ADHD
A chronic condition including attention difficulty, hyperactivity, and impulsiveness.
What is ADHD?
We often hear people talking about “attention deficit” or “ADD” or “hyper” when the issue of attention or focus comes up. ADHD is the official label we use for such issues. The acronym stands for Attention-Deficit/Hyperactivity Disorder and this disorder comes in a couple of variations. An individual might have ADHD that is characterized by inattention only, by hyperactivity and impulsivity only, or a combination of all of the above. All of these “flavors” of ADHD come in mild, moderate or severe form.
Different Categories
The different ways ADHD presents are probably best understood by thinking about two different categories. In the first category we have a set of behaviors that happen because the child or adult doesn’t respond to what’s happening around them. Perhaps they do respond but it’s a response that is milder or less frequent than the demands on them would require. In the second category we have issues that arise because of a behavior they do or a response they demonstrate to a stimulus. Basically, one set of behaviors arise from not doing something and another set of behaviors that arise from doing something.
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The first category – not doing something – is often referred to as “inattention.” This looks somewhat different from person to person and from setting to setting but there are some common characteristics that tie it all together. Individuals with inattention often “tune out” when “tuning in” is a requirement for the task or setting. They daydream in class or on the job. They are easily distracted. They don’t follow all the steps in directions or forget what they were just told. Individuals with inattention make careless mistakes in work and miss important details. They struggle to stay focused on lectures, or reading, or even conversations. They are described as forgetful and disorganized. These folks turn in late work or lose it altogether. They lose their keys, socks, backpack, phone, calendar, glasses, etc. They also lose track of time, often being late for appointments
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The second category – people who do things that trip themselves up – are often referred to as being “hyperactive” or “impulsive” or both. These two concepts really are difficulty to differentiate. These are the fidgeters, the wigglers, the blurters, the tappers, the squirmers, the interrupters, the wanderers, and the talkers. They are often described as constantly “on the go” or “driven by a motor.” Their behavior distracts them and others and is often a cause of interpersonal conflict because they can be seen as bothersome or annoying.
Characteristics
A lot of the symptoms above can come along with other disorders or issues making it important to talk to a professional to help sort out the differences. A diagnosis of ADHD requires that a certain number of characteristics be present before the age of 12, that the symptoms clearly impair the person in their pursuit of a job or education and that they can’t primarily be contributed to another disorder. The symptoms also have to occur in multiple settings, like home and work or school. A person with ADHD would not exhibit symptoms in only one setting, which would more likely be an environmental issue.
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It’s important that we don’t make ADHD synonymous with BAD. Individuals with ADHD have much less control over the symptoms they demonstrate than we think they do. Telling a person suffering from ADHD Inattentive Type to “focus” is about as helpful as telling someone to “get taller.” If ADHD has been well diagnosed, that is if we haven’t incorrectly identified some other problem as ADHD, we can assume that most of the symptoms they are demonstrating are biologically driven. The kids who have been identified as having ADHD Impulsive and Hyperactive are like cars that only have a gas pedal and no brake.
About half of people who have a diagnosis of ADHD have a co-occurring condition. The best way to determine if the issues at hand really are ADHD or something else that can masquerade as ADHD is through an evaluation. Many, many disorders have symptoms that overlap with ADHD but the cause, treatment and prognosis of the other conditions can vary greatly. In addition to the external characteristics of ADHD, there are common cognitive profiles found in students with ADHD that can only be identified through psychological testing.
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When we look at all of the negative or difficult things that come with ADHD, we lose sight of the positives that come with it as well. Children and adults with ADHD are often charismatic, charming, engaging and affectionate people. They can be quite creative, inventive, imaginative and talented with their hands. With proper treatment and in the right setting, they can use these gifts to excel and succeed in the school or work setting.
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ADHD is a condition that can impair a child’s performance in school. If the impairment is significant, the student might qualify for additional support in the school setting. In the state of Texas, ADHD is considered a “health” issue and as such might be the basis for a 504 accommodation plan or special education eligibility based on an “Other Health Impairment.” The degree to which the ADHD impacts learning and education determines the options for support or services in school.
Note:
ADHD is a very misunderstood disorder. It’s complicated and frankly, often messy. In the past it’s probably been overused as a way to categorize or understand a set of problematic behaviors that don’t cleanly fit into any other category. It’s gotten a bad rap and some people still think it’s being used as an excuse or a crutch.