Attention Deficit Hyperactivity Disorder (ADHD)
Attention Deficit Hyperactivity Disorder (ADHD) is a situation that becomes apparent in some children in the preschool and early school years. ADHD is hard for these children to control their behavior and pay attention. It is estimated that between 3 to 5 percent of children have a disorder characterized by consistent inattention, hyperactivity, and impulsiveness. This means that in a classroom of 25 to 30 children, it is likely that at least one will have ADHD.
ADHD was previously considered to be a neurological disorder, which usually shows up during the early childhood years. Children with ADHD find themselves unable to control their behavior and not able to close attention to lot of things.
All children cannot stay put at times. All may be inattentive and fantasize to pass the time away or may act without thinking at times, but when the child's hyperactivity, inattentiveness, poor concentration or impulsiveness start to negatively affect his performance in school, his demeanor at home or interfere with his relationship with other children, the presence of ADHD may be considered.
There are three types of ADHD based on the primary symptoms exhibited by an individual.
Hyperactivity-Impulsivity
Hyperactive children always seem to be constantly in motion. They dash around touching or playing with whatever is in sight, or talk incessantly. Sitting still at dinner or during a school lesson or story can be a difficult task. They squirm and fidget in their seats or roam around the room. Or they may wiggle their feet, touch everything, or noisily tap their pencil. Hyperactive teenagers or adults may feel internally restless. They often report needing to stay busy and may try to do several things at once.
Impulsive children seem unable to curb their immediate reactions or think before they act. They will often blurt out inappropriate comments, display their emotions without restraint, and act without regard for the later consequences of their conduct. Their impulsivity may make it hard for them to wait for things they want or to take their turn in games. They may grab a toy from another child or hit when they're upset. Even as teenagers or adults, they may impulsively choose to do things that have an immediate but small payoff rather than engage in activities that may take more effort yet provide much greater but delayed rewards.
Inattention
Children who are inattentive have a hard time keeping their minds on any one thing and may get bored with a task after only a few minutes. If they are doing something they really enjoy, they have no trouble paying attention. But focusing deliberate, conscious attention to organizing and completing a task or learning something new is difficult.
Homework is particularly hard for these children. They will forget to write down an assignment, or leave it at school. They will forget to bring a book home, or bring the wrong one. The homework, if finally finished, is full of errors and erasures. Homework is often accompanied by frustration for both parent and child.
The third type is combined type. These children display symptoms of the two earlier types.
Because all children may exhibit some of the symptoms stated above such as hyperactivity, inattentiveness and impulsiveness at times, strict guidelines have been set for diagnosing the disorder. Among the requirements for determining whether the symptoms indicate ADHD.
Symptoms of ADHD
The principal characteristics of ADHD are inattention, hyperactivity, and impulsivity. These symptoms appear early in a child's life. Because many normal children may have these symptoms, but at a low level, or the symptoms may be caused by another disorder, it is important that the child receive a thorough examination and appropriate diagnosis by a well-qualified professional.
Symptoms of ADHD will appear over the course of many months, often with the symptoms of impulsiveness and hyperactivity preceding those of inattention, which may not emerge for a year or more. Different symptoms may appear in different settings, depending on the demands the situation may pose for the child's self-control. A child who "can't sit still" or is otherwise disruptive will be noticeable in school, but the inattentive daydreamer may be overlooked. The impulsive child who acts before thinking may be considered just a "discipline problem," while the child who is passive or sluggish may be viewed as merely unmotivated. Yet both may have different types of ADHD. All children are sometimes restless, sometimes act without thinking, and sometimes daydream the time away. When the child's hyperactivity, distractibility, poor concentration, or impulsivity begin to affect performance in school, social relationships with other children, or behavior at home, ADHD may be suspected. But because the symptoms vary so much across settings, ADHD is not easy to diagnose. This is especially true when inattentiveness is the primary symptom.
The symptoms of ADHD fall into the following two broad categories
Inattention
Failure to pay close attention to details or making careless mistakes when doing schoolwork or other activities
Trouble keeping attention focused during play or tasks
Appearing not to listen when spoken to
Failure to follow instructions or finish tasks
Avoiding tasks that require a high amount of mental effort and organization, such as school projects
Frequently losing items required to facilitate tasks or activities, such as school supplies
Excessive distractibility
Forgetfulness
Procrastination inability to begin an activity
Difficulties with household activities.
Difficulty falling asleep, may be due to too many thoughts at night
Frequent emotional outbursts
Easily frustrated
Easily distracted
Hyperactivity-impulsive behaviour
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
Failure to await one's turn
Interrupting the activities of others at inappropriate times
Impulsive spending, leading to financial difficulties
Causes of ADHD
There is little compelling evidence at this time that ADHD can arise purely from social factors or child-rearing methods. Most substantiated causes appear to fall in the realm of neurobiology and genetics. This is not to say that environmental factors may not influence the severity of the disorder, and especially the degree of impairment and suffering the child may experience, but that such factors do not seem to give rise to the condition by themselves.
The parents' focus should be on looking forward and finding the best possible way to help their child. Scientists are studying causes in an effort to identify better ways to treat, and perhaps someday, to prevent ADHD. They are finding more and more evidence that ADHD does not stem from the home environment, but from biological causes. Knowing this can remove a huge burden of guilt from parents who might blame themselves for their child's behavior.
Over the last few decades, scientists have come up with possible theories about what causes ADHD. Some of these theories have led to dead ends, some to exciting new avenues of investigation.
Environmental Agents Causes
Studies have shown a possible correlation between the use of cigarettes and alcohol during pregnancy and risk for ADHD in the offspring of that pregnancy. As a precaution, it is best during pregnancy to refrain from both cigarette and alcohol use.
Another environmental agent that may be associated with a higher risk of ADHD is high levels of lead in the bodies of young preschool children. Since lead is no longer allowed in paint and is usually found only in older buildings, exposure to toxic levels is not as prevalent as it once was. Children who live in old buildings in which lead still exists in the plumbing or in lead paint that has been painted over may be at risk.
Brain Injury Causes
One early theory was that attention disorders were caused by brain injury. Some children who have suffered accidents leading to brain injury may show some signs of behavior similar to that of ADHD, but only a small percentage of children with ADHD have been found to have suffered a traumatic brain injury.
Food Additives and Sugar Causes
It has been suggested that attention disorders are caused by refined sugar or food additives, or that symptoms of ADHD are exacerbated by sugar or food additives. In 1982, the National Institutes of Health held a scientific consensus conference to discuss this issue. It was found that diet restrictions helped about 5 percent of children with ADHD, mostly young children who had food allergies. A more recent study on the effect of sugar on children, using sugar one day and a sugar substitute on alternate days, without parents, staff, or children knowing which substance was being used, showed no significant effects of the sugar on behavior or learning.
In another study, children whose mothers felt they were sugar-sensitive were given aspartame as a substitute for sugar. Half the mothers were told their children were given sugar, half that their children were given aspartame. The mothers who thought their children had received sugar rated them as more hyperactive than the other children and were more critical of their behavior.
Genetics Causes
Attention disorders often run in families, so there are likely to be genetic influences. Studies indicate that 25 percent of the close relatives in the families of ADHD children also have ADHD, whereas the rate is about 5 percent in the general population. Many studies of twins now show that a strong genetic influence exists in the disorder.
Researchers continue to study the genetic contribution to ADHD and to identify the genes that cause a person to be susceptible to ADHD. Since its inception in 1999, the Attention-Deficit Hyperactivity Disorder Molecular Genetics Network has served as a way for researchers to share findings regarding possible genetic influences on ADHD.
Attention Deficit Hyperactivity Disorder (ADHD) is a situation that becomes apparent in some children in the preschool and early school years. ADHD is hard for these children to control their behavior and pay attention. It is estimated that between 3 to 5 percent of children have a disorder characterized by consistent inattention, hyperactivity, and impulsiveness. This means that in a classroom of 25 to 30 children, it is likely that at least one will have ADHD.
ADHD was previously considered to be a neurological disorder, which usually shows up during the early childhood years. Children with ADHD find themselves unable to control their behavior and not able to close attention to lot of things.
All children cannot stay put at times. All may be inattentive and fantasize to pass the time away or may act without thinking at times, but when the child's hyperactivity, inattentiveness, poor concentration or impulsiveness start to negatively affect his performance in school, his demeanor at home or interfere with his relationship with other children, the presence of ADHD may be considered.
There are three types of ADHD based on the primary symptoms exhibited by an individual.
Hyperactivity-Impulsivity
Hyperactive children always seem to be constantly in motion. They dash around touching or playing with whatever is in sight, or talk incessantly. Sitting still at dinner or during a school lesson or story can be a difficult task. They squirm and fidget in their seats or roam around the room. Or they may wiggle their feet, touch everything, or noisily tap their pencil. Hyperactive teenagers or adults may feel internally restless. They often report needing to stay busy and may try to do several things at once.
Impulsive children seem unable to curb their immediate reactions or think before they act. They will often blurt out inappropriate comments, display their emotions without restraint, and act without regard for the later consequences of their conduct. Their impulsivity may make it hard for them to wait for things they want or to take their turn in games. They may grab a toy from another child or hit when they're upset. Even as teenagers or adults, they may impulsively choose to do things that have an immediate but small payoff rather than engage in activities that may take more effort yet provide much greater but delayed rewards.
Inattention
Children who are inattentive have a hard time keeping their minds on any one thing and may get bored with a task after only a few minutes. If they are doing something they really enjoy, they have no trouble paying attention. But focusing deliberate, conscious attention to organizing and completing a task or learning something new is difficult.
Homework is particularly hard for these children. They will forget to write down an assignment, or leave it at school. They will forget to bring a book home, or bring the wrong one. The homework, if finally finished, is full of errors and erasures. Homework is often accompanied by frustration for both parent and child.
The third type is combined type. These children display symptoms of the two earlier types.
Because all children may exhibit some of the symptoms stated above such as hyperactivity, inattentiveness and impulsiveness at times, strict guidelines have been set for diagnosing the disorder. Among the requirements for determining whether the symptoms indicate ADHD.
Symptoms of ADHD
The principal characteristics of ADHD are inattention, hyperactivity, and impulsivity. These symptoms appear early in a child's life. Because many normal children may have these symptoms, but at a low level, or the symptoms may be caused by another disorder, it is important that the child receive a thorough examination and appropriate diagnosis by a well-qualified professional.
Symptoms of ADHD will appear over the course of many months, often with the symptoms of impulsiveness and hyperactivity preceding those of inattention, which may not emerge for a year or more. Different symptoms may appear in different settings, depending on the demands the situation may pose for the child's self-control. A child who "can't sit still" or is otherwise disruptive will be noticeable in school, but the inattentive daydreamer may be overlooked. The impulsive child who acts before thinking may be considered just a "discipline problem," while the child who is passive or sluggish may be viewed as merely unmotivated. Yet both may have different types of ADHD. All children are sometimes restless, sometimes act without thinking, and sometimes daydream the time away. When the child's hyperactivity, distractibility, poor concentration, or impulsivity begin to affect performance in school, social relationships with other children, or behavior at home, ADHD may be suspected. But because the symptoms vary so much across settings, ADHD is not easy to diagnose. This is especially true when inattentiveness is the primary symptom.
The symptoms of ADHD fall into the following two broad categories
Inattention
Failure to pay close attention to details or making careless mistakes when doing schoolwork or other activities
Trouble keeping attention focused during play or tasks
Appearing not to listen when spoken to
Failure to follow instructions or finish tasks
Avoiding tasks that require a high amount of mental effort and organization, such as school projects
Frequently losing items required to facilitate tasks or activities, such as school supplies
Excessive distractibility
Forgetfulness
Procrastination inability to begin an activity
Difficulties with household activities.
Difficulty falling asleep, may be due to too many thoughts at night
Frequent emotional outbursts
Easily frustrated
Easily distracted
Hyperactivity-impulsive behaviour
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
Failure to await one's turn
Interrupting the activities of others at inappropriate times
Impulsive spending, leading to financial difficulties
Causes of ADHD
There is little compelling evidence at this time that ADHD can arise purely from social factors or child-rearing methods. Most substantiated causes appear to fall in the realm of neurobiology and genetics. This is not to say that environmental factors may not influence the severity of the disorder, and especially the degree of impairment and suffering the child may experience, but that such factors do not seem to give rise to the condition by themselves.
The parents' focus should be on looking forward and finding the best possible way to help their child. Scientists are studying causes in an effort to identify better ways to treat, and perhaps someday, to prevent ADHD. They are finding more and more evidence that ADHD does not stem from the home environment, but from biological causes. Knowing this can remove a huge burden of guilt from parents who might blame themselves for their child's behavior.
Over the last few decades, scientists have come up with possible theories about what causes ADHD. Some of these theories have led to dead ends, some to exciting new avenues of investigation.
Environmental Agents Causes
Studies have shown a possible correlation between the use of cigarettes and alcohol during pregnancy and risk for ADHD in the offspring of that pregnancy. As a precaution, it is best during pregnancy to refrain from both cigarette and alcohol use.
Another environmental agent that may be associated with a higher risk of ADHD is high levels of lead in the bodies of young preschool children. Since lead is no longer allowed in paint and is usually found only in older buildings, exposure to toxic levels is not as prevalent as it once was. Children who live in old buildings in which lead still exists in the plumbing or in lead paint that has been painted over may be at risk.
Brain Injury Causes
One early theory was that attention disorders were caused by brain injury. Some children who have suffered accidents leading to brain injury may show some signs of behavior similar to that of ADHD, but only a small percentage of children with ADHD have been found to have suffered a traumatic brain injury.
Food Additives and Sugar Causes
It has been suggested that attention disorders are caused by refined sugar or food additives, or that symptoms of ADHD are exacerbated by sugar or food additives. In 1982, the National Institutes of Health held a scientific consensus conference to discuss this issue. It was found that diet restrictions helped about 5 percent of children with ADHD, mostly young children who had food allergies. A more recent study on the effect of sugar on children, using sugar one day and a sugar substitute on alternate days, without parents, staff, or children knowing which substance was being used, showed no significant effects of the sugar on behavior or learning.
In another study, children whose mothers felt they were sugar-sensitive were given aspartame as a substitute for sugar. Half the mothers were told their children were given sugar, half that their children were given aspartame. The mothers who thought their children had received sugar rated them as more hyperactive than the other children and were more critical of their behavior.
Genetics Causes
Attention disorders often run in families, so there are likely to be genetic influences. Studies indicate that 25 percent of the close relatives in the families of ADHD children also have ADHD, whereas the rate is about 5 percent in the general population. Many studies of twins now show that a strong genetic influence exists in the disorder.
Researchers continue to study the genetic contribution to ADHD and to identify the genes that cause a person to be susceptible to ADHD. Since its inception in 1999, the Attention-Deficit Hyperactivity Disorder Molecular Genetics Network has served as a way for researchers to share findings regarding possible genetic influences on ADHD.
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