Attention deficit hyperactivity disorder (ADHD)
Key points
- ADHD is a problem with inattentiveness, over-activity, impulsivity, or some combination of these.
- ADHD affects children's school performance and their relationships with others.
- The Diagnostic and Statistical Manual (DSM-IV) divides the symptoms of ADHD into those of inattentiveness and those of hyperactivity/impulsivity.
- For these problems to be diagnosed as ADHD, they must be out of the normal range for the child's age and development.
Definition:
ADHD is a problem with inattentiveness, over-activity, impulsivity, or some combination of these. For these problems to be diagnosed as ADHD, they must be out of the normal range for the child's age and development.
Alternative Names:
ADD; ADHD; Childhood hyperkinesis
Causes, incidence, and risk factors:
Is ADHD over-diagnosed? Under-diagnosed? Probably both - and certainly real. ADHD affects children's school performance and their relationships with others.
Is ADHD over-diagnosed? Under-diagnosed? Probably both - and certainly real. ADHD affects children's school performance and their relationships with others. Parents who are wondering if their children have ADHD are often exhausted and frustrated.
Scientific studies, using advanced neuroimaging techniques of brain structure and function, show that the brains of children with ADHD are different from those of other children. These children handle neurotransmitters (including dopamine, serotonin, and adrenalin) differently from their peers.
ADHD is often genetic. Whatever the specific cause may be, it seems to be set in motion very early in life as the brain is developing. Other problems, such as depression, sleep deprivation, specific learning disabilities, tic disorders, and oppositional/aggressive behavior problems, may be confused with or appear along with ADHD. Every child suspected of having ADHD deserves a careful evaluation to sort out exactly what is contributing to his concerning behaviors.
Attention Deficit Disorder (ADD) is the most commonly diagnosed behavioral disorder of childhood, affecting an estimated 3 - 5% of school aged children. It is diagnosed much more often in boys than in girls.
Most children with ADHD also have at least one other developmental or behavioral problem. Every evaluation should include a search for possible additional conditions, including conduct disorder, oppositional defiant disorder, mood disorders, depression, anxiety, and learning disabilities.
Symptoms:
The Diagnostic and Statistical Manual (DSM-IV) divides the symptoms of ADHD into those of inattentiveness and those of hyperactivity/impulsivity.
To be diagnosed with ADHD, children should have at least 6 attention symptoms or 6 activity/impulsivity symptoms - to a degree beyond what would be expected for children their age.
The symptoms must be present for at least 6 months, observable in 2 or more settings, and not caused by another problem. The symptoms must be severe enough to cause significant difficulties. Some symptoms must be present before age 7.
Older children who still have symptoms, but no longer meet the full definition, have ADHD in partial remission.
Written and revised by
Gerald Hurowitz, M.D.
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