Understanding and Dealing with Attention Deficit & Hyperactivity Disorders

Revised: May 21, 2014

By: Michael G. Conner, Psy.D

Attention Deficit Hyperactivity Disorder (ADHD) is by definition a disorder that first occurs in childhood and may persist into adulthood.  ADHD is a relatively common psychiatric condition and is responsive to treatment.  The essential features are a persistent pattern of inattention and/or hyperactivity with impulsivity.  Inattention is an impaired ability to maintain a focused awareness and to recognize details, objects, as well as elements in a task, communication or sequence of events.  Hyperactivity means "extra-active".  The inclusion of the term hyperactivity has fallen in and out of favor and was recently reintroduced as an addition to the term attention deficit.  It is unclear whether or not hyperactivity is actually part of the condition or a separate condition.   Impulsivity is a tendency or pressure to act without a level of restraint that would be normal for the person's level of development. 

A person with ADHD has difficulty moderating and controlling their behavior.  They appear consistently driven, internally pressured and have difficulty remaining focused while participating in activities that many of us would find easy. The key to recognizing ADHD is an awareness of what constitutes age appropriate behavior in different environments.

There is good reason to be concerned whether a child has ADHD.  The behaviors and symptoms can make normal adjustment difficult. 

Symptoms Of Inattention

  • Often fails to give close attention to details or makes careless mistakes in school, work, etc..

  • Difficulty sustaining attention in tasks or play activities.

  • Often does not seem to listen when spoken to directly.

  • Does not follow through with instruction or fails to complete tasks.

  • Has difficulty organizing tasks or activities.

  • Avoids, dislikes and is reluctant to engage in tasks that require substantial mental effort.

  • Is easily distracted by unrelated stimuli.

  • Forgetful in daily activities

Symptoms of Hyperactivity

  • Often fidgets with hands or  feet or squirms in a seat.

  • Leaves the seat in situations where remaining seated is expected.

  • Moves around, climbs or is restless.

  • Has difficulty engaging in play or leisure activities quietly.

  • Seems to always be moving or driven to keep moving.

  • Often talks excessively.

Symptoms of Impulsivity

  • Often responds or speaks before questions are finished.

  • Has difficulty waiting or taking turns.

  • Interrupts or intrudes on others.

ADHD occurs in 3 to 5% of all school age children.  The disorder occurs 4 to 9 times more often in males than in females.  Data on the prevalence in adolescent and adult populations is very limited.  In most cases, symptoms diminish by adolescence and early adulthood.  ADHD-like behaviors tends to be more prevalent in children where there is a history of that behavior in family members.   This does not mean that ADHD is inherited.

Attention Deficit Hyperactivity Disorder is one of the most misunderstood diagnostic categories in mental health.   What is most apparent about children with ADHD are the differences in their attention and activity level. These differences are dramatically noticeable when these children are required to maintain their attention during dull, boring and repetitive tasks. 

There are a growing number of adults who believe they have ADHD.  The diagnosis of ADHD in an adult requires an evaluation of how that person functioned as a child.  Such retrospective diagnoses are in most cases extremely difficult, if not impossible.  If the person has any knowledge of the disorder or  investment in being diagnosed, it will be very difficult for the adult to give an accurate report. 

Diagnosis of ADHD is not a simple matter although many parents, teachers and some mental health professionals are quick to make it.  For many parents, having a diagnosis of a problem behavior pattern and hearing the problem can be treated with medication is not only a relief but can help restore balance to an otherwise disruptive home environment. 

Many scientists and mental health professionals argue that the symptoms used to diagnose ADHD are overly inclusive and end up diagnosing children with ADHD who are not disordered.   It is worth noting that the observed symptoms of ADHD in a particular child will vary considerably across settings and caregivers. Symptoms in large classrooms with boring topics that provide little interaction produce more ADHD symptoms that are smaller in classrooms with more frequent one-on-one interactions and more interesting activities.

ADHD is a controversial diagnosis with little or no scientific or medical basis.  There is no solid evidence that ADHD is a genuine disorder or disease of any kind.  In fact, there are a growing number of scientists and mental health professionals who feel that ADHD is not really a disorder but rather part of the human condition.  Many professionals believe the diagnostic system used to classify the behavior of inattentive overly active children does more harm than good.  Many diagnostic labels have been created that describe children who have a low attention span, impulsive tendencies, and difficulty maintaining "normal" activity levels in response to a demanding situation.  The question is whether or not these behaviors are abnormal and represent a disorder. 

ADHD does not appear to be a condition that involves abnormally high distractibility, but rather a lack of persistence in responding to tasks that are

  • not interesting,

  • have no intrinsic appeal, 

  • have minimal immediate consequences. 

Medication is by far the most common treatment for ADHD.  The number of children diagnosed and treated with medication for ADHD has increased 7 fold in the past 3 years. Several million children are being treated with Ritalin, stimulants and antidepressants on the grounds that they have attention deficit-hyperactivity disorder and suffer from inattention, hyperactivity, or impulsivity. Drugs used in the treatment of ADHD include:

  • Ritalin (methylphenidate)

  • Dexedrine and DextroStat (dextroamphetamine or d-amphetamine)

  • Adderall (d-amphetamine and amphetamine mixture)

  • Desoxyn and Gradumet (methamphetamine)

  • Cylert (pemoline)Imipramine

Interestingly, there is no proof of any physical abnormalities in the brains or bodies of children who are routinely labeled ADHD. They do not have known biochemical imbalances or "crossed wires."   Medications used to treat ADHD do not correct known chemical abnormalities, they create new ones.   The stimulants used to treat ADHD are addictive and can cause serious brain abnormalities.  

There is a great deal of research to confirm that environmental problems can cause ADHD-like symptoms.  But regardless of the cause, the impact of inattention, hyperactivity and impulsivity can be detrimental to normal development.   Educational systems, employers and social expectations can be rather rigid.   Conflict and failures shape our sense of life, self-esteem, our ability to learn and our ability to get along with others. 

Information And Steps You Can Take That May Help

  • Consult with a qualified mental health professional who is competent and experienced at diagnosing and treating ADHD. 
  • Get more than one professional opinion. Consult with a professional who supports the use of medication and a professional who is opposed to the use of medication unless absolutely necessary.
  • In order to a make a diagnosis, it is important to:

  • Explore all of the possibilities that could explain the child's behavior.

  • Determine if there are any problems such as learning disabilities, conduct disorders, depression, anxiety or medical concerns.

  • Fully evaluate the family structure, classroom situation, and any special conditions or problems.

  • Evaluate the child's thinking and academic abilities.

Copyright 1998 to 2008, Michael G. Conner