ADHD is among the most common mental disorders among children. It is one of the top reasons for referral to a pediatrician, family physician, pediatric neurologist, child psychiatrist or psychologist.
ADHD is best diagnosed by a child psychologist or other child specialist in ADHD
Symptoms of ADHD (from PsychCentral.com)
The main features of attention deficit disorder (or ADHD) are inattention, hyperactivity, and impulsivity. But because most young children display these behaviors from time to time, it is important not to assume that every child you see with these symptoms has ADHD. However, if the symptoms continue, advice should be sought from a qualified mental health professional.
Symptoms of attention deficit disorder usually develop over several months. In general, impulsiveness and hyperactivity are observed before one notices the lack of attention, which often appears later. It also may go unnoticed because the “inattentive daydreamer” may be overlooked when the child who “can’t sit still” at school or is otherwise disruptive will be noticed. The observable symptoms of ADHD will therefore vary a great deal depending on the situation and the specific demands it makes on the child’s self-control.
Different forms of ADHD may result in the child being labeled differently. For example, an impulsive child may be labeled a “discipline problem.” A passive child may be described as “unmotivated.” But ADHD could be the cause of both behavior patterns. It may only be suspected once the child’s hyperactivity, distractibility, lack of concentration, or impulsivity start affecting school performance, friendships, or behavior at home.
The official diagnosis of ADHD includes the three major symptoms (inattentiveness, hyperactivity and impulsiveness). The most recent version of the handbook for mental health professionals states that people with ADHD may have any or all of the major symptoms.
Three subtypes of ADHD are recognized by professionals:
- Predominantly Hyperactive-Impulsive Type — If symptoms of hyperactivity-impulsivity but not symptoms of inattention have been shown for at least six months to an extent that is disruptive and inappropriate for the individual’s developmental level.
- Predominantly Inattentive Type — If symptoms of inattention but not symptoms of hyperactivity-impulsivity have been shown for at least six months to an extent that is disruptive and inappropriate for the individual’s developmental level.
- Combined Type — If symptoms of both inattention and hyperactivity-impulsivity have been shown for at least six months to an extent that is disruptive and inappropriate for the individual’s developmental level.
Hyperactive/Impulsive Type of ADHD
Hyperactive children always seem to be “on the go” or 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 difficult. 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 feel the need to stay busy and may try to do several things at once.
Impulsive children seem unable to control their immediate reactions or think before they act. They will often blurt out inappropriate comments, show their emotions without restraint, and act without considering the consequences. They may find it hard to wait for things they want, or to take their turn in games. They may grab a toy from another child or hit out when upset. As teenagers or adults, impulsive people may choose to do things that have an instant reward instead of seeing through activities which take more effort but would lead to greater but delayed rewards.
Indicators of hyperactivity-impulsivity:
- Feeling restless, fidgeting with hands or feet, and squirming while seated
- Running, climbing, or leaving a seat in situations where sitting or quiet behavior is expected
- Blurting out answers before hearing the whole question
- Interrupting or intruding on others
- Having difficulty waiting in line or taking turns or enjoying leisure activities quietly
- Adolescents or adults may feel very restless, as if “driven by a motor”, and talk excessively.
Have you ever had trouble concentrating, found it hard to sit still, interrupted others during a conversation or acted impulsively without thinking things through? Can you recall times when you daydreamed or had difficulty focusing on the task at hand?
Most of us can picture acting this way from time to time. But for some people, these and other exasperating behaviors are uncontrollable, persistently plaguing their day-to-day existence and interfering with their ability to form lasting friendships or succeed in school, at home and with a career.
Unlike a broken bone or cancer, attention deficit hyperactivity disorder (ADHD, also sometimes referred to as just plain attention deficit disorder or ADD) does not show physical signs that can be detected by a blood or other lab test*. The typical ADHD symptoms often overlap with those of other physical and psychological disorders.
The causes remain unknown, but ADHD can be diagnosed and effectively treated. Many resources are available to support families in managing ADHD behaviors when they occur.
ADHD, also known as attention deficit disorder (ADD) or hyperkinetic disorder, has been around a lot longer than most people realize. In fact, a condition that appears to be similar to ADHD was described by Hippocrates, who lived from 460 to 370 BC. The name Attention Deficit Disorder was first introduced in 1980 in DSM-III, the third edition of the ‘Diagnostic and Statistical Manual of Mental Disorders’, used in psychiatry. In 1994 the definition was altered to include three groups within ADHD: the predominantly hyperactive-impulsive type; the predominantly inattentive type; and the combined type. ADHD usually appears in childhood but can be diagnosed in adults.
Interestingly enough many adults are undiagnosed and experience sub-optimal lives as a result of untreated ADHD.
Here is a quiz that helps you examine if you may have some symptoms of Adult ADHD:
Recent steps forward in our understanding of ADHD include:
- An estimated 3 to 5 per cent of children are affected – approximately 2 million children in the US. In a classroom of 25 to 30 children, it is likely that at least one will have ADHD.
- ADHD is among the most common mental disorders among children. It is one of the top reasons for referral to a pediatrician, family physician, pediatric neurologist, child psychiatrist or psychologist. ADHD is best diagnosed by a child psychologist or other child specialist in ADHD.
- ADHD is about three times more common among boys than girls.
- The symptoms of ADHD do not always go away – up to 60 per cent of child patients retain their symptoms into adulthood. Many adults with ADHD have never been diagnosed, so may not be aware they have the disorder. They may have been wrongly diagnosed with depression, anxiety, bipolar disorder or a learning disability.
- ADHD has been identified in every nation and culture that has been studied.
ADHD is difficult for everyone involved to deal with. As well as the difficulty of living with the symptoms, wider society may face challenges. Some experts have linked ADHD with an increased risk of accidents, drug abuse, failure at school, antisocial behavior and criminal activity. But others view ADHD in a positive light, arguing that it is simply a different method of learning involving greater risk-taking and creativity.
ADHD is often accompanied by:
- learning disabilities
- speech or hearing problems
- obsessive-compulsive disorder
- behavioral problems such as oppositional defiant disorder (ODD) or conduct disorder (CD)
Exactly what causes ADHD has not been pinpointed, though many practitioners believe neurobiological or genetic elements play a role. In addition, numerous social factors such as family conflict or poor child-rearing practices, while not causing the condition, may complicate the course of ADHD and its treatment.
The following are some good additional articles on understand the many nuances of ADHD and ADD:
Neurofeedback Therapy an Effective, Non-Drug Treatment for ADHD By Kristi Dename (Psych Central June 10th 2013)
Pills are not the only way to manage your child’s inappropriate or maladaptive behaviors.
Neurofeedback therapy is a safe, non-invasive, alternative option for the treatment of attention-deficit hyperactivity disorder (ADHD) in children and adolescents. In November 2012, the American Academy of Pediatrics approved biofeedback and neurofeedback as a Level 1 or “best support” treatment option for children suffering from ADHD.
For parents looking for an effective, non-drug treatment of ADHD, neurofeedback is one worth serious consideration.
It is estimated that two million children in the United States are struggling with the symptoms of ADHD, which are inattention or inattention combined with hyperactivity. Common indicators of ADHD with hyperactivity are:
- feeling restless, fidgeting, and/or squirming
- Impulsive speech and blurting answers
- Having difficulty remaining patient and quiet
- Excessive talking and moving, constantly in motion
Indicators of inattention type include:
- Inability to focus
- Carelessness with schoolwork and other tasks
- Very easily distracted
- Losing or forgetting important items
- Commonly do not complete tasks once started and bounce from one activity to the next
Neurofeedback Treatment for ADHD
Neurofeedback trains children to become more aware of their physiological responses and how to gain control of the brain’s frontal lobe, which is the executive functioning center. Electroencephalography (EEG) neurofeedback is a specific technique under biofeedback therapy, and it is the recording of electrical activity within the cells of the scalp. EEG neurofeedback focuses on the central nervous system and the brain’s activity in order to give moment-to-moment information.
Children with ADHD have higher rates of EEG abnormalities compared to children without ADHD, such as higher theta wave rhythms (drowsiness), lower sensorimotor rhythms (movement control), and lower beta waves (attention and memory processes). Neurofeedback provides audio and visual interpretations of these brain waves, and children learn how to maintain the appropriate levels for functioning.
During a neurofeedback session, EEG sensors are situated on the scalp. Specific brain wave activity is then detected, amplified, and recorded. The information is instantaneously fed back to the therapist and client on a screen. The therapist informs the client what they are observing, and trains them on how to control the brain activity so that it reaches the desired range. With the help of a video game program, the child learns to maintain low activity of the delta waves and an increase in beta waves, or the game will not continue to play. With this, the child exercises the brain and increases his focus and attention.
It also has been studied and reported that the brains of children with ADHD are lacking the regulation from the frontal region, allowing the mid-brain to quickly react without a type of checking system. Neurofeedback restores the strength of the frontal region of the brain, and builds a better connection between the mid-brain and forebrain, allowing focus, attention, impulses, and emotional reactions to become manageable. Children build memory for how they were able to achieve the desired results within the sessions and use it outside of the sessions to produce lasting results.
Methylphenidate (Ritalin) is a psychostimulant drug commonly used for the treatment of ADHD in children and adolescents. Research suggests that neurofeedback is an equally effective treatment. Children are typically given three doses of 10 mg Ritalin per day on school days. Neurofeedback training is shown to be a favorable option that provides the same results as medication. For parents who prefer other options aside from medication, neurofeedback is a non-invasive, safe, effective, and long-lasting treatment option. Typically, the child will participate in 30 to 40 sessions or more depending on severity of symptoms, and each session lasts 30 to 60 minutes.
At HW, we conduct behavioral contracts as well as Neurofeedback with ADHD. Since we do believe in looking at how the person with ADD or ADHD is eating, we will make recommendations that help the journey of re-training the brain. Our collaborative approach where we team with family members makes us highly user friendly to the entire family system. Our philosophy is to treat the entire system and achieve optimum results with a combination of treatment modalities. We do not have a one size fits all treatment philosophy.
Arns, M., de Ridder, S., Strehl, U., Breteler, M., & Coenen, A. (2009). Efficacy of neurofeedback treatment in ADHD: the effects on inattention, impulsivity and hyperactivity: a meta analysis. Clinical EEG and Neuroscience, 40(3), 180-189.
Duric, N., Assmus, J., Gundersen, D., & Elgen, I. (2012). Neurofeedback for the treatment of children and adolescents with ADHD: a randomized and controlled clinical trial using parental reports. BMC Psychiatry, 12(1), 107.
American Academy of Pediatrics report: Evidence-based Child and Adolescent Psychosocial Interventions, released November 2012