ADHD is a neurodevelopmental disorder that begins in childhood and continues through adolescence and often into adulthood. Approximately 5-7% of children in the United States have ADHD, and similar rates have been found in other countries throughout the world. ADHD is characterized by developmentally inappropriate levels of inattention, hyperactivity, and impulsivity that interfere with school or work, friendships, and family relationships
What causes ADHD?
Research suggests that ADHD is caused by a combination of genetic and environmental factors. Scientists are still working to uncover more details about the target genes implicated in the development of ADHD and the specific environmental factors that contribute to the development of the disorder. However, we do know that the role of genetics is very strong. In fact, studies suggest that ADHD is as heritable as height. Environmental factors, like prenatal exposure to nicotine or alcohol, premature birth or low birth weight, and exposure to lead or other toxins have all been identified as factors that increase the likelihood that a person will develop ADHD. Parenting and teaching strategies do not cause ADHD, however, both can impact symptom severity.
What are the symptoms of ADHD?
ADHD symptoms are related to inattention, hyperactivity, and impulsivity. These symptoms occur at times in all children, teens, and adults, but they are more frequent, severe, and cause more problems in individuals with ADHD. Not everyone with ADHD has all of the symptoms of the disorder. Some people may only have symptoms related to inattention, while others, usually young children, may only have symptoms related to hyperactivity and impulsivity. As a result, there are three different presentations of ADHD that are associated with the type and number of symptoms a person has: the predominantly inattentive presentation, the predominantly hyperactive impulsive presentation, and the combined presentation.
DSM-5 ADHD inattention symptoms
- Makes careless mistakes or doesn’t pay attention to details
- Has difficulty sustaining attention
- Does not seem to listen when spoken to directly
- Has difficulty following instructions, or starts tasks but doesn’t finish them
- Has difficulty staying organized
- Avoids tasks that require “sustained mental effort” (i.e., homework)
- Loses things
- Is easily distracted
DSM-5 hyperactive/impulsive symptoms
- Often fidgets or squirms
- Leaves seat, when staying seated is expected (i.e., during dinner, during class)
- Often runs or climbs on things excessively
- Often unable to play quietly
- Often “on the go” almost as if driven by a motor
- Often talks excessively
- Often blurts out answers before questions have been completed
- Often has difficulty waiting turn
- Often interrupts or intrudes on others
How is ADHD diagnosed?
Diagnosing ADHD requires a comprehensive evaluation by a psychologist, psychiatrist, or pediatrician, or another clinician with specialized mental health training. It’s important that the evaluation include rating scales collected from parents and teachers, as well as a comprehensive parent interview. The doctor will also rule out other causes of the symptoms, such as anxiety, depression, learning differences, or a medical condition. The ADHD symptoms of hyperactivity and impulsivity can appear as early as age 3. Symptoms of inattention tend to emerge later. So children who struggle solely with inattention may not display impairing symptoms until around 4th grade, or even middle school. In general, in order for an ADHD diagnosis to be considered, at least some symptoms of ADHD should be evident by the age of 12.
How do you treat ADHD?
Effective ADHD treatments are available, including medication and the following evidence-based psychotherapy interventions: behavioral parent training, child social skills training, and organizational skills training, classroom interventions, and cognitive behavioral therapy. Many children, teens, and adults with ADHD experience significant improvement in their symptoms from psychotherapy alone or medication alone. However, many require both medication and psychotherapy for maximum symptom improvement.
APA. (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. Washington, D.C: American Psychiatric Publishing.
National Institute of Mental Health. Attention Deficit Hyperactivity Disorder. Retrieved from: http://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtml.