Attention Deficit Hyperactivity Disorder (ADHD) is a brain-based biological disorder. Low levels of dopamine (a brain chemical), which is a neurotransmitter, are found in children with ADHD. Brain imaging studies using PET scanners (positron emission tomography; a form of brain imaging that allows the human brain to be observed at work) show that brain metabolism in children with ADHD is lower in the areas of the brain that control attention, social judgment and movement.
Types of ADHD
There are three major types of ADHD:
Combined type. The most common type of ADHD, this is characterized by impulsive and hyperactive behaviors as well as inattention and distractibility.
Inattentive and distractible type. This is characterized predominately by inattention or distractibility without hyperactivity.
Impulsive/hyperactive type. The least common type of ADHD, this is characterized by impulsive and hyperactive behaviors without inattention or distractibility.
Causes of ADHD
Despite being one of the most researched areas in child and adolescent mental health, the cause of the disorder is still unknown. Available evidence suggests that ADHD is genetic. Many parents of children with ADHD experienced symptoms of ADHD when they were younger, and it is commonly found in siblings within the same family.
Diagnosis of ADHD
A key element in the diagnosis of ADHD is that symptoms must significantly impair adaptive functioning in both home and school environments.
Although symptoms of hyperactivity can begin to be present in preschoolers and are almost always apparent by the age of seven, ADHD is not just a childhood disorder. ADHD can progress into adulthood, be developed later in life or go undiagnosed until adulthood.
The three categories of symptoms of ADHD are:
Inattention. Short attention span for age, difficulty listening to others, difficulty attending to details, easily distracted, forgetfulness, poor study and organizational skills for age.
Impulsivity. Interrupts others, difficulty waiting turn in school or social games, takes frequent risks – often without thinking before acting.
Hyperactivity. Fidgets, seems to be in constant motion, difficulty remaining in his or her seat even when it is expected, talks excessively, difficulty engaging in quiet activities, loses or forgets things often, inability to stay on task
A detailed history of the child’s behavior from parents and teachers, observations of the child’s behavior and psychoeducational testing contribute to the diagnosis of ADHD.
Many of the symptoms may occur in individuals who do not have ADHD, resembling other medical conditions or behavior problems. Always consult your primary care provider for a diagnosis.
Treatment Options for ADHD
If not treated appropriately, attention deficit hyperactivity disorder (ADHD) can lead to school failure, failure with employment and difficulty with interpersonal relationships.
When establishing a treatment for confirmed ADHD, it is important to work closely with your primary care provider on an option that is best for you or your child’s needs. Major components of treatment for children include parental support and education in behavioral training, appropriate school placement and medication.
If you or your child are struggling with attention, learning, discipline or behavior, talk to your primary care provider.
Medications are used to balance chemicals in the brain that prohibit the individual from maintaining attention and controlling impulses. These medications help stimulate the brain to focus and may be used to reduce the major characteristics of ADHD.
Examples of psychostimulant medications include:
- Methylphenidate (Ritalin, Metadate, Concerta, Methylin)
- Dextroamphetamine (Dexedrine, Dextrostat)
- A mixture of amphetamine salts (Adderall)
- Atomoxetine (Strattera). A nonstimulant SNRI (selective serotonin norepinephrine reuptake inhibitor) medication with benefits for related mood symptoms.
- Lisdexamfetamine (Vyvanse)
Antidepressant medications may also be administered for children and adolescents with ADHD to help improve attention while decreasing aggression, anxiety or depression.
Classes in behavior management skills for parents can help reduce stress for all family members and are often done in a group setting, which encourages parent-to-parent support. Additionally, teachers may learn behavior management skills to use in the classroom setting and to communicate in-school behaviors to parents.
These methods tend to improve targeted behaviors but are usually not helpful in reducing overall inattention, hyperactivity or impulsivity.
Management of Related Medical Conditions
About half of all children with ADHD have another condition, such as learning disorder, dyslexia or mood disorder. If this is the case with your child, your doctor will develop a plan to help you treat those symptoms as well.