in excess of those required to make the diagnosis are present, and symptoms result in no more than minor impairments in social or occupational functioning
Moderate symptoms or functional impairment between ‘mild’ and ‘severe’ are present
Severe many symptoms in excess of those required to make the diagnosis, or several symptoms that are particularly severe, are present; or the symptoms result in marked impairment in social or occupational functioning.

What are the other conditions associated ADHD?
Children with ADHD often have other associated conditions as well.  Such as

  • Behavior disorders
  • Emotional regulation issues
  • Learning disabilities
  • Auditory processing disorder
  • Social (pragmatic) communication disorder
  • Oral-Motor tic disorders

How ADHD is managed or treated?
ADHD can be treated using medication or therapy, but a combination of both is often best.

Medication

  • There are five types of medications generally used for the treatment of ADHD. They are
  • methylphenidate 
  • dexamfetamine
  • lisdexamfetamine
  • atomoxetine
  • guanfacine
  • Although, these medicines aren't a permanent cure for ADHD, but they may help to concentrate better, be less impulsive, feel calmer, and learn and practice new skills.

Therapy

  • Along with medications, different therapies can be useful in treating ADHD in children.
  • There is a long list of therapies available. Some of these are:
  • Behavior therapy
  • Social skills training
  • Psychotherapy
  • Cognitive behavioral therapy (CBT)
  • Parent training and education program
  • Diet
  • Supplements

What is the possible prognosis of the condition?
Mostly children with ADHD can lead a productive and successful life. They are always managed with medications and structured therapies. A few of them can have the problem life long which can mask his / her potentials.  

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