Attention Deficit Hyperactivity Disorder?

It is normal for all children to be inattentive, hyperactive, or impulsive at times and we usually interpret these behaviours as that of a lively, intelligent child. However, when these behaviours are heightened and more frequent, they can lead to severe difficulties in school, at home and during activities. They can furthermore continue through adolescence and into adulthood. These symptoms describe Attention Deficit/Hyperactivity Disorder (ADHD).

Three main elements that define the behaviour of a person with ADHD are inattention, hyperactivity, and impulsivity. Specifically:

1.Inattention, including:

• difficulties completing a task
• being easily distracted
• switching from one activity to another because of lack of focus
• seeming not to listen when spoken to
• boredom with a task
• avoiding activities that require concentration
• losing or forgetting things
• loss of attention due to external stimuli
• struggling to follow instructions

2.Hyperactivity, including:

• fidgeting and squirming in their seats and an inability to sit for a long time
• dashing around and being constantly in motion
• difficulty performing tasks or activities quietly
• talking nonstop

3.Impulsivity, which may result in:

• being very impatient to wait their turn and interrupting conversations with inappropriate comments or other activities

ADHD has three subtypes: combined hyperactive-impulsive and inattentive,which includes symptoms of bothinattention and hyperactivity-impulsivity; predominantly hyperactive-impulsive, which has more hyperactivity-impulsivity symptoms; and predominantly inattentive, with more symptoms of inattention.

Positive symptoms

Individuals with ADHD may have a lot of problems because of symptoms such as often losing things and giving up on activities, being bullied or bullying at school, having frequent fights at home and being aggressive, impulsive or addicted to alcohol, etc., or even depressive. But there are also positive elements of ADHD, such as:

• ability to pay particular attention to details during school lessons
• increased creativity and ingenuity
• being adventurous and willing to take chances
• ability to process information and make extensive comments
• high levels of energy
• good negotiation skills
• intuition
• ability to hyper-focus

The diagnosis of ADHD is not very easy. First of all we are dealing with children, which means that we have to be sure that these symptoms are stable and conduct interviews with parents and teachers during evaluation. Furthermore, ADHD can coexist with many other problems or disorders such as learning disabilities (56%), behavioural problems (Conduct Disorder and Oppositional Defiant Disorder 43%), Anxiety Disorders (phobias, etc.), depression, OCD (Obsessive-Compulsive Disorder) and tics. It is necessary to take a detailed history that will also provide information about the conditions of birth and the situation in school, at home, and in other activities in order to exclude bullying or abuse as causes of symptoms.

ADHD has no specific known cause, so we can only hypothesize according to the results of studies.

Heredity seems to play role as 75% of cases have incidences in the same family, especially in parents. Other results have shown that environmental factors such complications at birth, like low birth weight, skull trauma or the mother’s use of benzodiazepines, alcohol or nicotine, as well as marital disharmony, can play a role.

Although the disorder is not fully curable, it can be controlled by various means including behavioural therapy, educating parents on proper ways of dealing with children, and good cooperation with the child’s teachers. Thus, it is extremely important to be able to recognize it early and start treatment as early as possible. We should mention that, although medication is often used as a treatment for the disorder in older children, most experts do not recommend drugs when it comes to preschoolers.

American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders (Revised 4th ed.). Washington, DC: Author.

Kaplan, H.I., & Sadock, B.J., Grebb, J.A (1994). In (eds): Kaplan & Sadock’s Synopsis of Psychiatry. 7^th ed. Baltimore, MD: Williams & Wilkins, pp 1016-1154.

Rutter, M. Taylor, E., Hersov, L. (1994). Child and Adolescent