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ADHD Overview
Attention deficit hyperactivity disorder (ADHD), also known as attention deficit
disorder (ADD), is a condition in which a person's inability to focus and
concentrate on a task or purpose interferes with his or her ability to be
productive. It can also affect how people develop social relationships or
self-esteem.
Children with ADHD are often seen as unable to
settle down —impulsive, hyperactive, disruptive, and even aggressive in
classroom and social settings.
Look out for the following:
- Difficulty with sitting still, fidgety,
constantly moving
- Excitable, impulsive, unpredictable behaviour
- Poor sleeping habits, night terrors
- Short attention span, poor concentration,
distractible
- Compulsive aggression, disruptive behaviour,
frustration
- Cannot be diverted from action, punishment
ineffective
- Poor gross and fine muscle co-ordination
- Auditory and visual memory deficits
The medical community recognises 3 basic forms of
the disorder, as follows:
- Primarily inattentive: Inattentiveness to
tasks or activities is the primary problem.
- Primarily hyperactive-impulsive: Impulsivity
and inappropriate movement (fidgeting, inability to keep still) or
restlessness are the primary problems.
- Combined: This is a combination of the
inattentive and hyperactive-impulsive forms.
The combined type of ADHD is the most common. The
predominantly inattentive type is being recognised more and more, especially in
girls and in both sexes of adults. The predominantly hyperactive-impulsive type,
without significant attention problems, is rare.
We are still learning about ADHD, and experts'
ideas of the disorder are still being shaped. Some believe, for example, that
the term attention deficit is misleading.
They maintain that people with ADHD are actually
able to pay attention too well, rather than too little, but have difficulty
regulating their attention, leaving them unable to properly focus.
Others have trouble ignoring irrelevant details
and/or focus so intensely on specific details that they miss the bigger, more
important, picture.
Many cannot shift gears from one thing to another
when they need to, leaving them unable to focus on what needs to be done.
Extreme difficulty getting a child to stop playing a video game to come to
dinner is a common example.
Contrary to some media accounts, attention
disorders are not new. Childhood hyperactivity was a focus of interest in the
early 1900s. Today, hyperactivity, impulsivity, and inattention are the focus,
but disability related to hyperactivity and distractibility has been alluded to
throughout medical history. What is new is the greater awareness of ADHD thanks
to rapidly mounting research findings.
In the United States, ADHD affects about 3-7% of
children. Similar rates are reported in other developed countries such as
Germany, New Zealand, and Canada.
In most cases, the unusual behaviours are noticed
by the time the child is about 7 years old, although ADHD is occasionally
diagnosed in teenagers or young adults.
Boys are much more likely than girls to be
diagnosed with ADHD. At one time, the ratio of boys to girls with ADHD was
thought to be as high as 4:1 or 3:1. This ratio has been decreasing, however, as
more is known about ADHD. For instance, greater recognition of the inattentive
form of ADHD has increased the number of girls diagnosed with the disorder.
People identified with ADHD in adulthood are
almost as likely to be women as men, suggesting that we may have been missing
the diagnosis in many young girls.
There is disagreement over whether ADHD persists as children grow into adults.
Some believe that most children simply grow out
of ADHD. Others believe that ADHD persists into adulthood in most cases.
Estimates of the number of children with ADHD who continue to have the disorder
in adulthood range from 30%-80%.
Hyperactive symptoms may decrease with age,
usually diminishing at puberty, perhaps because people tend to learn how to gain
greater self-control as they mature.
Inattention symptoms are less likely to fade with
maturity and tend to remain constant into adulthood.
As we learn more about ADHD, certain subtypes
will likely be found to cause more adult dysfunction than others.
People with ADHD are much more likely than the
general population to have other related conditions such as learning disorders,
restless legs syndrome, ophthalmic convergence insufficiency, depression,
anxiety disorder, antisocial personality disorder, substance abuse disorder,
conduct disorder, and obsessive-compulsive behaviour. People with ADHD are also
more likely than the general population to have a family member with ADHD or one
of the related conditions.
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