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ADHD/ADD

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image008ADHD vs. ADD

Many may be surprised to learn that both ADD (Attention-Deficit-Disorder) and ADHD (Attention-Deficit-Hyperactive-Disorder) are now considered the same condition. ADHD falls on the autism spectrum because it is the result of different parts of the brain not functioning well together. According to medical literature, the term ADD is no longer relevant and has been dropped. Knowing this, we will concentrate on these three types of ADHD and how they can affect people at any age, including adults.

Definition

Attention Deficit Hyperactive Disorder is one of the most common disorders with which children are diagnosed. Often first noted in childhood, nearly 30% to 50% will continue to have symptoms during adulthood. ADHD is considered a chronic condition defined by constant inattention, hyperactivity, and at times, impulsivity. There are approximately 6.4 million children in the United States who have been diagnosed with ADHD, with boys more likely to be diagnosed than girls. The American Psychiatric Association released the fifth edition of Diagnostic and Statistical Manual of Mental Disorders in 2013, which provides specific criteria for how the condition should be diagnosed.

Autism vs. ADHD

Not all whom are diagnosed with ADHD are actually on the autism spectrum, yet approximately two-thirds of those who do receive the ADHD diagnosis have already been diagnosed with an autism spectrum disorder, or will receive it shortly after the initial ADHD analysis. The primary components of ADHD and ASD are different, but many of the symptoms overlap. For example, children diagnosed with ADHD will understand taking turns at play, but may not want to. Furthermore, they may not respond when their name is called not because they fail to recognize their own name, but because they are not paying attention or are socially engaged in another activity.

Causes

The causes for ADHD are unknown, although it is believed to be a combination of genes and environmental factors, as noted by brain imaging studies which have shown significant differences in children with ADHD and children without the condition.

 Three Basic Types of ADHD

image009Symptoms of ADHD are categorized into three groups based on a combination of hyperactivity, impulsivity, and inattention. Some are mainly inattentive, referred to as predominantly inattentive presentation, while others have a combination of hyperactive and impulse symptoms, known as predominantly hyperactive-impulsive presentation.  Lastly, some mainly have symptoms of impulsivity. Each of these three subcategories is used to identify exactly how ADHD is affecting an individual child, or an adult.

Predominantly Inattentive

This category of ADHD was often referred to as ADD until that terminology was removed from the medical field. Nevertheless, it consists of the following typical symptoms:

  • Does not pay close attention to details or makes careless mistakes.
  • Has difficulty listening.
  • Often does not follow all instructions.
  • Has difficulty organizing various tasks and activities to ensure all are completed.
  • May avoid or refuse to attempt tasks that require lengthy time spans, especially schoolwork.
  • May have difficulty keeping track of tools needed for tasks and activities.
  • May forget directions easily.
  • Finds it difficult to maintain attention during play, while doing any school related tasks, or with daily activities at home.

The above symptoms might describe a child who cannot pay attention for long periods of time, but are less likely to act out. This category is often difficult for teachers and parents to recognize since the child is still following the majority of the directions.

Predominantly Hyperactive

Our next category is most well-known for being referred to as ADHD itself, and also one of the most disruptive with the following symptoms:

  • Fidgets with hands or feet, or may squirm while seated.
  • May not work or play quietly.
  • May be found moving consistently, or be found climbing in inappropriate situations.
  • Always wants to be ‘on the go’.
  • Leaves seat when they are expected to remain seated.

Impulsivity

While some children are more likely to rush around or have difficulty paying attention, a child with impulsivity symptoms will likely do one or more of the following:

  • Blurt out answers before the question is finished.
  • Does not like to wait for their turn.
  • Interrupts or intrudes on others’ conversations or games.

 Treating ADHD

For children diagnosed with any of the three categories of ADHD, a professional doctor will suggest one or both of the following treatments:

  • Various medications, depending on the severity of the condition and the individual child’s needs.
  • Psychotherapy/talk therapy, or other types of behavioral therapy to help correct the child’s behavior.

Regardless of which treatments and medications are recommended, doctors also strongly encourage parents to become well educated about their child’s needs after an ADHD diagnosis. A parent may consider doing the following to help their child succeed:

  • Regularly talk with their child’s teachers.
  • Keep a regular daily schedule that allots specific time for homework, play, chores, and meals. Any changes to the schedule should be discussed with the child in advance and not at the last minute.
  • Limit the amount of distractions a child may have in each environment.
  • Ensure the proper amount of sleep.
  • Make sure the child receives a healthy, varied diet with basic nutrients and the proper amount of fiber.
  • Praise and reward good behavior.
  • Maintain clear and consistent rules for the child to follow.

Conclusion

As a long-term and chronic condition, if ADHD is not treated correctly it may lead to any or all of the following:

  • Falling behind in school
  • Difficulty maintaining a job
  • Law trouble
  • Potential abuse of drugs and alcohol

Lastly, if a child is diagnosed with both ADHD and an autism spectrum disorder, make sure to discuss with the child’s doctor everything the parents can do to help the child excel in the classroom, and for the rest of their life. For those diagnosed with both, it will be a long journey, but not impossible, if the parents and child’s doctor work together.

References

Reviewed by Fred K. Berger, MD, Addiction and Forensic Psychiatrist, Scripps Memorial Hospital, La Jolla, California. (2014). Attention Deficit Hyperactivity Disorder.

The National Institute of Mental Health. (2014). What is Attention Deficit Hyperactivity Disorder (ADHD, ADD)?

Tricia Kinman, Reviewed by George Krucik, MD, MBA. (2012). ADHD and ADD: Differences, Types, Symptoms, and Severity.

Kay Marner. (2015). Is it ADHD or Autism? Or Both?