Definition: ADHD is a neurodevelopmental disorder affecting both children and adults. In diagnosing ADHD in adults, clinicians now look back to middle childhood and the teen years for the beginning of symptoms. ADHD is described as a persistent or on-going pattern of inattention and/or hyperactivity-impulsivity that gets in the way of daily life or typical development and must be in two settings, such as home and school. Individuals with ADHD may also have difficulties with maintaining attention, executive function (or the brain’s ability to begin an activity, organize itself and manage tasks) and working memory.

There are three presentations of ADHD:

  • Inattentive
  • Hyperactive-impulsive
  • Combined inattentive & hyperactive-impulsive

Symptoms: Children should have six or more symptoms to be diagnosed with the disorder while older teens/adults should have at least five of the symptoms in either or both categories for at least six months.

Inattentive presentation:

  • Fails to give close attention to details or makes careless mistakes.
  • Has difficulty sustaining attention.
  • Does not appear to listen.
  • Struggles to follow through on instructions.
  • Has difficulty with organization.
  • Avoids or dislikes tasks requiring a lot of thinking.
  • Loses things.
  • Is easily distracted.
  • Is forgetful in daily activities.

Hyperactive-impulsive presentation:

  • Fidgets with hands or feet or squirms in chair.
  • Has difficulty remaining seated.
  • Runs about or climbs excessively in children; extreme restlessness in adults.
  • Difficulty engaging in activities quietly.
  • Acts as if driven by a motor; adults will often feel inside like they were driven by a motor.
  • Talks excessively.
  • Blurts out answers before questions have been completed.
  • Difficulty waiting or taking turns.
  • Interrupts or intrudes upon others.

Combined inattentive & hyperactive-impulsive presentation:

  • Has symptoms from both of the above categories.

Causes: Research has demonstrated that ADHD has a very strong neurobiological basis. Although precise causes have not yet been identified, there is little question that heredity plays a large role. In instances where heredity does not seem to be a factor, difficulties during pregnancy, prenatal exposure to alcohol and tobacco, premature delivery, significantly low birth weight, excessively high body lead levels, and postnatal injury to the prefrontal regions of the brain have all been found to contribute to the risk for ADHD to varying degrees.

Treatment: The management of ADHD typically involves behavior therapy or medications either alone or in combination. Medications used include stimulants and sometimes antidepressants. They have at least some effect in about 80% of people. The use of medication in young children is controversial and may not be advised. In the long term, medication and behavior therapy are equally effective. Parent education and support is also necessary in order for parents to help their children with becoming organized, develop problemsolving skills, and learning to cope with symptoms of the disorder. Dietary modifications may also be of benefit with evidence supporting free fatty acids and reduced exposure to food coloring.