Attention Deficit Hyperactivity Disorder (ADHD)

Attention Deficit Hyperactivity Disorder affects 3-5% of school age children and is responsible for 30-40% of child and adolescent psychological referrals . Boys are referred for evaluation at least 4 times more often than girls. ADHD is thought to persist through adolescence and into adulthood about 50% of the time. The 3 typical components of ADHD are hyperactivity, impulsivity, and inattentiveness. To be considered clinically significant, these symptoms must be present to more of a degree than in most children the same age.

Hyperactivity involves such behaviors as fidgeting or being always on the go, as if "driven by a motor." However, in the "Inattentive Type" of ADHD, there may be no hyperactivity. Inattentiveness would be characterized chiefly by difficulty maintaining attention in the classroom or in following directions, and being generally distractible and disorganized. These children have great difficulty following through and frequently get their schedule mixed up and lose their belongings. Often, they dislike or are unable to sustain mental activity that is not inherently interesting, in contrast to their being able to maintain focus on highly stimulating activities such as video games or children's TV programs. Academic difficulties are common and may also be the result of co-existing learning disorders.

Impulsive children or teens may need supervision to avoid injury from behavior that can be reckless or destructive. They may be aggressive or act as if they have no sense of danger. In class they may blurt out answers, have trouble waiting for their turn, and begin tasks or assignments without waiting to hear all of the instructions being given. Their behavior may result in their being socially isolated and unhappy, and having low self-esteem. Additional behavior problems that may co-exist with ADHD include drug abuse, anxiety disorders, OCD, depression, and tic or movement disorders.

Symptoms of ADHD must be present before the age of 7, although diagnosis is often not made until the child (or adult) is older and a clear pattern of behavior and symptoms has been manifested at home, at school, or at work. Diagnosis should be made after taking into account the symptom history and reports of current functioning in school, work, and home settings. ADHD appears to be genetically linked, and it is quite common for a parent of a child being evaluated to say, "Hey, now that I think about it, the symptoms you are listing sound a lot like my problems."

Psychological treatments for ADHD include individual and family therapy, social skills training, parent education, and behavior therapy. When clinically indicated, a psychologist will recommend that a referral be made to a medical professional for evaluation of the need for medication or further medical or neurological assessment. In addition, a psychologist can be extremely helpful in monitoring and coordinating aspects of treatment to enhance the communication of school and mental health professionals and parents.


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