Attention Deficit Disorder

Definition
The official clinical diagnosis is Attention Deficit Hyperactivity Disorder (ADHD) but the term Attention Deficit Disorder (ADD) is used as well. ADHD is a diagnosis applied to children and adults who consistently display certain characteristic behaviours over a period of time. The most common core features include:

• distractibility (poor sustained attention to tasks)
• impulsivity (impaired impulse control and delay of gratification)
• hyperactivity (excessive activity and physical restlessness)

In order to meet diagnostic criteria, these behaviours must be excessive, long-term, and pervasive. The behaviours must appear before the age of 7, and continue for at least 6 months.

A crucial consideration is that the behaviours must create a real handicap in at least two areas of a person's life, such as school, home, work, or social settings. ADHD usually persists throughout a person's lifetime. It is not limited to children. Approximately one half to two thirds of children with ADHD will continue to have significant problems with ADHD symptoms and behaviours as adults.

They are three types of attention deficit disorder:

• Attention deficit/hyperactivity disorder predominantly inattentive type (the person can not get focused on a task or an activity)
• Attention deficit/hyperactivity disorder predominantly hyperactive-impulse type (the person is very active and often acts without thinking)
• Attention deficit/hyperactivity disorder combined type (the person is inattentive and too active)

Causes
ADHD is a neurobiological disorder. The most recent research shows that the symptoms are caused by a chemical imbalance in the brain: some people do not have enough of certain chemicals in their brain that help control behaviour. Parents and teachers do not cause ADHD. Still, there are many things that parents and teachers can do to help a child with ADHD.

Characteristics
There are three main symptoms of ADHD:

• Problems with paying attention
• Being very active (hyperactivity)
• Acting before thinking (impulsivity)

Inattentive type
Children with the inattentive type of ADHD often:

• Do not pay attention to details
• Cannot stay focused on play or school work
• Do not follow through on instructions or finish school work or chores
• Have difficulties organizing tasks and activities
• Get distracted easily
• Lose things such as toys, books

Hyperactive-impulsive type
Being too active is probably the most visible sign of ADHD. The hyperactive child is "always on the go." Nevertheless, as he or she gets older, the level of activity may go down. These children also act before thinking. For example, they may run across the road without looking. Children with the hyperactive-impulsive type of ADHD often may:

• Fidget and squirm
• Get out of their chairs when they are not supposed to
• Run around or climb constantly
• Have trouble playing quietly
• Talk too much
• Blurt out answers before questions have been completed
• Interrupt others when they are talking
• Be easily bored

Combined type
Children with the combined type of ADHD have symptoms of both types described above. They have problems with paying attention, with hyperactivity, and with controlling their impulses.

These behaviours can cause a child to have real problems at home, at school, and with friends. As a result, many children with ADHD will feel anxious, unsure of themselves, and depressed. These feelings are not symptoms of ADHD. They come from having problems again and again at home and in school.

Treatment
Treating ADHD children often requires medical, educational, behavioural, and psychological intervention. This approach is called "multimodal" and often includes:

• Parent training
• Appropriate educational programs
• Individual and family counselling
• Medication, when required
• Education regarding ADHD

Children who received medication, alone or in combination with behavioural treatment, have showed significant improvement in their behaviour and academic work plus better relationships with their classmates and family.
(On February 9, 2005, Health Canada suspended the market authorization of ADDERALL XR ®, a drug prescribed for ADHD in children.)

Behavioural interventions are also a major component of treatment. Important strategies include being consistent and using positive reinforcement, as well as teaching problem-solving, communication, and self-advocacy skills.

Children - especially teenagers - should be actively involved as respected members of the school planning and treatment teams. School success may require a variety of classroom accommodations and behavioural interventions.

Most children with ADHD can be taught in the regular classroom with minor adjustments to the environment. Some children may require special education services if an educational need is indicated.

Teenagers with ADHD present a special challenge. These impulsive youngsters are facing typical adolescent issues: discovering their identity, establishing independence, dealing with peer pressure, exposure to illegal drugs, emerging sexuality, and the challenge of teen driving. Adults may experience career difficulties. They may lose jobs due to poor job performances, attention and organization problems, or interpersonal relationships. As a result, some adults experience periods of sadness or depression.

Complications
One of the difficulties in diagnosing ADD/ADHD is that is often accompanied by other problems:

• Children can have a specific learning disability, which means they have trouble mastering language or certain academic skills, typically reading and math.
• Children can have a rare disorder called Tourette's syndrome. People with Tourette's have tics and other movements like eye blinks or facial twitches that they cannot control. Fortunately, these behaviours can be controlled with medication.
• Children can have another disease called Oppositional Defiant Disorder. They may be stubborn, have outbursts of temper, or act belligerent or defiant.
• Children with this combination of problems are at risk of getting in trouble at school or with the police.

In addition to these complications, the frustration and hopelessness felt by the sufferer is at times debilitating.  They are unable to control even their own mind and body. This can be an incredibly scary situation for a child and a frustrating one as they can not explain why they can not sit still or pay attention. This frustration and fear can lead to depression and disrupted sleep, appetite, and the ability to think.more frequent than normal fears, they can affect the child's thinking and behaviour. Others experience depression that can disrupt sleep, appetite, and the ability to think.

This resource is by no means intended as a substitute for a doctor's advice or diagnosis. Any concerns you may have with regard to your child's health and development should be discussed with a professional in an appropriate field.