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Children's Mental Health
Attention-Deficit/Hyperactivity Disorder

In the 1970s, experts started using the term "Attention Deficit Disorder" to describe the condition. Recently, however, the word "hyperactivity" has been added back to the official description. The condition is now called Attention-Deficit/Hyperactivity Disorder or ADHD.

Some children may have all behaviors in one group or the other, but for a diagnosis of ADHD, children should have at least 2/3rds of the behaviors in one group or the other. Many children with ADHD are inconsistent in their behavior, so they may show symptoms at one time of day but not at another.

Literally, hyperactive means "extra active," but the term does not really tell us very much, because the activity level of children who are called "hyperactive" varies so much.

For some children, the most obvious symptom may be problems with attention span. For others, the primary difficulty will be hyperactive or impulsive behavior.

So there are two groups of such children - those who are mainly hyperactive or impulsive and those who are predominantly inattentive. Some will have mixtures of both types.

Symptoms of an ADHD Child.

With Hyperactivity(Impulsive) Is fidgety. Leaves seat when shouldn’t. Runs or climbs inappropriately. Talks excessively. Difficulty playing quietly. Always on the go. Blurts out answers. Has trouble waiting turn. Interrupts.

Without Hyperactivity(Inattentive) Difficulty following through on instructions. Difficulty keeping attention on tasks or play. Loses things at school and home. Doesn’t listen. Fails to give close attention to detail. Seems disorganized. Trouble with tasks needing long-term effort. Is forgetful. Easily distracted.

What Causes ADHD?
There are still many different theories about the true cause of ADHD. Until the 1970s, experts felt that many of these people had suffered some type of brain damage or that the brain had some other disorder.

More recently, however, it has become clear that the problem isn’t with the structure of the brain itself. Instead, researchers have been looking at brain chemistry - especially those substances that help transmit messages (called neurotransmitters) within the brain, such as dopamine, norepinephrine, and serotonin.

If one or more of these chemicals is in short supply, or for some reason is not doing its job, that would account for many of the signs and symptoms of ADHD.

Is ADHD Inherited?
We now know that ADHD is very much a "family affair". At the present time, specialists agree that at least 30% to 40% of children diagnosed with ADHD have relatives with the same type of problem.

However, this doesn’t mean that all children in a family will have ADHD. In most families with ADHD, there is usually only one child who shows these signs and symptoms.

How Is The Diagnosis Made?
Diagnosis is not a simple matter, and may require more than one specialist. It’s a mistake for a "snap" diagnosis to be made or to try to intervene before all of the facts are known.

Evaluation should be done by pediatricians and/or neurologists with a background in behavioral and developmental problems, licensed mental health professionals, specially-trained family and general practitioners, or by a team of professionals from the all of these specialties.

It is important for the diagnosis:

• To explore all of the possibilities that could explain the child’s behaviors.
  
• To find if there are any additional problems such as learning disabilities, conduct disorders, depression, anxiety, or various physical illnesses.
  
• To know about the family structure, classroom situation, and any special conditions or problems.
  
• To have a good idea of the child’s thinking ability and academic skills.
  

Physical Examination
A recent thorough physical examination, including hearing and vision, is very important to exclude certain medical problems. It is also important to find out whether the child has any developmental difficulties such as problems with motor skills, memory, remembering things in sequence, listening and speaking, or recognizing and reproducing pictures and symbols.

Learning Disabilities
Probably the most significant condition in addition to ADHD is some type of a learning problem or learning disability. Between 40 and 60% of children with ADHD will have academic difficulties in school, and many others will have problems with producing school work (such as with large amounts of writing or timed tests).

ADHD is a very common cause of school underachievement from preschool right through college and graduate school - and even into the business world.

The Treatment Of ADHD
Standard therapies for ADHD include educational approaches, psychological and behavioral approaches, and medication.

Adulthood
Many of the signs and symptoms of ADHD may persist into the adult years, including restlessness, disorganization, being impulsive, and social difficulties.

Adults may still have:

• A tendency to be easily distracted.
  
• Hyperactivity, usually in the form of restlessness.
  
• Mood swings (which very often become the main symptom in adults).
  
• Inability to complete things.
  
• A hot temper, with low stress tolerance.
  
• Difficulties getting along with spouses, co-workers, and other significant people in their lives.

MHAFC needs your financial support to continue to improve awareness and understanding of mental illnesses. Please click here to make a contribution.

This publication is generously supported by a grant from the William H. Donner Foundation and Eli Lilly and Company.
Copyright 1996

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