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Attention Deficit Hyperactivity Disorder (ADHD)

May 08, 2012  by: Sarika  Points: 12   Category: Health  Earning $1.20   Views: 621

Attention deficit hyperactivity disorder is a neurobehavioral medical condition which starts in childhood and can continue further in adulthood.


Attention Deficit Hyperactivity Disorder (ADHD)

What is ADHD?

Attention deficit hyperactivity disorder (ADHD) is the most commonly diagnosed neurobehavioral developmental disorder in children. It starts in childhood and can continue through adolescence and adulthood. It is characterized by inattentiveness, hyperactivity and impulsiveness or a combination of two or all of these symptoms. ADHD was used to be known as Attention Deficit Disorder (ADD) but in 1994 was renamed to ADHD. The disorder is mainly diagnosed between the ages of three to seven and is two to four times more frequent in boys than in girls. However, in some cases it may be diagnosed at a later time point or during adulthood but it is still uncertain that ADHD can occur in adults without first appearing in childhood.

Signs and Symptoms:

It is difficult to diagnose this disease as children have a natural tendency towards inattentiveness, hyperactivity and impulsiveness or a combination of these. However children suffering from this disorder are different from other normal children of the same age, in the sense, that they have increased levels of above mentioned traits and medical intervention is needed. Some of these signs and symptoms are:

Inattentive symptoms:

1. The child is easily distracted, miss details and very often switch from one activity to another.

2. The child is forgetful and often loses things (e.g. toys, pencils, homework, assignments, books etc.) needed to complete tasks or daily activities.

3. The child has difficulty in focusing on the task at hand and has difficulty following instructions.

4. The child does not seem to listen when is spoken to.

5. The child has trouble in learning something new and avoids and dislikes activities which require mental effort (e.g. homework, assignments etc.).

6. The child has often difficulties in organizing the tasks and completing the activities.

7. The child has difficulty in processing the information as quickly and accurately as other normal children.

8. The child becomes easily confused, move slow, become lazy and daydream.

9. The child becomes bored with a task very quickly unless and until doing something enjoyable.

Hyperactivity symptoms:

1. The child fidgets or squirms in his/her seat.

2. The child has trouble sitting still during dinner, school, and story time.

3. The child talks non-stop and has difficulty in doing quiet exercises and activities.

4. The child is abnormally inquisitive and dashes around, touching or playing with anything and everything in sight.

5. The child is often "on the go," acts as if "driven by a motor," and has difficulties in sitting at one place for a long time.

Impulsivity Symptoms:

1. The child is impatient and has difficulty in waiting for its term in games or waiting for things they want.

2. The child blurts out comments and answers even when the question is not finished.

3. The child expresses its emotions without restraint, and act without regard for consequences.


ADHD is a behavioral disorder and can be mistaken for other problems. Therefore it is very important to identify and define the disorder. Based on the above mentioned signs and symptoms ADHD is divided into three main subtypes:

1. Predominantly hyperactive-impulsive.

a. Most symptoms (six or more) are in the hyperactivity-impulsivity categories.

b. Fewer than six symptoms of inattention are present, although inattention may still be present to some degree.

2. Predominantly inattentive.

a. The majority of symptoms (six or more) are in the inattention category and fewer than six symptoms of hyperactivity-impulsivity are present, although hyperactivity-impulsivity may still be present to some degree.

b. Children with this subtype are less likely to act out or have difficulties getting along with other children. They may sit quietly, but they are not paying attention to what they are doing. Therefore, the child may be overlooked, and parents and teachers may not notice symptoms of ADHD.

3. Combined hyperactive-impulsive and inattentive.

a. Six or more symptoms of inattention and six or more symptoms of hyperactivity-impulsivity are present.

b. Most children with ADHD have the combined type.


The exact cause or causes of ADHA are not known but studies have suggested that a number of genetic, environmental and social factors play a major role. Also the influence of developmental problems, nutrition and brain injuries in the development of ADHD disorder cannot be overlooked.

Genetics: Twin studies conducted around the world have revealed that ADHD is heritable and accounts for almost 75% of the reported cases. Scientists are working to identify the genes responsible for the development of the disease with considerable success and perhaps in future would be able to prevent the disease before the symptoms develop.

Environmental Factors: Exposure to alcohol and tobacco smoke at early stages of life (fetus) are strongly linked with the development of ADHD. Nicotine present in cigarette smoke causes hypoxia during fetal life and alcohol causes dehydration which causes brain damage. Complications during pregnancy and birth and also premature birth are considered to be involved in ADHD. Exposure to lead during the early years of life is also onsidered as a factor in ADHD development. Recent studies have shown that insecticides and pesticides containing organophosphates could also increase the risks of developing ADHD.

Social Factors:
Studies have shown that children, who were ignored, had inadequate care and dysfunctional families were at higher risk of developing ADHD. Those children who were subjected to violence or were exposed to emotional and other type of abuses, showed symptoms of ADHD and other behavioral disorders.


It is difficult to diagnose ADHD and to rule out any other behavioral disorder or any comorbidity a proper psychiatric and physical assessment is made. DSM-IV is the main criteria which is mainly used in North America to diagnose the disorder and classify it into its three different subtypes. However European countries usually use the ICD-10 criteria. Diagnosis of ADHD is shown to be 3-4 times more likely if the DSM-IV criteria was used. The children should be extensively evaluated by a qualified health care professional before being labeled as ADHD patients. The American Academy of Pediatrics (AAP) has issued guidelines to diagnose ADHD based on the specific symptoms which must be present in one or more settings. For e.g.

1. Children should have at least 6 attention symptoms or 6 hyperactivity/impulsivity symptoms, with some symptoms present before age 7.

2. The symptoms must be present for at least 6 months, seen in two or more settings, and not caused by another problem.

3. The symptoms must be severe enough to cause significant difficulties in many settings, including home, school, and in relationships with peers.

4. Use of parent and teacher questionnaires (for example, Connors, Burks).

5. Proper and extensive psychological evaluation of the child AND family, including IQ testing and psychological testing.

6. Complete developmental, mental, nutritional, physical, and psychosocial examination of the child.

Management and Treatment:

ADHD is a neurobehavioral problem and combinations of Psychosocial and medical therapeutic approaches are used to treat the disorder. Behavioral therapy, interpersonal psychotherapy, family therapy, neuro feedback, social skills training and parent management training are some of the effective psychosocial techniques employed to manage ADHD.

Most common type of medication used to treat ADHD is “stimulant”. Although these drugs are called stimulant they have a soothing effect on the patient. There is lack of in-depth knowledge and data on the long term benefits or side effects of stimulants on the patient. There are also other alternative non-stimulant medications available to treat ADHD like “atomoxetine”. However lack of good comparative studies between different medications available for ADHD makes it difficult to access the effectiveness of the treatment. Till today there is no cure for ADHD and medicines only help to control the symptoms as long as they are taken.


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