"What is ADHD?"

Sometimes we struggle to sit still, pay attention or think before we act. Sometimes we make bad choices because we do not think about them ahead of time. But for some people, these problems happen most of the time. When a person cannot sit still, cannot pay attention for a very long time or cannot think ahead before making a decision, this causes problems in his or her every day life at home, at school, at work, with friends and with spouses or partners.

Attention Deficit Hyperactivity Disorder (ADHD)

There are three types of ADHD:

1. Inattentive (can't pay attention)
What does this look like? The person with ADHD...

• Makes careless mistakes
• Does not pay attention to details
• Has problems staying focused on something
• Forgets and loses things s/he needs
• Has difficulty organizing tasks
• Does not follow through
• Does not seem to be paying attention when someone is talking
• BUT, is able to pay attention to things that are very interesting to him/her

2. Hyperactive (has too much energy to handle)
What does this look like? The person with ADHD...

• Fidgets with hands or feet or squirms in a chair
• Gets up and moves around or gets up when s/he should not
• Runs around or climbs when s/he should not
• Cannot play quietly
• "On the go", like s/he is driven by a motor
• Talks a lot

3. Impulsive (acting without thinking)
What does this look like? The person with ADHD...

• Interrupts other people often
• Has a hard time waiting his/her turn
• "Blurts out answers" before the person is done asking the question
• Does not think about his/her actions, for example:

• Runs out into the street for a ball without looking both ways
• Knocks over a plant while running across a room
• Interrupts conversations throughout a party

Effects of ADHD

Because people with ADHD have problems paying attention, they might get in trouble more often.

• Parents sometimes get angry with their child who has ADHD because s/he doesn't do what s/he is supposed to, doesn't finish his/her chores (sometimes never starts them!), doesn't play fairly with siblings and can't seem to remember the household rules or what parents told him/her.
• Teachers sometimes think children with ADHD are "problems" or "troublemakers" because they don't follow instructions, don't turn in their homework, interrupt the classroom by talking to other students when they are not supposed to, or dont wait their turn.
• Adults with ADHD interrupt conversations, forget important events, don't pay attention to details that could help them gain a promotion at work or make their spouses feel loved.

Children and adults with ADHD often end up in trouble, are labeled "bad" or "stupid" and are picked on by others. These factors may make the child or adult think that s/he is a bad person. These ideas can lead to low self-esteem, discouragement, failure in school and loss of friends. If these feelings and situations continue, there is a future risk of not being able to relate to others and possible criminal behavior.

Causes of ADHD

A great deal of research has been done to learn more about ADHD. Even so, the causes of ADHD are still unknown. Most of the research suggests that the causes come from problems with brain development and from a genetic link (passed down from grandparents and parents). This means that ADHD tends to run in families. ADHD does not seem to be caused by food, sugar, bad parenting or television. A small percentage of ADHD cases are caused by lead exposure, complications during birth, thyroid disorder and brain damage.

Diagnosis (labeling) of ADHD

There is no single test to diagnose ADHD. Therefore, a thorough evaluation is necessary to establish a diagnosis, make sure the behaviors are not from other causes and find out if other problems exist. This kind of an evaluation takes time and effort. The clinician should gather information about how the person is doing in school, at work, with family and friends, and in controlling his/her emotions. The clinician should take a careful history, talking to the parents, teachers and the child, if possible. Checklists are used by clinicians for rating ADHD symptoms and deciding if other problems exist. The "Diagnostic and Statistical Manual IV" is used to establish an actual diagnosis. A medical exam by a physician is important to decide if other problems are causing symptoms that look like ADHD, such as vision problems, hearing problems or thyroid problems. If an adult suspects s/he has ADHD, the clnician needs to examine his/her childhood history as well as current symptoms.

Who can diagnose ADHD? School psychologists, private psychologists, social workers, nurse practitioners, psychiatrists and medical doctors.

Who can prescribe medication for ADHD? Only medical doctors.

Treatment of ADHD

Treating ADHD in children requires a "Multimodal Approach", including:

• Parent training in diagnosis, treatment and specific behavior management techniques
• School accommodations, when needed
• Individual and family counseling, when needed
• Medication, when required

Adults can benefit from ADHD coaching ( daily contact with a person that helps them stay on track and meet their personal daily goals), individual therapy and medication.

Prognosis of ADHD

Children with ADHD are "at-risk" for school failure and emotional difficulties. But with early identification and treatment, these children can succeed. Studies show that up to 70 percent of children with ADHD will continue to exhibit symptoms of ADHD into adulthood. Treatment can successfully continue, if adults need it. Long-term studies show that children who receive adequate treatment for ADHD have fewer problems with school, friends, and alcohol/drug abuse and show improvement in behavior compared to those who do not receive treatment.

The Health and Wellness Program for Deaf and Hard of Hearing People has clinicians who specialize in the diagnosis and treatment of ADHD in Deaf and Hard of Hearing children and adults. Please feel free to contact us for an evaluation at (651) 254-5708 or by sending an e-mail to: Jackie.S.Niemand@HealthPartners.com

Some of this information was compiled and adapted from CHADD, a national organization providing education to adults and parents with children who have ADHD.