Attention deficit hyperactivity disorder (ADHD or AD/HD or ADD) is a developmental disorder.
It is primarily characterized by "the co-existence of attentional problems and hyperactivity, with each behavior occurring infrequently alone" and symptoms starting before seven years of age.
ADHD is the most commonly studied and diagnosed psychiatric disorder in children, affecting about 3 to 5 percent of children globally and diagnosed in about 2 to 16 percent of school aged children.
It is a chronic disorder with 30 to 50 percent of those individuals diagnosed in childhood continuing to have symptoms into adulthood. Adolescents and adults with ADHD tend to develop coping mechanisms to compensate for some or all of their impairments.
It is estimated that 4.7 percent of American adults live with ADHD.Standardized rating scales such as WHO's Adult ADHD Self-Report Scale can be used for ADHD screening and assessment of the disorder’s symptoms severity.
ADHD is diagnosed two to four times more frequently in boys than in girls, though studies suggest this discrepancy may be partially due to subjective bias of referring teachers.
ADHD management usually involves some combination of medications, behavior modifications, lifestyle changes, and counseling. Its symptoms can be difficult to differentiate from other disorders, increasing the likelihood that the diagnosis of ADHD will be missed.
Additionally, most clinicians have not received formal training in the assessment and treatment of ADHD, particularly in adult patients.
ADHD and its diagnosis and treatment have been considered controversial since the 1970s.The controversies have involved clinicians, teachers, policymakers, parents and the media. Topics include the actuality of the disorder, its causes, and the use of stimulant medications in its treatment.
Most healthcare providers accept that ADHD is a genuine disorder with debate in the scientific community centering mainly around how it is diagnosed and treated.
The American Medical Association concluded in 1998 that the diagnostic criteria for ADHD are based on extensive research and, if applied appropriately, lead to the diagnosis with high reliability.
ADHD may be seen as one or more continuous traits found normally throughout the general population.It is a developmental disorder in which certain traits such as impulse control lag in development. Using magnetic resonance imaging of the prefrontal cortex, this developmental lag has been estimated to range from 3 to 5 years.
A diagnosis of ADHD does not, however, imply a neurological disease. ADHD is classified as a disruptive behavior disorder along with oppositional defiant disorder, conduct disorder and antisocial disorder.
ADHD has three subtypes: Predominantly hyperactive-impulsive Most symptoms (six or more) are in the hyperactivity-impulsivity categories.
Fewer than six symptoms of inattention are present, although inattention may still be present to some degree. Predominantly inattentive The majority of symptoms (six or more) are in the inattention category and fewer than six symptoms of hyperactivity-impulsivity are present, although hyperactivity-impulsivity may still be present to some degree.
Children with this subtype are less likely to act out or have difficulties getting along with other children. They may sit quietly, but they are not paying attention to what they are doing.
Therefore, the child may be overlooked, and parents and teachers may not notice symptoms of ADHD. Combined hyperactive-impulsive and inattentive Six or more symptoms of inattention and six or more symptoms of hyperactivity-impulsivity are present.
Most children with ADHD have the combined type. Inattention, hyperactivity, and impulsivity are the key behaviors of ADHD.
The symptoms of ADHD are especially difficult to define because it is hard to draw the line at where normal levels of inattention, hyperactivity, and impulsivity end and clinically significant levels requiring intervention begin.
To be diagnosed with ADHD, symptoms must be observed in two different settings for six months or more and to a degree that is greater than other children of the same age.
The symptom categories of ADHD in children yield three potential classifications of ADHD—predominantly inattentive type, predominantly hyperactive-impulsive type, or combined type if criteria for both subtypes are met:
1. Be easily distracted, miss details, forget things, and frequently switch from one activity to another
2. Have difficulty maintaining focus on one task
3. Become bored with a task after only a few minutes, unless doing something enjoyable
4. Have difficulty focusing attention on organizing and completing a task or learning something new or trouble completing or turning in homework assignments, often losing things (e.g., pencils, toys, assignments) needed to complete tasks or activities
5. Not seem to listen when spoken to
6. Daydream, become easily confused, and move slowly
7. Have difficulty processing information as quickly and accurately as others Struggle to follow instructions.
1. Fidget and squirm in their seats
2. Talk nonstop
3. Dash around, touching or playing with anything and everything in sight
4. Have trouble sitting still during dinner, school, and story time
5. Be constantly in motion
6. Have difficulty doing quiet tasks or activities.
Be very impatient
Blurt out inappropriate comments, show their emotions without restraint, and act without regard for consequences
Have difficulty waiting for things they want or waiting their turns in games
Most people exhibit some of these behaviors, but not to the degree where such behaviors significantly interfere with a person's work, relationships, or studies—and in the absence of significant interference or impairment, a diagnosis of ADHD is normally not appropriate.
The core impairments are consistent even in different cultural contexts. Symptoms may persist into adulthood for up to half of children diagnosed with ADHD.
Estimating this is difficult as there are no official diagnostic criteria for ADHD in adults.
ADHD in adults remains a clinical diagnosis.
The signs and symptoms may differ from those during childhood and adolescence due to the adaptive processes and avoidance mechanisms learned during the process of socialisation.
A 2009 study found that children with ADHD move around a lot because it helps them stay alert enough to complete challenging tasks.
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