Attention Deficit-Hyperactivity Disorder
The symptoms of ADHD include inattention, impulsiveness and hyperactivity that are inappropriate for a person’s age level.
Children who have ADHD are often:
Easily distracted by sights and sounds in their environment
Unable to concentrate for long periods of time
Restless and impulsive
Have a tendency to daydream
Are slow to complete tasks
Have difficulty with social skills
There are three types of ADHD. Some children with ADHD show symptoms of inattention and are not hyperactive or impulsive. Others only show symptoms of hyperactivity-impulsivity. Most, however, show symptoms of both inattention and hyperactivity-impulsivity.
Predominantly inattentive type
Predominantly hyperactive-impulsive type
Combined type
While the term ADHD is the technically correct term for either of the three types indicated above, in the past the term attention deficit disorder (ADD) was used, and still is by many. For the past ten years ADD and ADHD have been used synonymously in publications and in public policy.
The exact cause of ADHD isn’t known. Experts do know that there are changes in the neurology and brains of people with the condition. Some evidence suggests that drug or alcohol use and other conditions during pregnancy can increase the chances of ADD, but in most cases this is not easy to correlate. ADD is not caused by home or school situations or by poor parenting, though the behavioral difficulties can be worsened by lack of understanding and mismanagement by family members.
We test for ADD/ADHD
Psychological Services Long Island provides several reliable assessments to detect the nature and severity of childhood and adult ADD. It is usually only diagnosed after a child has shown some or all symptoms of ADD on a regular basis for more than six months.
The diagnosis of ADHD usually involves the gathering of information from several sources, including school, caregivers and parents. Psychologists can consider how a child’s behavior compares with that of other children the same age.
Adult ADD/ADHD
Five to Twelve percent of adults in the United States have ADD, also known as ADHD or attention-deficit/hyperactivity disorder. As you’ve probably discovered by now, ADD affects every aspect of your life: work, home, and even your social life. Adult Symptoms can include:
Quick temper
Problems with organization
Having a series of marriages
Changing jobs frequently
Lacking friends
Difficulties managing money
Low self-esteem
Underemployed (working below your ability)
Disliking traffic so much that you will drive out of your way to avoid it
Mood swings
Substance abuse
Scheduling too many activities
Excessive speeding tickets
Feelings of not living up to your potential
Chronically procrastinating
Impulsively taking risks
Difficulties finishing projects
Frequently losing items
It might surprise you to learn that ADD is not all negative. There are also positive aspects to having ADD, and it is likely that you have these traits as well. People with ADD can have:
An ability to multitask effectively
Excellent skills in crisis situations
A good sense of humor
Versatility
Creativity
The ability to let go of grudges
A talent for thinking “outside the box”
Constant themes of death
Sudden happiness (after intense sadness)
Verbalizing despair, intense grief, or depression
There is help!
Although there is no cure for ADHD, treatment can help control symptoms. There are several types of treatments available.
Medication
Stimulant medications have been used to successfully treat ADHD symptoms for many years. Stimulants are used to treat both moderate and severe ADHD in adults and children over age six. Stimulants used to treat ADHD include:
Adderall and Adderall XR
Concerta
yclert
Dexedrine, Dexedrine Spansules Capsules
Focalin
Metadate CD, Metadate ER
Methylin
Ritalin, Ritalin LA
Strattera
Several types of antidepressant medications can be used to treat ADHD. Antidepressant therapy for ADHD is sometimes used as the initial treatment in children or adults who also suffer from significant depression. Antidepressants, however, are generally not as effective as stimulants or the newer non-stimulant treatments at improving attention span and concentration. It also may take two to four weeks for the full benefits of antidepressants to appear. Antidepressant medications may increase the risk of suicidal thinking and behavior in children and adolescents with depression and other psychiatric disorders. Two other medications, Catapres and guanfacine, normally taken to treat high blood pressure, have been shown to be of some benefit for ADHD when used alone or in combination with stimulant drugs. The drugs can improve mental functioning as well as behavior in ADHD.
Learning behavior management
techniques are considered to be an essential part of any successful ADHD treatment program. Most experts agree that combining medication treatments with extended behavior management is the most effective way to manage ADHD in children and adolescents. A multi-modality approach to treatment of the disorder aimed at assisting the child medically, psychologically, educationally and behaviorally is often most effective. This requires the coordinated efforts of a team of health care professionals, educators and parents who work together to identify treatment goals, design and implement interventions, and evaluate the results of their efforts.
Ideally, treatment should also include consideration of the individual’s psychological adjustment targeting problems involving self-esteem, anxiety, and difficulties with family and peer interaction. Frequently family therapy is useful along with behavioral and cognitive interventions to improve behavior, attention span, and social skills. Educational interventions such as accommodations made within the regular education classroom, compensatory educational instruction, or placement in special education may be required depending upon the particular child’s needs.
Students with ADHD may have more difficulty with spelling. They may not pay attention to detail when writing or may be careless. This can cause spelling errors. Some students may have weaknesses in auditory or visual memory which can also contribute to problems with spelling. Teach a phonetic approach to word analysis. Although many words are not spelled as they sound, a good understanding of phonics can be a powerful aid to weak spellers.
Students with ADHD often have difficulty with fine-motor control. This can affect their handwriting. For some, written work becomes so laborious they avoid it. Writing assignments that may take other students a few minutes, may take the student with fine-motor problems hours to complete. Encourage the student to use a sharp pencil and have an eraser available. Teach appropriate posture and how to position the paper correctly. Experiment with pencil grip, special papers, etc. Allow student to use laminated handwriting cards, containing samples of properly formed letters.
Behavior modification principles involving systematic delivery of reinforcements and punishments work pretty well. Parents and teachers who are structured, consistent, provide close supervision and feedback about behavior to children and teens with ADHD get the best results. Instruction in such strategies can be obtained through parent training groups offered in school districts or community clinics or practices. The following suggestions apply to parents and teachers
Post house/school rules in a conspicuous place.
Clearly communicated rules are helpful in maintaining proper behavior. Children with ADHD may need such rules to be reviewed daily. When possible, consequences for rule violations should be specified.
Be alert to early warning signs of a problem.
Anticipate trouble brewing. Intervene quickly before a situation becomes problematic.
Provide concrete, visual examples of appropriate and
inappropriate behavior.
Use role-playing to illustrate these behaviors giving students clear guidelines as to teacher expectations.
Establish routines for regular family or classroom
activities.
(i.e. at home; cleaning room, doing homework, morning and bedtime tasks; at school; handing out and collecting papers in class, entering and leaving the room, taking attendance, answering questions, etc.)
Use proximity control to manage problem behavior.
Stay near the child who is acting out so you can provide immediate, frequent praise for appropriate behavior and quickly intervene when/if negative behavior occurs.
Redirect the acting out child to more appropriate behavior
when you notice inappropriate behavior.
(i.e., a student who is talking to another student could be redirected to get on task).
Praise positive behavior often.
Positive reinforcement is an effective way to motivate children to behave appropriately. Use of verbal praise can be extremely effective.
Six Principles for Parents of ADHD Children and Teens
Provide unconditional love and positive regard.
Spend enjoyable time with your child. Become an AD/HD expert
Model good values.
Provide structure at home with clear and consistent rules
Monitor compliance with rules and check behavior regularly
Inspire confidence as a parent-coach.
