Issues of Education

Source: National Institutes of Mental Health

Attention Deficit Hyperactivity Disorder (ADHD) is a condition wherein people are unable to focus, sit still or otherwise have difficulty controlling their behavior. ADHD was previously also known as Attention Deficit Disorder (ADD).

ADHD was first described in 1845 by a children’s book author but wasn’t recognized until the early 1900 by the Royal College of Physicians in England when Sir George F. Still described children who would today be described as having ADHD-like symptoms which he said was caused by a brain disorder rather than bad parenting.

It is typically thought that about two million children have the disorder (about three to five percent of children) which is equal to one child in each classroom of 25 to 30 students.
Attention Deficit Hyperactivity Disorder is not something that children grow out of as adults struggle with the symptoms, also.

Symptoms

The key symptoms are: inattention, hyperactivity, and impulsivity. Typically these are hard to diagnose at young ages because many children have these issues, too, but at a lower level. Impulsivity and hyperactivity are the symptoms that will typically emerge first followed by the inattention.

Attention Deficit Hyperactivity Disorder is typically diagnosed is when the behavior begins to affect performance in more than one locale including school, home, church or interactions with other children.

According to the most recent version of the Diagnostic and Statistical Manual of Mental Disorders² (DSM-IV-TR), there are three patterns of behavior that indicate ADHD.

A. Hyperactivity-Impulsive

The hyperactive-impulsive child is the one that is constantly in motion with fidgety feet, dashing around a room, banging or tapping a table or gymnastics around the room. They tend to fidget and wiggle a lot and dash around. Talking incessantly is another symptom. Adults will frequently feel an internal restlessness which they try to curb by becoming involved in more than one thing at a time. Adults with ADHD will frequently be attracted to fast-paced, highly active jobs.

Impulsiveness is the inability to think before acting. Blurting out answers, inappropriate comments, repeatedly grabbing at something they aren’t supposed to touch, and acting without regard to the consequences of their actions are symptoms of impulsivity. Impulsive children tend to find it hard to wait their turn and will hit others when they are upset. Impulsive adults will frequently make choices that will have immediate rewards with a smaller payoff than engage in activities that will have a larger benefit in a longer time frame.

B. Inattention

Inattention is demonstrated by a person’s difficulty or inability to keep their mind on one thing or getting bored with a task after a few minutes. A child with inattention will frequently forget to bring home books from school, forget to write down telephone messages and homework, if it is even completed, will frequently be filled with errors. An adult with inattention will forget to pay bills, not keep track of employment deadlines or have a problem tracking their children’s activities.

This child will appear like they are daydreaming, confused, and are slower to process information as quickly as other children. The child may appear to be working and on task but after reviewing the work it is apparent that the child is not understanding the instructions or not on task. The child with Inattentive ADHD will typically not have the same social skills problems as those with Hyperactivity-Impulsivity but their need for help is just as important.

C. Combined Type

As expected, those with the Combined Type will have aspects of both Hyperactivity-Impulsivity along with inattentiveness.

Is It Really ADHD?

To receive a diagnosis of ADHD it is critical that the behavior in question be inappropriate for the person’s age. The behaviors must appear before age 7 and continue for at least 6 months. The problem behaviors must be significant in at least two different areas of a person’s life such as church, social settings, home, playground, etc. It is possible to have the symptoms of ADHD and not get a diagnosis because they might not be impaired by the behaviors.

Diagnosis

In order to begin the process of determining whether or not a problem exists starting with the pediatrician can give guidance as to whether behaviors are inappropriate. If concern is noted by a pediatrician, teacher, friends or the parents it is important to get further evaluation by one who is experienced and trained in ADHD or in diagnosing mental disorders. Child psychiatrists and psychologists, developmental/behavioral pediatricians, or behavioral neurologists are those most often trained in differential diagnosis. Clinical social workers may also have such training.

The specialist that will be working with the family will need to gather information to rule out other possible reasons for the child’s behavior.

They include:

• A sudden change in the child’s life—the death of a parent or grandparent; parents’ divorce; a parent’s job loss
• Undetected seizures, such as in petit mal or temporal lobe seizures
• A middle ear infection that causes intermittent hearing problems
• Medical disorders that may affect brain functioning
• Underachievement caused by learning disability
• Anxiety or depression.

The specialist should next gather information about the child’s behavior by speaking with the child, teachers, caregivers and parents, and hopefully observing the child in other settings.

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