ADD and ADHD - Do You Suspect Someone You Know Needs to Be Evaluated for Attention Deficit Disorder?

What is ADD/ADHD?

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Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD) are genetic disorders that result in a lack of blood flow in the frontal lobe of the brain. This results in a poor attention span, impulsive behavior, and/or hyperactivity. People rarely grow out of ADD/ADHD.

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Is ADD or ADHD over diagnosed today?

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It may be misdiagnosed. For instance, if a child has a parent with an 'I am the boss' parenting style, the child may exhibit many symptoms that an ADD/ADHD child exhibits. Symptoms similar to those of ADD/ADHD may also be indicative of mood, cognitive, or personality disorders. Many evaluators use the Conrad ADHD Test (with a reliability of 40%) as the assessment tool to diagnose ADD/ADHD; however, Dr. Worthing uses the ADHDT by PRO-ED, Inc., which has a reliability of over 90%.

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What are the three types of ADD/ADHD and their symptoms?

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*Not all need to be present

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Inattentive Type

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Poor Concentration

Fails to Finish Projects

Disorganized

Poor Planning Ability

Absentminded

Inattentive

Difficulty Following Directions

Short Attention Span

Easily Distracted

Difficulty Staying on Task

Difficulty Completing Tasks

Frequently Loses Things

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Impulsive Type

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Acts before Thinking

Shifts from One Activity to the Next

Fails to Wait for One's Turn

Difficulty Waiting Turn

Blurts Out Answers

Impulsive

Interrupts Conversations

Intrudes on Others

Does Not Wait for Directions

Fails to Follow Rules

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Hyperactive Type

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Loud

Constantly 'On-The-Go'

Excessive Activity

Wiggling in Seat

Easily Excited

Grabs Objects

Excessive Talking

Manipulates Objects

Inability to Play Quietly

Fidgets/Restless/Squirms

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What are the Life-Altering Aspects of Untreated ADD or ADHD?

More than 40% of children with ADHD indulge in early tobacco and alcohol abuse, compared with 30% or less of those without ADHD.
Up to 58% of children with ADHD have failed a grade in school. In one study, 46% of children with ADHD had been suspended from school.
As many as 30% of adolescents with ADHD will drop out of or fail to complete high school, compared with 10% of those without ADHD.
On average, in their first 2 years of driving, adolescents with ADHD are involved in automobile accidents significantly more often; they are more likely both to be at fault and to incur bodily injuries in such accidents than are those without the disorder.
38% of young adults with ADHD are likely to have been pregnant or to have caused a pregnancy, compared with 4% of those without ADHD.
17% of young adults with ADHD are likely to have contracted a sexually transmitted disease, compared with 4% of those without ADHD.
Some research has shown that when children with ADHD reach adulthood, up to 79% of them may complain of difficulties with symptoms of anxiety, sadness, and physical ailments, compared with 51% of those without ADHD.
Adults with ADHD are 78% more likely to be addicted to tobacco or smoking, compared with those without ADHD.
ADHD adults (compared with those without it) are 58% more likely to use illegal drugs.
Over an extended study period, the overall medical costs for persons with ADHD were more than twice those of individuals without the disorder ($4,300 vs. $1,900).

The Importance of An Accurate Diagnosis: ADHD Is Similar to Other Disorders

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Symptoms of ADHD

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Easily distracted, poor concentration

Excessive activity, restlessness

Acts before thinking

Interrupts, blurts out answers

Easily excited

Impulsive, self-defeating behavior

Conflict-seeking behavior

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Symptoms of Bipolar Disorder

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Distractibility

Increased activity or agitation

Impulsive, poor judgment

Rapid, pressured speech at times

Elevated mood or extremely social

Self-destructive behavior

Carol Ann Worthing, PhD of Individual & Family Wholeness, is a psychotherapist in private practice since 1992. She has her PhD in Psychology from Northcentral University in Arizona. She provides a safe and caring approach to your psychotherapy and evaluations for individuals, couples, families, and children. Her practice represents integrity, competency, and confidentiality, a safe and caring place for psychotherapy. It is her mission to guide you and your family to become emotionally and psychologically whole and to help you deliberately build your lives and families on that wholeness.

Attention Deficit Hyperactivity Disorder (ADHD) : Challenges Established Family Norms and Beliefs

Attention Deficit Hyperactivity Disorder (ADHD) is the most common behavioral disorder of childhood. It is commonly estimates that from 3% to 6% of the child and adolescent population in the United States is diagnosed with ADHD. However, a recent report issued by the American Psychiatric Association (APA) suggest that ADHD may affect as many as 8% to 17% of America's youth. The APA report indicating a greater public health threat than previously thought.

Children and adolescents with ADHD are at a significantly higher risk for numerous emotional and social problems than those without ADHD, including academic and occupational underachievement, violence and criminality, increased suicide and risk-taking behavior. Children with ADHD are also at risk for depression, interpersonal difficulties, and family disruption (J. Kendall, 2003). Although studies have demonstrated that family dysfunction is common in families with ADHD children. Also, family members may suffer serious psychological effects, however, knowledge is noticeable lacking as to how to help these families cope with the daily challenges ADHD.

Article of interest Recently I read an article titled, Working with the Family of a Child with Attention Deficit Hyperactivity Disorder (ADHD). The authors of this article are: D.J. DeMarle, L. Denk, and C.S. Ernsthausen. I recommend this particular article for several reasons the most important being that it is replete with great ideas; and some very good suggestions that sets the framework for addressing family members' relevent concerns about ADHD and make recommendation for effective treatment and support system. Most practitioners understand ADHD as a medical condition. I don't agree with that assessment. It is true that ADHD has a biological and a physiological component. However, I believe that ADHD is a psychological, behavioral, and medical disorder. When we view ADHD as a single entity we run the risk of treating part of the symptoms. For example, if we focus on the medical aspect ADHD, the medical practitioner is commonly consulted to determined if the child meets the criteria for ADHD as required by the Diagnostic and Statistical Manual of Mental Disorder (DSM IV). The evaluating physicians are also called upon for advice and to prescribe treatment for the disorder. However, most physicians with a very active practice cannot devote the time that is necessary with the family to review the nature and causes of ADHD and the multi-disciplinary approach to treating the disorder. Therefore, there is an elevated risk that the doctor may inadvertently reinforce existing fears and misconceptions about ADHD in the minds of family members.

With this in mind we can understand how crucial the multi-disciplinary team and their experiences working with and supporting families throughout the interviewing and consulting process. Research shows that family's reaction may directly influence parental attitudes, the child, and their actions with him or her. It is an accepted fact that parents' attitude is affected by the information received, compassionate understanding, and the level of attention shown by the physician and other professionals sharing the news. This article, in my opinion, is a road map that can guide families through the process and help the team to develop strategy to reduce family members' anxities.

Because ADHD has received mass media attention in recent years many in the general public have reached an opinion about ADHD that is not supported by scientific facts. I offer this brief quote from the article to established a foundation for the unsupported, but wide, belief about ADHD. The authors described the verbal exchange between Don and Mary Butler (pseudonym) who had just been told by their pediatrician that their son Tommy had ADHD and suggests Ritalin as the appropriate treatment. Don turns to Mary and said, "See I told you he was just a lazy and rotten kid, even the doctor thinks so; that's why he is putting him on medication."

ADHD Real or Imagined? Don is expressing a widely held belief that ADHD is not a legitimate medical illness. It has been suffested that many in the medical community has strayed from the scientific path and created a disorder to ease teachers and parents' anxieties regarding childhood inappropriate behavior by routinely drugging children into proper behavior. Those who continue to believe that ADHD is a medical myth must ignore a mountain of scientific studies and research literatures that documents the existence of ADHD as a ligitimate and serious disorder. Based on the criteria established by the DSM IV, ADHD accounts for the greatest number of referrals to child mental health clinic than all other psychiatric and behavioral problems of childhood adolescent.

The continued questioning of the validity of the diagnosis of ADHD has caused uncertainties about its management in the minds of many clinicians and the public at large. Inaccurate beliefs about the validity of ADHD may hinder the appropriate care of some patients and cause confusion about the need for approved treatment. As stated above, critics describe ADHD as a means to label difficult children who are not ill but whose behavior is the problem. They further contend that, far from having a biological basis, ADHD results from improper parenting and poor, ineffective, teaching practices. These attitudes further stigmatize patients and their families, and increase the burden of this debilitating disease. There is overwhelming medical evidence that ADHD not only cause specific disabling symptoms that often persist into adulthood, but many studies shows a biological connection and a characteristic response to approved treatment.

Rodney Dangerfield, the well-known actor/comedian, often said "I get no respect." The thought that came to my mind was ADHD gets no respect. That is certainly the conclusion one might reach after reading so many insidious statements that ADHD is not an authentic and debilitating disorder. Many of us, including this author, who work with children diagnosed with ADHD have no illusion about the reality and seriousness of this disorder.

Like many teachers, in todays educational settings, I come in daily contact with students diagnosed with various disabilities, including ADHD. Therefore I have a profound sense of resentment toward those who support the beliefs that ADHD is not a legitimate illness but nothing more than a label created specifically to absolve parents and teachers of their responsibility to manage uncontrollable children. However, I can understand how the uninformed and those who choose to view ADHD from a distance might easily be led astray. For example, many of us at some point exhibit some of the symptoms common of ADHD. We sometime get distracted, we have trouble finishing assigned work or completing other important tasks. On the other hand, children with ADHD are, in most case, less able to care for themselves, less able to behave appropriately in social setting; and less able to communicate on the same level as other children of the same age.

Phantom Symptoms

Final, for unknown reason, symptoms indicating the present of ADHD may temporarily be absent leading others to believe that the person with ADHD can control the behaviors. Also, a definite diagnosis is difficult because there are no tests that can consistently detect ADHD. A physician can only observe behaviors and offer a professional conclusion weather the child has ADHD. If a child is having trouble concentrating, or may be unwilling to cooperate on the day they see the doctor this could lead to an incorrect diagnosis. Therefore, it is very important that ADHD be diagnosed by health care professionals that specializes in these types of disorders with the help and cooperation of parents and teachers.

DeMarle D.J., Denk L., Ernsthausen C.S. (2003) Working with the Family of a Child with Attention Deficit Hyperactivity Disorder. Pediatric Nursing, Vol. 29 (4), 302-308.

Dr. William Smith is a psychologist and consultant with many years experience working with families and individuals, including those who have a child with disability. For additional information, Dr. Smith can be contacted by completing the contact form at: insightconsultant.com Dr. Smith will give a FREE initial assessment to any one who request such.

An Overview of Inattentive ADHD and ADD (Attention Deficit Disorder)

This overview discusses the differences between Inattentive ADHD and the other subtypes of ADHD.

Overview:

Inattentive ADHD is one of the three subtypes of Attention Deficit Hyperactivity Disorder (ADHD).

Inattentive ADHD is sometimes referred to as ADD which is short for Attention Deficit Disorder. This subtype of ADHD is also called ADHD predominantly inattentive (ADHD-I, ADHD-PI).

Symptoms:

ADD differs from the other two subtypes in several ways. The characteristic symptoms of the inattentive subtype are inattention, easy distractibility, disorganization, procrastination and forgetfulness.

About a third of people with the Inattentive subtype also have coexisting lethargy and fatigue and people with this variant of ADD are said to have Sluggish Cognitive Tempo or SCT.

People with ADD and Sluggish Cognitive Tempo have fewer or no symptoms of hyperactivity or impulsiveness and they are less likely to have a co-existing diagnosis of Oppositional Defiance Disorder or Conduct disorder. Hyperactivity and Impulsiveness are symptoms that are the hallmark of the other two subtypes of ADHD, the Combined type of ADHD referred to as ADHD-C and the Hyperactive/Impulsive subtype of ADHD which is referred to as ADHD-HI.

People with this condition have been shown in studies to perform more poorly in school than people with the other subtypes of ADHD but they are less likely to suffer the adverse life outcomes, such as substance abuse disorder or law enforcement problems, seen more commonly in people with the other two subtypes of ADHD.

Causes:

The cause of ADHD-PI is unknown but genetic influences are thought to play a major role. It is estimated that up to 70% of people with ADD have a relative with Inattentive ADD. Other factors that may play a causative roll in ADD and SCT include:

Dietary allergies-It is possible that certain people may have increased ADHD-PI symptoms after consuming certain foods or food dyes.

Environmental Factors and Toxins - pesticides and lead have both been implicated in causing increased symptoms.

Prematurity and Traumatic head injuries- may be related to an increased risk of symptoms.

Social Influences- maternal separation and other social factors are being studied to determine their role in causing this condition.

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Testing:

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ADHD questionnaires are standardly administered to diagnose this condition. These questionnaires consist of a series of symptoms questions where parents and teachers rate the severity of symptom sand the perceived degree of disability caused by each symptom.

Other diagnostic methods include computerized programs that measure attention, hyperactivity and impulsive behavior. The computerized test can give a more objective view of symptoms which is important because parent and teacher questionnaires responses can vary greatly and often do not agree on the severity of disabling characteristic of the ADHD symptom.

Treatment:

The appropriate dose of medication, which may be lower in the case of treating ADD than it is for the other subgroups of ADHD.

The following is a list of medications used to treat Inattention:

Dextroamphetamine (Adderall, Dexedrine,Vyvanse) - most commonly used stimulant treatment (along with methylphenidate) for all subtypes of this condition.

Methylphenidate (Ritalin, Concerta, Focalin, Daytrana,Metadate) - some people may have a genetic basis for NOT responding to methylphenidate.

Atomexitine (Strattera) - non-stimulant therapy.

Alpha-2A-Adrenoceptor Agonist (Intuniv, Clonidine) - especially useful for combined ADHD and Tourette's syndrome

Selective Serotonin Re-uptake Inhibitors (Paxil, Zoloft, Prozac) - useful for the treatment of associated depression or as a second line treatment for ADHD-PI when stimulants fail.

Try-cyclic Antidepressants (Norparmine,Tofranil) - also used for treating co-existing depression but the try-cyclics can have unpleasant side effects and must be used with extreme caution in children.

Bupropion (Wellbutrin) - Wellbutrin is a norepinephrine and dopamine reuptake inhibitor and is another second line treatment for the inattentive subtype.

Behavioral therapy is useful sometimes alone and sometimes combined with medication to better treat issues related to motivation, persistence, academic issues and social skill problems. Behavioral therapy may be more useful for ADHD-PI than it is for the other subtypes.

Lifestyle skills treatment generally addresses lifestyle issues such as diet, exercise and stress reduction.

Classroom treatment methods include: Classroom management, parent support training and classroom accommodation.

Additional useful treatment methods include:

Vitamin supplementation - to address potential deficiencies in Omega-3 fatty acids, iron or zinc.

Behavioral therapy and Coaching.

Psychotherapy - to treat the problems that can co-exist with Inattentive ADHD such as anxiety, depression and social phobias.

Cognitive-behavioral therapy (CBT) - to address common areas of cognitive weaknesses.

Social skills training methods - to address the problems that result socially from the inattentive symptoms of ADHD-PI.

The symptoms and treatment for Inattentive ADHD are different from the symptoms and treatment of the other subtypes of ADHD. People with Inattentive ADHD and parents of children with ADHD must assure that an appropriate diagnosis of ADHD is made in order that this subtype of ADHD be appropriately managed.

For more information on Primarily Inattentive ADHD please visit Tess Messer at http://www.primarilyinattentiveadd.com/2010/02/why-blog.html. There you will find information on ADHD symptoms, ADHD treatment, alternatives to medications, Information on ADHD vitamins and supplements and much more. Looking forward to meeting you there!!

Children With Fetal Alcohol Spectrum Disorders (FASD) Have More Severe Behavioral Problems Than Children With Attention Deficit Hyperactivity Disorder (ADHD), Study Finds

First direct evidence that ADHD is a genetic disorder: Children with ADHD more likely to have missing or duplicated segments of DNA

ScienceDaily (Sep. 30, 2010) ? New research provides the first direct evidence that attention-deficit/hyperactivity disorder (ADHD) is a genetic condition. Scientists at Cardiff University found that children with ADHD were more likely to have small segments of their DNA duplicated or missing than other children.

The study also found significant overlap between these segments, known as copy number variants (CNVs), and genetic variants implicated in autism and schizophrenia, proving strong evidence that ADHD is a neurodevelopmental disorder -- in other words, that the brains of children with the disorder differ from those of other children.

The research, published in the journal The Lancet, was largely funded by the Wellcome Trust, with additional support from Action Medical Research, the Medical Research Council and the European Union.

"We hope that these findings will help overcome the stigma associated with ADHD," says Professor Anita Thapar. "Too often, people dismiss ADHD as being down to bad parenting or poor diet. As a clinician, it was clear to me that this was unlikely to be the case. Now we can say with confidence that ADHD is a genetic disease and that the brains of children with this condition develop differently to those of other children."

ADHD is one of the most common mental health disorders in childhood, affecting around one in 50 children in the UK. Children with ADHD are excessively restless, impulsive and distractible, and experience difficulties at home and in school. Although no cure exists for the condition, symptoms can be reduced by a combination of medication and behavioural therapy.

The condition is highly heritable -- children with ADHD are statistically more likely to also have a parent with the condition and a child with an identical twin with ADHD has a three in four chance of also having the condition. Even so, until now there has been no direct evidence that the condition is genetic and there has been much controversy surrounding its causes, which some people have put down to poor parenting skills or a sugar-rich diet.

The team at Cardiff University analysed the genomes of 366 children, all of whom had been given a clinical diagnosis of ADHD, against over 1,000 control samples in search of variations in their genetic make-up that were more common in children with the condition.

"Children with ADHD have a significantly higher rate of missing or duplicated DNA segments compared to other children and we have seen a clear genetic link between these segments and other brain disorders," explains Dr Nigel Williams. "These findings give us tantalising clues to the changes that can lead to ADHD."

The researchers found that rare CNVs were almost twice as common in children with ADHD compared to the control sample -- and even higher for children with learning difficulties. CNVs are particularly common in disorders of the brain.

There was also significant overlap between CNVs identified in children with ADHD and regions of the genome which are known to influence susceptibility to autism and schizophrenia. Whilst these disorders are currently thought to be entirely separate, there is some overlap between ADHD and autism in terms of symptoms and learning difficulties. This new research suggests there may be a shared biological basis to the two conditions.

The most significant overlap was found at a particular region on chromosome 16 which has been previously implicated in schizophrenia and other major psychiatric disorders and spans a number of genes including one known to play a role in the development of the brain .

"ADHD is not caused by a single genetic change, but is likely caused by a number of genetic changes, including CNVs, interacting with a child's environment," explains Dr Kate Langley. "Screening children for the CNVs that we have identified will not help diagnose their condition. We already have very rigorous clinical assessments to do just that."

Dr John Williams, Head of Neuroscience and Mental Health at the Wellcome Trust, which has supported Professor Thapar's work for ten years, says: "These findings are testament to the perseverance of Professor Thapar and colleagues to prove the often unfashionable theory that ADHD is a brain disorder with genetic links. Using leading-edge technology, they have begun to shed light on the causes of what is a complex and often distressing disorder for both the children and their families."

Editor's Note: This article is not intended to provide medical advice, diagnosis or treatment.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Wellcome Trust, via EurekAlert!, a service of AAAS.

Journal Reference:

Nigel M Williams, Irina Zaharieva, Andrew Martin, Kate Langley, Kiran Mantripragada, Ragnheidur Fossdal, Hreinn Stefansson, Kari Stefansson, Pall Magnusson, Olafur O Gudmundsson, Omar Gustafsson, Peter Holmans, Michael J Owen, Michael O'Donovan, Anita Thapar. Rare chromosomal deletions and duplications in attention-deficit hyperactivity disorder: a genome-wide analysis. Lancet, 2010; DOI: 10.1016/S0140-6736(10)61109-9

Note: If no author is given, the source is cited instead.

View the original article here