A ttention-Deficit/Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder characterized by hyperactivity, inattention and impulsivity. Although many people experience these symptoms occasionally, for someone with ADHD, they are much more severe and disruptive. ADHD impacts a person’s ability to function well in many aspects of their lives, including being at home, at school or work, or with friends.
Although ADHD symptoms are usually present from an early age (and must occur prior to age 12), the disorder often is not diagnosed until someone is in school. This may be because the home environment is often less restrictive than a classroom, where hyperactive and impulsive behaviour is more disruptive and noticeable. However, children with ADHD will experience many difficulties at home or in social situations prior to beginning school.
ADHD is one of the most common disorders in childhood. Approximately 5 percent of children have ADHD, 65 percent of whom will also have ADHD as teenagers. In adults, approximately 2.5 percent of the population has ADHD. Thus, although some people grow out of it, a large percentage of people with ADHD as children will have the disorder for their whole life.
ADHD is a neurodevelopmental disorder, which means that it’s a disorder caused by problems in the growth or development of the brain. This is why some children may “grow out” of ADHD. Their brain growth and development improves. What causes these problems? From what we understand today, ADHD has an important genetic component. It tends to run in families, which means that the immediate family members of someone with ADHD are much more likely to also have ADHD than the general population. Environmental factors may also play a role. Of particular concern are those that impact brain growth and development in the womb, during birth or in early childhood. A person’s environment can also influence the extent to which ADHD causes problems in their life.
ADHD is diagnosed more often in boys than girls. Girls with ADHD are more likely to have difficulty paying attention, but they often don’t demonstrate as much hyperactivity as boys. Girls who have trouble paying attention often daydream, whereas inattentive boys are more likely to move around constantly or fiddle aimlessly.
ADHD, and other mental disorders, should only be diagnosed by a medical doctor, clinical psychologist or a trained health provider who has spent time with the person and has conducted a proper mental health assessment. Diagnoses are complicated with many nuances. Please do not attempt to diagnose someone based on the symptoms you read about in magazines or on the internet. If you are concerned, speak to a trained health professional. Remember, the presence of ADHD symptoms does not equal the diagnosis of ADHD. Many very active children may seem hyperactive but do not have ADHD. There are three types of ADHD, which are diagnosed based on the type of symptoms the person is experiencing:
- Predominantly Inattentive
- Predominantly Hyperactive/Impulsive
- Combined Presentation (both Inattentive and Hyperactive/Impulsive symptoms)
Some things to watch for:
- Frequently starts many activities without finishing any
- Doesn’t pay close attention to detail (messy & easily distracted)
- Difficulty following things through (i.e.. instructions, order of activities)
- Easily distracted by environment (such as noise) and will avoid tasks that need a lot of attention
- Difficulty maintaining attention (parents may often hear ‘this kid doesn’t listen’)
- Rushes into things such as games or other activities without taking the time to learn the rules
- Organizational problems (such as spacing between each word when writing, or doing math problems in order)
- Loses things (can’t keep track of possessions)
- Forgets things (appears forgetful but it’s usually because they were not paying attention to instructions)
- Difficulty staying in one place (such as sitting in a desk or in a group)
- Runs around the room or climbs on furniture instead of focusing on group activities (if younger)
- Fidgets, talks a lot, makes noises during quiet activity and generally seems wound up
- Often ‘on the go’, as if driven by a motor
- Seems impatient or has low tolerance for frustration
- Often interrupts others
- Fails to listen to instructions
- Rushes into situations without thinking about the consequences
- Does not seem to learn from negative experiences or mistakes
- Difficulty waiting their turn
- Interrupts or blurts out answers to questions
At least some of these symptoms must be present before age 12, and they must have occurred for at least 6 months in two or more settings (i.e., at home, at school, in social settings).
*In accordance with the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition
Remember, you cannot diagnose someone with ADHD without a proper mental health assessment conducted by a properly trained health provider.
ADHD is often less obvious in activities that require a lot of physical participation (e.g., playing sports) or that are highly enjoyed (e.g., a fun video game). Symptoms usually are most noticeable when the young person is in a group setting that requires quiet attention, or when they are working in a really distracting environment.
- Encourage the person to seek help (or take them to a trained health professional yourself, if appropriate)
- Ask the person a few questions to get a better sense of what is going on:
- Do you have difficulty paying attention or sitting still?
- Do you find it hard to remember instructions for assignments or projects?
- Do you often lose things that you need or that are important?
- Do you find it really easy to get distracted?
- Do people often get frustrated with you for interrupting or not waiting your turn?
If someone in your life has been diagnosed with ADHD, here’s what you can do:
- Be well-informed. Learn everything you can about ADHD and how it may affect the life of the person you care about. Read books, trusted websites and talk to your doctor. Check out Evidence Based Medicine for information on how to critically evaluate the information you read and Communicating With Your Health Care Provider for a list of questions to ask your health care provider.
- Remember that someone with ADHD has difficulty paying attention or sitting still, it’s not that they don’t want to do so. This is because of differences in the way their brain works, not because they are trying to cause trouble. Try to limit the frequency of negative comments and avoid comments about “bad behaviour” unless it’s apparent that the person is intentionally misbehaving. It can be really frustrating and upsetting for someone with ADHD when their disorder is confused with misbehaviour.
- Try not to decrease the person’s self-esteem by focusing only on problem areas. Make sure you also notice and support their strengths and accomplishments.
- If you know someone who has been diagnosed with ADHD, they should also be assessed for learning problems as learning disabilities are more common in children with ADHD.
A variety of treatment options exist for ADHD. Successful treatment for ADHD improves school and work function, family and peer relationships, and decreases risk of traffic accidents and substance abuse. Determining which course of action is appropriate for each individual should be done with the guidance of a health professional who is knowledgeable about effective treatment options. Options include:
- Medication: Medication is the most effective treatment for ADHD symptoms, as it helps the brain function the way it should. Common medications include stimulants and some types of antidepressants.
- Social Skills Training: Many children and teenagers with ADHD have social problems due to their impulsivity and hyperactivity. Social Skills Training helps them learn and practice positive ways of interacting with other people.
- Learning Modifications/Adaptations: Often, making changes to the persons’ learning environment can be a big help. Examples include providing quieter places to work, allowing homework to be done in small amounts over an extended period of time, breaking tasks down into manageable chunks, etc.
- Parental Behaviour Training: Children and teenagers with ADHD often benefit most from particular parenting techniques that their parents can learn how to use. Parental Behaviour Training helps parents better understand ADHD and how it impacts their child in order to parent in a way that will be most beneficial for someone with ADHD.
- School supports: Sometimes certain adaptations can be made by the school to assist a student in coping with and managing their symptoms.
- Community supports: Community supports can include peer support groups for teenagers, support groups for families, and other helpful resources.
- For help maintaining the kind of healthy lifestyle that should accompany professional treatment, encourage your teenager or friend to check out Taking Charge of Your Health.
Remember, all treatments have the same goals: decrease symptoms and improve functioning; decrease risk of relapse; and promote recovery. Think about it this way: Get well; Stay well; Be well.
It’s not uncommon for people to have more than one diagnosis. Other common co-occurring disorders with ADHD (also called comorbid disorders) include:
- Oppositional Defiant Disorder
- Conduct Disorder
- Disruptive Mood Dysregulation Disorder
- Learning Disorders
- Major Depressive Disorder
- Anxiety Disorders
- Substance Abuse Disorder
- Other disorders such as Obsessive-Compulsive Disorder, Tic Disorders, and Autism Spectrum Disorder
Remember, a person with ADHD does not feel “sick”. Their symptoms are what they have always experienced. This can make it difficult for a person with ADHD to understand that something is not right.