Attention-Deficit/Hyperactivity Disorder (ADHD)
is thought to be a neurological disorder, and is sometimes referred
to as ADD for those without hyperactivity. It is always present
from childhood, which manifests itself with symptoms such as hyperactivity,
forgetfulness, poor impulse control, and distractibility. ADHD is
currently considered to be a chronic syndrome for which no medical
cure is available and is a co-morbid disorder associated with Autism Spectrum Disorders such as autism
Controversy surrounds the designation of ADHD
as a true medical disorder, such as whether or not the diagnosis
denotes a disability in its traditional sense, or simply describes
the neurological property of an individual. A wide body of evidence
has shown that stimulant medication is the most effective way to
treat the disorder. According to a majority of medical research
in the United States, as well as other countries, ADHD is today
generally regarded to be a non-curable neurological disorder for
which, however, a wide range of effective treatments are available.
Methods of treatment usually involve some combination of medication,
psychotherapy, and other techniques. Some patients are able to control
their symptoms over time, without the use of medication. Other individuals
who meet the diagnostic criteria of ADHD do not consider themselves
to be handicapped by the disorder and therefore may remain undiagnosed
or, after a positive diagnosis, untreated.
ADHD is most commonly diagnosed in children and,
over the past decade, has been increasingly diagnosed in adults.
It is believed that around 60% of children diagnosed with ADHD retain
the disorder as adults.
Symptoms of ADHD
The symptoms of ADHD fall into the following two
The first is Inattention and can include:
• Failing to pay close attention to details
• Making careless mistakes when doing schoolwork or other activities
• Trouble keeping attention focused during play or tasks
• Appearing not to listen when spoken to
• Failing to follow instructions or finish tasks
• Avoiding tasks that require a high amount of mental effort and
• Frequently losing items required to facilitate tasks or activities
• Excessive distractibility and forgetfulness
• Procrastination, inability to begin an activity
• Difficulties with household activities.
The second category is Hyperactivity-impulsive
• Fidgeting with hands or feet or squirming in seat
• Leaving seat often, even when inappropriate
• Running or climbing at inappropriate times
• Difficulty in quiet play
• Frequently feeling restless
• Excessive speech
• Answering a question before the speaker has finished
• Failing to await one’s turn
• Interrupting the activities of others at inappropriate times
• Impulsive spending, leading to financial difficulties.
A positive diagnosis is usually only made if the
person has experienced six of the above symptoms for at least three
months. Symptoms must appear consistently in varied environments
(e.g., not only at home or only at school) and interfere with function.
One of the difficulties in diagnosis is the incidence of co-morbid
conditions, especially the presence of Autism Spectrum Disorders,
disorder which is being reported at earlier ages than
Children who grow up with ADHD often continue
to have symptoms as they grow into adulthood. Adults face some of
their greatest challenges in the areas of self-control and self-motivation,
as well as executive functioning (also known as working memory).
If the child is not treated appropriately, co-morbid conditions,
such as depression, anxiety and self-medicating substance abuse
may present as well. If a patient presents with such conditions
as well, the co-morbid condition may be treated first, or simultaneously.
Research has raised possible causes but with no
definitive proof as yet. Some proposed causes include:
• A PET scan study revealing global cerebral glucose metabolism
was 8.1% lower in ADHD patients
• A combination of various genes to do with dopamine transporters
• Children with ADHD lose zinc when exposed to a food dye
• A lack of fatty acids, specifically omega-3 fatty acids
• A moderate to severe protein deficiency.
• Biohazards including alcohol, tobacco smoke, and lead poisoning.
• Allergies, such as those to artificial additives
• Complications during pregnancy and birth
• Premature birth
• Babies of women who smoked while pregnant
• Head injuries.
Treatment of ADHD
There are many options available to treat people
diagnosed with ADHD. The options with the greatest scientific support
include a variety of medications, behavior modification, and educational
Medications for ADHD
The most frequently prescribed medications for
ADHD are stimulants, which work by stimulating the areas of the
brain responsible for focus, attention, and impulse control. Because
many of the medications used to treat ADHD are powerful stimulants
with a potential for abuse, there is controversy surrounding prescribing
these drugs for children and adolescents. However, research on ADHD
sufferers who either receive treatment with stimulants or go untreated
has indicated that those treated with stimulants are in fact much
less likely to abuse any substance than ADHD sufferers who are not
treated with stimulants.
Diet modification for ADHD
As noted above there are indications that children
with ADHD are metabolically different from others, and it has therefore
been suggested that diet modification may play a role in the management
of ADHD. Perhaps the best known of the dietary alternatives is the
Feingold diet which involves removing salicylates, artificial colors
and flavors, and certain synthetic preservatives from children's
diets. In the 1980s vitamin B6 was promoted as a helpful remedy
for children with learning difficulties including inattentiveness.
Later, zinc and multivitamins have been promoted as cures, and currently
the addition of certain fatty acids such as omega-3 has been proposed
Herbs, coffee and ADHD
For some people with ADHD mild stimulants such
as caffeine and theobromine have similar effects to the more powerful
drugs commonly used in treating the disorder. Herbal supplements
such as ginkgo biloba are also sometimes cited. There is some empirical
data suggesting caffeine can improve the function of children suffering
Audio-visual therapy and ADHD
Other alternatives include audio-visual entrainment
which uses light and sound stimulation to guide and change brainwave
patterns. While safe for most, it cannot be used by those suffering
from photosensitive epilepsy
due to the risk of triggering a seizure.
Cerebellar stimulation assumes that by improving
the patient’s cerebellar function, many ADHD symptoms can be reduced
or even eliminated permanently. As noted above, several studies
have shown that the cerebellums of children with ADHD are notably
smaller than their non-ADHD counterparts. Several programs of balance,
coordination, eye and sensory exercises that specifically involve
the functions of the cerebellum are used to treat ADHD, Asperger’s
syndrome, and many learning difficulties such as dyslexia and dyspraxia.
Most prominent are the DORE program, the Learning Breakthrough Program,
and the Brain Gym. No substantial body of research exists as yet
to support these treatment approaches.
Controversy about ADHD
Some people argue that ADHD is simply a variant
of normal human behavior. Others claim that the diagnostic criteria
are vague enough to allow virtually anybody with persistent unwanted
behaviors to be classified as having ADHD. It has also been noted
that most people with ADHD have no difficulties concentrating when
they are doing something that interests them, whether it is educational
or entertainment. Others have argued that children in foster care
or in violent abusive environments often have symptoms similar to
ADHD, suggesting environmental factors may be involved.
Supporters of the ADHD diagnosis say that somewhere between 60 and
80% of children diagnosed with ADHD have a second diagnosis such
as a comorbid conduct disorder, Tourette
syndrome, or Asperger’s
Further reading: Brain
chemistry and autism
Click here for the full
range of Asperger's and autism fact sheets at www.autism-help.org
This autism fact sheet is licensed under the GNU
Free Documentation. It is derivative of an autism and Asperger's
syndrome-related articles at http://en.wikipedia.org