Attention Deficit Hyperactivity Disorder or ADHD is a common mental disorder
suffered by children in preschool and early school years which may continue into
adulthood. It is hard for these
children as they have great difficulty in controlling their behaviour and/or paying
attention hence the name. It is estimated that ADHD afflicts one child in in
about 25 or 30 children.
Some suspect that that children diagnosed with adhd are not sick, they simply
have an overflowing spirit that does not conform to social ideology. Many adhd
children are far above average intelligence and actually require advanced
educational facilities to help them reach their dreams and not medications to
dumb them down.
An exuberance that is not necessarily anti social or harmful, the problem is
those suspected or diagnosed with adhd are not conforming to the prevailing
social expectations and
those who desire a particular order see any deviance as a disease whereas
the desire for order and conformity may be the disease.
ADHD was first described by Dr. Heinrich Hoffman in 1845. A physician who wrote
books on medicine and psychiatry, Dr. Hoffman was also a poet who became
interested in writing for children when he couldn't find suitable materials to
read to his 3-year-old son. The result was a book of poems, complete with
illustrations, about children and their characteristics. "The Story of Fidgety
Philip" was an accurate description of a little boy who had attention deficit
hyperactivity disorder. Yet it was not until 1902 that Sir George F. Still
published a series of lectures to the Royal College of Physicians in England in
which he described a group of impulsive children with significant behavioural
problems, caused by a genetic dysfunction and not by poor child rearingóchildren
who today would be easily recognized as having ADHD.1 Since then, several
thousand scientific papers on the disorder have been published, providing
information on its nature, course, causes, impairments, and treatments.
Impulsive children seem unable to curb their immediate reactions or think before
they act. They will often blurt out inappropriate comments, display their
emotions without restraint, and act without regard for the later consequences of
their conduct. Their impulsivity may make it hard for them to wait for things
they want or to take their turn in games. They may grab a toy from another child
or hit when they're upset. Even as teenagers or adults, they may impulsively
choose to do things that have an immediate but small payoff rather than engage
in activities that may take more effort yet provide much greater but delayed
A child with ADHD and his or her family face a difficult but not insurmountable
task. This document offers information on ADHD and its management, including
research on medications and behavioural interventions, as well as helpful
resources on educational options and because ADHD often continues into
adulthood, this document contains a section on the diagnosis and treatment of
ADHD in adults.
The principal characteristics of ADHD are inattention, hyperactivity, and
impulsivity. These symptoms appear early in a child's life. Because many normal
children may have these symptoms, but at a low level, or the symptoms may be
caused by another disorder, it is important that the child receive a thorough
examination and appropriate diagnosis by a well-qualified professional.
Symptoms of ADHD appear over the course of months with the child displaying
symptoms of impulsiveness and hyperactivity preceding to inattention, which may
not emerge for a year or more. Different symptoms may appear in different
settings, depending on the demands being made on the child. A child who "can't
sit still" or is otherwise disruptive will be noticeable in school, but the
inattentive daydreamer may be overlooked. The impulsive child who acts before
thinking may be considered just a "discipline problem," while the child who is
passive or sluggish may be viewed as merely unmotivated. Yet both may have
different types of ADHD. All children are sometimes restless, sometimes act
without thinking, sometimes daydream the time away. When the child's
hyperactivity, distractibility, poor concentration, or impulsivity begin to
affect performance in school and affect social relationships with other
children, or behavior at home, ADHD may be suspected. But because the symptoms
vary so much across settings, ADHD is not easy to diagnose. This is especially
true when inattentiveness is the primary symptom.
According to the most recent version of the Diagnostic and Statistical Manual of
Mental Disorders* (DSM-IV-TR), there are three patterns of behaviour that
indicate ADHD. People with ADHD may show several signs of being consistently
inattentive. They may have a pattern of being hyperactive and impulsive far more
than others of their age. Or they may show all three types of behaviour. This
means that there are three subtypes of ADHD recognized by professionals. These
are the predominantly hyperactive-impulsive type (that does not show significant
inattention); the predominantly inattentive type (that does not show significant
hyperactive-impulsive behaviour) sometimes called ADDóan outdated term for this
entire disorder; and the combined type (that displays both inattentive and
Hyperactive children always seem to be "on the go" or constantly in motion. They
dash around touching or playing with whatever is in sight, or talk incessantly.
Sitting still at dinner or during a school lesson or story can be a difficult
task. They squirm and fidget in their seats or roam around the room. Or they may
wiggle their feet, touch everything, or noisily tap their pencil. Hyperactive
teenagers or adults may feel internally restless. They often report needing to
stay busy and may try to do several things at once.
In the two videos,
Sari Solden, Psychotherapist & Dr. Ellen Littman, Clinical Psychologist join Thom Hartmann
on Conversations with Great Minds.
Dr. Ellen Littman is a clinical psychologist in private practice in New York - an international speaker - and has been involved with the spectrum of attentional disorders for over 25 years.
In her private practice - Dr. Littman focuses on the high IQ adult and adolescent ADHD populations. She specializes in identifying and treating complex presentations of ADHD that may be misinterpreted or overlooked.
She's also the co-author the book "Understanding Girls With ADHD." Sari Solden is a psychotherapist and has worked with individuals - couples - and groups with ADHD adults for over 25 years.
She is also a prominent international keynote speaker and trains and consults with other mental-health professionals in assessing and counseling adults with ADHD.
Sari is also the author of the book
"Journeys Through ADDulthood: Discover a New Sense of Identity and Meaning with Attention Deficit Disorder."
And the book, "Women with Attention Deficit Disorder" -
which is now also available in Spanish and all digital formats.
Some signs of hyperactivity-impulsivity are:
Feeling restless, often fidgeting with hands or feet, or squirming while seated
Running, climbing, or leaving a seat in situations where sitting or quiet behavior is expected
Blurting out answers before hearing the whole question
Having difficulty waiting in line or taking turns.
Children who are inattentive have a hard time keeping their minds on any one
thing and may get bored with a task after only a few minutes. If they are doing
something they really enjoy, they have no trouble paying attention. But focusing
deliberate, conscious attention to organizing and completing a task or learning
something new is difficult.
Homework is particularly hard for these children. They will forget to write down
an assignment, or leave it at school. They will forget to bring a book home, or
bring the wrong one. The homework, if finally finished, is full of errors and
erasures. Homework is often accompanied by frustration for both parent and
The DSM-IV-TR gives these signs of inattention:
- Often becoming easily distracted by irrelevant sights and sounds
Often failing to pay attention to details and making careless mistakes
Rarely following instructions carefully and completely losing or forgetting
things like toys, or pencils, books, and tools needed for a task
Often skipping from one uncompleted activity to another.
Children diagnosed with the Predominantly Inattentive Type of ADHD are seldom
impulsive or hyperactive, yet they have significant problems paying attention.
They appear to be daydreaming, "spacey," easily confused, slow moving, and
lethargic. They may have difficulty processing information as quickly and
accurately as other children. When the teacher gives oral or even written
instructions, this child has a hard time understanding what he or she is
supposed to do and makes frequent mistakes. Yet the child may sit quietly,
unobtrusively, and even appear to be working but not fully attending to or
understanding the task and the instructions.
These children don't show significant problems with impulsivity and overactivity
in the classroom, on the school ground, or at home. They may get along better
with other children than the more impulsive and hyperactive types of ADHD, and
they may not have the same sorts of social problems so common with the combined
type of ADHD. So often their problems with inattention are overlooked. But they
need help just as much as children with other types of ADHD, who cause more
obvious problems in the classroom.
Is It Really ADHD?
Not everyone who is overly hyperactive, inattentive, or impulsive has ADHD.
Since most people sometimes blurt out things they didn't mean to say, or jump
from one task to another, or become disorganized and forgetful, how can
specialists tell if the problem is ADHD?
Because everyone shows some of these behaviours at times, the diagnosis requires
that such behaviour be demonstrated to a degree that is inappropriate for the
person's age. The diagnostic guidelines also contain specific requirements for
determining when the symptoms indicate ADHD. The behaviors must appear early in
life, before age 7, and continue for at least 6 months. Above all, the behaviours
must create a real handicap in at least two areas of a person's life such as in
the schoolroom, on the playground, at home, in the community, or in social
settings. So someone who shows some symptoms but whose schoolwork or friendships
are not impaired by these behaviours would not be diagnosed with ADHD. Nor would
a child who seems overly active on the playground but functions well elsewhere
receive an ADHD diagnosis.
To assess whether a child has ADHD, specialists consider several critical
questions: Are these behaviours excessive, long-term, and pervasive? That is, do
they occur more often than in other children the same age? Are they a continuous
problem, not just a response to a temporary situation? Do the behaviours occur in
several settings or only in one specific place like the playground or in the
schoolroom? The person's pattern of behaviour is compared against a set of
criteria and characteristics of the disorder as listed in the DSM-IV-TR.
Some parents see signs of inattention, hyperactivity, and impulsivity in their
toddler long before the child enters school. The child may lose interest in
playing a game or watching a TV show, or may run around completely out of
control. But because children mature at different rates and are very different
in personality, temperament, and energy levels, it's useful to get an expert's
opinion of whether the behaviour is appropriate for the child's age. Parents can
ask their child's pediatrician, or a child psychologist or psychiatrist, to
assess whether their toddler has an attention deficit hyperactivity disorder or
is, more likely at this age, just immature or unusually exuberant.
ADHD may be suspected by a parent or caretaker or may go unnoticed until the
child runs into problems at school. Given that ADHD tends to affect functioning
mostly in school, sometimes the teacher is the first to recognize that a
child is hyperactive or inattentive and may point it out to the parents and/or
consult with the school psychologist. Because teachers work with many children,
they come to know how "average" children behave in learning situations that
require attention and self-control. However, teachers sometimes fail to notice
the needs of children who may be more inattentive and passive yet who are quiet
and cooperative, such as those with the predominantly inattentive form of ADHD.