Website design By BotEap.comAttention deficit / hyperactivity disorder (ADHD) has had many alternative labels, including attention deficit disorder (ADD), minimal brain dysfunction, hyperkinetic syndrome, and developmental hyperactivity. This syndrome appears in early childhood and can have a lifelong course. Research results show a major deficit in the ability to inhibit response, delay response, or tolerate externally imposed behavioral delays once a task is started.

Website design By BotEap.comStudents with ADHD do not see the value of working hard in school and academic performance is often below the measured intelligence of the student. Sustained mental effort tends to be an inherent punishment. Conflict with parents and teachers is common. Compared to most people of the same age, there is greater variability in the behavior of the person with ADHD according to situations and time. Classrooms and other group settings that require sustained attention to homework produce much more symptomatic behavior than individual situations, novel settings, or situations in which the person receives frequent feedback or reinforcement.

Website design By BotEap.comIn 1994, the American Psychiatric Association recognized three types of ADHD: combined type, predominantly inattentive type, and predominantly hyperactive-impulsive type.

Website design By BotEap.comThere are nine criteria for diagnosing the inattentive type. Six or more of these must have been true often or very often for at least six months in order to make a diagnosis of ADHD. These criteria are that the person does not pay much attention to detail or makes careless mistakes in school work, work, or other activities; has difficulty maintaining attention to tasks or play activities; does not seem to listen when spoken to directly; does not follow directions and does not complete school work, chores, or duties in the workplace; often has difficulty organizing tasks and activities; avoids, dislikes, or is reluctant to participate in tasks that require sustained mental effort; loses things necessary for homework or activities, such as schoolwork, pencils, books, or tools; is easily distracted by strange stimuli; and is forgetful in daily activities.

Website design By BotEap.comThere are also nine criteria for the hyperactive-impulsive type. As with inattention, six or more of these must have been true often or very often for at least six months in order to make a diagnosis of ADHD. Six of them are related to hyperactivity: the person fidgets with the hands or feet or squirms in the seat; leaves the seat in the classroom or in other situations where you are expected to remain seated; runs or climbs excessively in situations where it is inappropriate or has subjective feelings of unease; has difficulty playing or participating in leisure activities in silence; it is in motion or acts as if it were being driven by a motor; and talks excessively. The final three criteria in this set cover impulsivity: the person blurts out answers before questions are completed, has difficulty waiting their turn, and interrupts or intrudes on others.

Website design By BotEap.comThe diagnosis of ADHD also requires that some of the symptoms appeared before age seven, that the symptoms affected functioning in at least two settings (eg, school and home), that there must be a deterioration in functioning social, academic or occupational that is clinically significant, and that the symptoms are not caused by another mental or physical disorder.

Website design By BotEap.comFor children and adolescents, at least six criteria within both sets of nine must be met to make the diagnosis of ADHD, combined. ADHD experts have not reached a consensus to make the diagnosis in adults; however, there is evidence to suggest that when an adult meets at least four of the criteria in a given set, the diagnosis of ADHD is appropriate. Retrospective data collection on adult behavior in childhood can be helpful in clarifying whether the diagnosis is appropriate.

Website design By BotEap.comRegardless of the patient’s age, personal history and current symptoms form the basis for making the diagnosis. Particularly for children and adolescents, there are many questionnaires available to help determine if ADHD is present. Common clinical practice requires the use of multiple informants to complete a variety of such measurements. No medical laboratory test is helpful in diagnosing ADHD. Psychological tests are also of little value in making the diagnosis. Many computerized tests are available to measure sustained attention to task, but most of them do not appear to be helpful in differentiating ADHD from other disorders.

Website design By BotEap.comInattention, restlessness, hyperactivity, and impulsivity are common in young children. They are also often present in children with lower intelligence who are placed in academic settings that do not match their ability or in intellectually gifted children who are under-stimulated. Additionally, symptoms of inattention, hyperactivity, and impulsivity can appear in various other disorders. Although there is some overlap in some of the defining symptoms of ADHD and these other disorders, the diagnostic criteria in use in the mid-1990s are clear enough to discriminate between these disorders.

Website design By BotEap.comComorbidity refers to the phenomenon in which people with a disorder have a greater chance than the possibility of having one or more disorders. ADHD has several comorbidities. Up to 85% of children with ADHD have at least one other diagnosable behavioral, emotional, or learning disability. They also have more minor physical abnormalities, wet the bed more often, have more physical accidents, have greater sleep problems, and have more aches and pains than other children. They are at higher risk for antisocial, defiant, and oppositional behavior problems. ADHD appears to increase the risk of substance abuse, job failure, marital discord, and divorce, but longitudinal studies suggest that it is a comorbid oppositional, defiant, and aggressive behavior that places the child at high risk for serious problems in later life instead of the ADHD symptoms themselves.

Website design By BotEap.comADHD is the most common referral problem to clinics and professionals serving children and adolescents with behavioral or psychological problems in the United States. It occurs in all cultures and socioeconomic levels. This disorder is diagnosed much more often in boys than in girls. There appears to be a significant hereditary contribution to the development of the disorder. If the father of a child had ADHD, the child has a greater than 50% chance of having the disorder. The basic problem does not appear to be an attention problem; rather, it is an impairment in cortical regulation of response inhibition and impulse control.

Website design By BotEap.comEffective treatment of children with ADHD is multifaceted. Medications are usually a part of the treatment regimen. 70% to 90% of children with ADHD benefit from one of the psychostimulants: methylphenidate, amphetamine, and pemoline. Available evidence indicates that adolescents and adults also benefit from stimulant medication.

Website design By BotEap.comAlthough individual play therapy or psychotherapy has not proven useful in treating ADHD, other psychological interventions are recommended. Parent training is standard practice (see Parent Training Programs). This training covers many points. The child’s difficulties are not the result of faulty parenting. The symptoms will make parenting difficult, demanding, and complex. Parenting that includes writing and managing contingency contracts between parents and children will be helpful. These contracts identify what the parents want the child to do and not do, as well as the specific consequences the child will receive for the desired behaviors. Seeing the child being good, giving rewards immediately and often after good behavior, and using mild punishments such as time out and cost of response are some of the keys to success.

Website design By BotEap.comPsychological consultation with the child’s teacher is also important. The purpose of this consultation is to identify what educational services will benefit the student and to establish a contingency management program at school similar to that used by parents at home. Home and school programs are often linked by the teacher sending home a daily report on the child’s behavior and academic performance. This report allows parents to reinforce the good behavior that occurs at school. Academic tutoring by adults or peers is often helpful.

Website design By BotEap.comThe direct therapeutic work of mental health professionals includes social skills training; coaching in goal setting, in self-monitoring of progress toward goals, in making plans to achieve one’s goals, and in the use of timers, checklists, organizers, and other tools for self-management; and family therapy.

Website design By BotEap.comWhen treating ADHD in adolescents, all the procedures described can be used, but it is valuable to emphasize self-management strategies, including cognitive-behavioral therapy. When the patient is an adult, self-regulatory approaches are also relevant. Marriage therapy by a professional experienced in treating ADHD can be helpful.

Website design By BotEap.comVarious experts have proposed the value of various other treatments without providing adequate scientific evidence of their effectiveness. Among these treatments that have no empirical validity are the elimination of food additives or sugar from the diet, the use of megavitamins and mineral supplements, the intake of anti-motion sickness medication, antifungal medication combined with a low sugar diet, biofeedback directed at brain waves, sensory integration training, chiropractic neural organization technique (kinesiology), and applied optometry training.