Attention Deficit Hyperactivity Disorder

Definition of Attention Deficit Hyperactivity Disorder

Attention deficit hyperactivity disorder is one of the most common neurodevelopmental disorders of childhood. It is usually first diagnosed in childhood and often prevails into adulthood. The Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-V) (American Psychiatric Association, 2013), is a handbook that is used by professionals around the world to diagnose mental disorders.The DSM–V describes ADHD as a type of neurodevelopmental disorder, which means there is atypical growth and development of the brain or central nervous system resulting in their abnormal functioning. 

ADHD is defined by a pattern of behaviour involving inattention, disorganisation and/or hyperactivity-impulsivity. An individual can have symptoms in one or both categories of inattention and/or hyperactivity/impulsivity to receive the diagnosis of ADHD. The diagnosis is generally made by the age of 12 and ADHD can continue into adulthood. From time to time, most of children will have trouble sitting still, paying attention, or controlling their impulses – as part of normal development. Whilst most children gradually grow out of such behaviours, individuals with attention deficit hyperactivity disorder (ADHD) do not.

Types of ADHD

In the DSM-V (American Psychiatric Association, 2013), three presentation types of ADHD are identified:

• Predominantly inattentive type: the individual has trouble paying attention, poor concentration, ignoring distractions and getting organised. The individual can sit still and appear to be working as their symptoms are less obvious.
• Predominantly hyperactive/impulsive type: the individual has difficulty staying on task, constantly talking and fidgeting and never seems to slow down. The individual does not think through consequences before acting so may constantly be interrupting others and taking risks.
• Combined type: the individual exhibits both inattentive and hyperactive/ impulsive symptoms.

The associated symptoms interfere with or reduce the quality of social, academic or occupational functioning. A range of classroom behaviour management strategies are required to address these symptoms.

Causes of ADHD

There is no single cause for ADHD, rather a number of risk factors that contribute to its development. They include:

• Hereditary (i.e. a genetically transmitted disorder and inherited from birth via genes)
• Parental health (e.g. infections and diseases the mother might have had during pregnancy)
• Parental behaviours (e.g. smoking, drinking and drug taking during pregnancy)
• Exposure to high levels of environmental toxins (e.g. lead) in utero
• Around birth related factors such as low birth weight, prematurity and obstetric complications.
• After birth related factors such as exposure to infections, diseases, malnutrition, brain injury and a history of abuse and neglect.
• Temperamental traits may also predispose the individual to ADHD (e.g. reduced behavioural inhibition, negative emotionality and elevated novelty seeking)

Symptoms of ADHD

Individuals with ADHD may exhibit some, or all of following:

Inattention Symptoms:

• Fails to pay attention to details or makes careless mistakes in schoolwork.
• Difficulties with sustaining attention during tasks or play.
• Appears not to listen when spoken to directly.
• Does not follow through on instructions and moves from task to task without finishing anything.
• Difficulties with organising tasks and activities.
• Avoids, or dislikes doing tasks that require sustained mental effort or concentration.
• Often loses things needed for tasks or activities.
• Easily distracted.

For more help with attention span and ADHD see:

• Strategies for Improving Attention Span and Avoiding Distraction

Hyperactivity/impulsivity symptoms:

• Constantly restless, fidgets with hands or feet or squirms in seat.
• Leaves seat in classroom or in other situations in which remaining seated is expected.
• Runs about or climbs excessively in situations where it’s inappropriate.
• Has difficulty playing quietly.
• Is often ‘on the go’, acts as if ‘driven by a motor’.
• Talks excessively.
• Blurts out answers before questions have been completed (or before raising hand).
• Has difficulty waiting turn.
• Interrupts or intrudes on others.

For more help with Hyperactivity/impulsivity and ADHD see:

• Strategies to Manage Hyperactivity

Without adequate support, children with ADHD experience academic, social, self-esteem, personal organisation and emotional difficulties.

References

American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.).Arlington, VA: American Psychiatric Association.