Attention deficit hyperactivity disorder (ADHD) is a psychological condition more commonly seen in pre-school and school children, particularly of the age group of 6-12 years. It is characterized by features of inattention, hyperactivity, and impulsiveness. It is normal to see some features of inattention and hyperactivity in any person once in a while, but in ADHD these features are seen more frequently and in a severe manner than what is normal. The condition also interferes with daily life activities and adversely affects developmental outcomes expected at school and/or job performance later in life. ADHD is often associated with other conditions such as depression, anxiety disorders, and substance abuse etc.
Symptoms and Diagnosis of ADHD
It must be noted that most of the following features may be observed in any normal person’s behavior. It should be considered as a symptom of ADHD only if it occurs more often and severe than normal, and comes to a point that is disruptive and inappropriate to a person’s developmental level.
- Making careless mistakes due to lack of attention
- Trouble keeping focus on tasks or activities
- Does not seem to listen when spoken to directly
- Failure to finish schoolwork, chores, or duties in the workplace
- Having trouble organizing activities
- Getting easily distracted
- Being forgetful in daily activities
- Fidgeting with hands or feet
- Getting up from seat when remaining seated is expected
- Running about and climbing when and where it is not appropriate
- Having trouble playing or enjoying leisure activities quietly
- Staying “on the go” or acting as if “driven by a motor”
- Excessive talking
- Blurting out answers before questions have been finished
- Having trouble waiting one’s turn
- Interrupting or intruding on others
A diagnosis of ADHD may be made by a licensed clinician such as a pediatrician, psychiatrist or a psychologist when one or more of the above sets of symptoms have been present in a person from an age less than 12 years, and if these symptoms are not due to any other psychological condition. The diagnosis is often made at an early age, but in some persons the symptoms may not have been properly noted during childhood and hence the diagnosis may be made during teenage or early adulthood.
Risk Factors for ADHD
It has still not been properly understood as to what exactly causes ADHD, but the following factors have been shown to play a role in the development of ADHD.
- Genetic factors
- Structural brain abnormalities
- Abnormalities in higher brain function
- Low birth weight
- Brain injury in early life
- Alcohol, smoking, and drug abuse in pregnant mothers
- Exposure to high levels of toxins such as lead during early life
Treatment for ADHD
Even though ADHD is not curable, proper treatment can lead to significant control of symptoms and thereby bring about better outcomes in day-to-day life as well as in the fields of education and employment. The Olympic swimming champion Michael Phelps who was diagnosed with ADHD at the age of nine years is a good example of a person who beat the condition with proper treatment and the right parental support.
The main modes of treatment include psychological treatment and medication. Those with mild to moderate symptoms can be treated only with psychological treatment methods such as behavioral therapy, social skills training, and cognitive behavioral therapy (CBT) while those with severe symptoms may need medications along with the aforementioned methods of therapy.
This is targeted mainly at parents and other family members of a child diagnosed with ADHD. The parents are trained to cope up with difficult situations and to figure out what triggers such situations to arise. They are also trained how to modify the child’s behavior based on a rewarding system where the child gets positive rewards for positive behavioral control and negative rewards for negative behavior. This is usually done in group sessions where the parents who have a child with ADHD get to meet one another and are taught about these methods.
Cognitive Behavioral Therapy (CBT)
Cognitive behavioral therapy can be used as an effective method for treating ADHD in children as well as adults. Children may undergo CBT in groups while teenagers and adults can undergo individual CBT sessions.
CBT is based on the principle that behavior is a result of thought patterns of an individual. CBT provides training to recognize maladaptive thought patterns that lead to abrupt emotions, shift of attention and inappropriate behavior of the individual and to modify such thought patterns in a better oriented manner in order to bring about better behavioral outcomes. It also involves improvement of problem solving skills and analytical skills which equip the patient with the necessary tactical approach to cope up with difficult situations.
Studies have shown that CBT can be used as an effective method for the treatment of ADHD in order to bring about significant control of core symptoms such as inattention, hyperactivity, and impulsiveness, as well as other associated symptoms of depression and anxiety.
For those with mild to moderate ADHD, the above forms of psychotherapy alone can bring about significant improvement of symptoms while those with severe ADHD may need stimulant medications along with psychotherapy.
- National Institute of Mental Health – www.nimh.nih.gov
- Psychiatry: Fourth Edition – Oxford University Press