When it's Attention Deficit/Hyperactivity and when it's not

A good number of children in this country are diagnosed with Attention Deficit Disorders (ADD and ADHD).Some of these children are misdiagnosed because the symptoms present are similar to symptoms of other  disorders or problems.  If you or the school believe your child has  ADD or ADHD it is vital an assessment be completed by a mental health professional experienced in ADD/ ADHD. As you will see by reading this article, the behaviors you see demonstrated by your child may not be ADD/ ADHD.  Appropriate treatment is determined by an appropriate assessment.

DEFINITION OF ADHD:

"ADHD is a diagnosis applied to children and adults who consistently display certain characteristic behaviors 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 behaviors must be excessive, long-term, and pervasive. The behaviors must appear before age 7, and continue for at least 6 months. A crucial consideration is that the behaviors must create a real handicap in at least two areas of a person's life, such as school, home, work, or social settings. These criteria set ADHD apart from the "normal" distractibility and impulsive behavior of childhood, or the effects of the hectic and overstressed lifestyle prevalent in our society.

According to the DSM-IV (the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) some common symptoms of ADHD include: often fails to give close attention to details or makes careless mistakes; often has difficulty sustaining attention to tasks; often does not seem to listen when spoken to directly; often fails to follow instructions carefully and completely; losing or forgetting important things; feeling restless, often fidgeting with hands or feet, or squirming; running or climbing excessively; often talks excessively; often blurts out answers before hearing the whole question; often has difficulty awaiting turn.

Please keep in mind that the exact nature and severity of ADHD symptoms varies from person to person. Approximately one-third of people with ADHD do not have the hyperactive or overactive behavior component, for example." (c) 1998, Peter Jaksa, Ph.D. FACT SHEET ON ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD/ADD)   ADDA www.add.org

Lets take a look at the three core features of ADHD.  We must remember these core features must be EXCESSIVE, LONG TERM AND PERVASIVE - or on going

Distractibility/ Inattention- Children with ADD has difficulty paying attention.  In addition they are unable to focus , or be organize.  They may have a hard time completing tasks- particularly those that are boring or repetitive.  They have difficulty remembering things.  They may show themselves to be careless in their work. 

Impulsive- These children do not think before they act.  they do not make good decisions based on thought. They do not have the social skills necessary to maintain friendships. As adults they are the type of person who switches jobs or spends money inappropriately.

Hyperactive- These children have difficulty sitting still.  They squirm, fidget, run and climb at inappropriate times.  They have difficulty playing with friends. They may talk excessively. In adolescents and adults, the excessive behaviors may not be present.  They may feel keyed up , restless and fidgety most of the time.  They report they are not able to sit quietly or enjoy quiet time.

What causes ADD/ ADHD

The cause is unclear, however research has shown it is not caused by "poor parenting, family problems, poor teachers or schools, too much TV, food allergies, or excess sugar."  1998, Peter Jaksa, Ph.D   ADD and ADHD appears to be  chemical imbalance in the brain  that effects behavior and temperament.  ADD/ ADHD appears to run in families thus having a genetic link.

Conditions with ADHD "look-alike" Symptoms

• Post Traumatic Stress Disorder
• Depression
• Bi-polar Disorder
• Sleep problems
• Kinesthetic / Tactile learners
• Highly special, musical or body kinesthetic intelligences
• Sensory integration dysfunction
• Asperger's Syndrome
• Chronic middle ear infections
• Visual or hearing problems
• Too warm temperatures
• Thyroid Problems
• Poor diet food allergies, sensitivity to food additives
• Emotional problems
• Lack of clear guidance or instruction
• inadequate feedback
• Fetal Alcohol syndrome
• Reactive Attachment Disorder
• Oppositional Defiant Disorder
• Conduct Disorder
• Oversensitivity to sights sounds, difficulty processing auditory or visual input
• Use of stimulants
• Deliberate misbehavior

A complete assessment by a mental health professional should include observation and interaction with your child, a complete history, an inventory of behaviors, and collateral contact with teachers to collect impression and behavioral information. In addition the therapist should ask about recent medical exams and family history.

Referrences

2001, 2002 Jane Bluestein, PhD  Creating Emotionally Safe Schools

(c) 1998, Peter Jaksa, Ph.D. FACT SHEET ON ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD/ADD)   ADDA www.add.org

2003 MSN Health Conditions Centers