Attention deficit hyperactivity disorder (ADHD) is present in about 9% of children in the United States. Symptoms suggestive of ADHD include difficulties with inattention or hyperactivity/impulsivity or both.
Signs of inattention include but are not limited to:
- careless mistakes in work
- poor attention to detail
- difficulty sustaining attention
- easy distractibility
- poor task completion
- poor organization of thoughts, activities and belongings
- being forgetful especially of routines
- losing belongings
Signs of hyperactivity/impulsivity include but are not limited to:
- being fidgety
- difficulty sitting still
- difficulty playing calmly or entertaining oneself
- blurting things out
- excessive talking
- difficulty waiting one's turn
- acting without thinking which can cause safety issues
People with ADD or ADHD have often been described as "lazy" and "unmotivated" when the fact of the matter is that they have tremendous difficulty sustaining attention. This impacts them at home, at school, at work and affects their relationships with others. It is not uncommon for people with ADHD to miss social cues or to not know exactly what is going on in the conversation. This can certainly cause some anxiety and distress. What is most frustrating to parents, family, friends, teachers and spouses is that people with ADHD have good days and bad days. We like to say that people with ADD/ADHD are consistently inconsistent. You never know from one moment to the next how they will do. Sometimes, those close to people with ADHD feel that their forgetfulness and disorganization reflects a lack of caring about the other person. It can feel deliberate and obstinate. If you can imagine a radio, someone with ADD/ADHD is in constant scan mode and they have difficulty tuning in to a particular station. Once they finally do tune into a station, it requires significant mental effort to stay tuned in. They often have an amazing ability to focus on things that interest them which makes many feel that the lack of attention in other areas is more of a character defect. The reality is that school can be tedious and dull and people with ADHD have a lot of trouble sustaining attention when things are dull.
Studies have shown that people with ADD/ADHD have decreased activity in certain parts of their brains. When they are interested, it is almost as though they get a burst of neurochemical activity, which helps them focus.
Contrary to popular belief, a person can have ADD without being hyperactive. These people are the classic daydreamers and underachievers. These children often get missed in school, as they usually have no behavior problems. Most people with ADD/ADHD have symptoms by the time they start school. However, it is not always picked up right away. Some children only need a miniscule amount of attention to learn. There comes a time when the little bit of attention they are able to muster is just not enough and they start struggling more academically. This could be in 3rd grade, middle school, high school or even college.
It is important to recognize that 70% of people with ADD/ADHD have other difficulties as well, which can include learning disabilities, tics, mood disorders and substance abuse. These need to be screened for.
Not all inattention is ADD or ADHD. Other causes of ADHD can include sleep apnea, anxiety, post-traumatic stress and thyroid abnormalities.
There are many ways to help people who struggle with ADD/ADHD. These can include school interventions and modifications, behavior modification; different ways to set up the home to make it work better, parenting classes and even medication. People with ADD/ADHD do much better in a structured environment with clearly defined expectations. Usually, there is no one thing that is the key. It is the combination of different strategies that work best for an individual person. It is important to realize that no treatment can completely eliminate all of the symptoms of ADHD.