What is ADHD?

Summary

Dr. Erin Shane Felder Gonzalez, a psychologist at Seattle Children's Hospital, explains ADHD as a neurodevelopmental disorder affecting the brain. ADHD involves two main symptom clusters: inattentiveness and hyperactivity-impulsivity. Diagnosis requires symptoms to be more severe than typical development and consistent across multiple settings, such as home and school. ADHD is linked to differences in brain chemistry, particularly dopamine and norepinephrine, which affect motivation and focus. These differences contribute to challenges in completing tasks and maintaining attention, with some children hyper-focusing on activities they find particularly rewarding. A thorough evaluation is essential for proper diagnosis and treatment.

Takeaways

• 😀 ADHD is a neurodevelopmental disorder, meaning it's based in the brain and persists over time from a young age.
• 😀 There are two main clusters of ADHD symptoms: inattentive symptoms (e.g., getting distracted, disorganization) and hyperactive-impulsive symptoms (e.g., high energy, blurting out).
• 😀 A diagnosis of ADHD can be made if symptoms appear in one or both categories (inattentive or hyperactive-impulsive).
• 😀 ADHD is diagnosed when symptoms are significantly more pronounced than in most children of the same age and are consistent across different settings.
• 😀 Symptoms need to be present in multiple settings like at home, in the classroom, and in social situations for a diagnosis of ADHD.
• 😀 ADHD symptoms must cause a significant impairment in daily life, such as difficulty with schoolwork or social interactions.
• 😀 ADHD is a lifelong condition that begins in childhood but can remain present throughout adulthood, though symptoms may evolve over time.
• 😀 It's essential to rule out other potential causes for the symptoms, such as major life transitions, medical conditions, or other mental health issues.
• 😀 Individuals with ADHD show differences in brain function, especially in the regulation of dopamine and norepinephrine, neurotransmitters involved in focus, motivation, and reward.
• 😀 Delayed myelination in the frontal lobe of the brain affects executive functions like planning, organizing, and staying focused, leading to difficulties in these areas for children with ADHD.

Q & A

What is ADHD and what are its two main symptom clusters?

ADHD (Attention-Deficit/Hyperactivity Disorder) is a neurodevelopmental disorder with brain-based differences. It has two main symptom clusters: inattentive symptoms (e.g., distractibility, difficulty following instructions, disorganization) and hyperactive-impulsive symptoms (e.g., high energy, impulsiveness, blurting out).

How do symptoms of ADHD differ from typical childhood behavior?

While many children and adults may experience symptoms like distractibility or impulsiveness, ADHD symptoms are more intense, persistent, and widespread across multiple settings, such as home, school, and social environments.

What are the five criteria used to diagnose ADHD in children?

The five criteria for diagnosing ADHD are: 1) Symptoms are present to a higher degree than typical for their age; 2) Symptoms are consistent across different settings; 3) Symptoms cause significant difficulty in daily life; 4) Symptoms have been present consistently over time; 5) Other possible explanations for the symptoms (e.g., stress or other mental health conditions) have been ruled out.

What does it mean when ADHD is diagnosed as 'predominantly inattentive subtype' or 'predominantly hyperactive-impulsive subtype'?

If a child exhibits primarily inattentive symptoms, they are diagnosed with ADHD predominantly inattentive subtype. If hyperactive-impulsive symptoms are more prominent, they are diagnosed with ADHD predominantly hyperactive-impulsive subtype. The most common diagnosis is ADHD combined type, which includes both symptom clusters.

Why is it important to observe ADHD symptoms across multiple settings?

It is important to see symptoms across different settings, such as home, school, and social situations, because ADHD symptoms that only appear in one setting may suggest another cause, such as a classroom-specific issue, rather than ADHD.

What is the significance of the developmental aspect of ADHD?

ADHD is considered a developmental disorder, meaning its symptoms are present from a young age and often continue throughout life. Symptoms might not always be apparent early on, but the disorder's developmental nature means it persists over time, sometimes becoming more noticeable during specific life stages.

How do dopamine and norepinephrine play a role in ADHD?

Dopamine and norepinephrine are neurotransmitters that help brain cells communicate. In people with ADHD, these chemicals are not processed and regulated the same way, leading to difficulties with motivation, attention, and focus. This difference can cause children with ADHD to find routine tasks boring or hard to focus on.

Why might children with ADHD hyper-focus on certain activities like video games?

Children with ADHD can hyper-focus on activities they find particularly interesting, such as video games, because these activities provide a higher reward or dopamine reaction, which engages their motivation more strongly than mundane tasks.

How does the frontal lobe affect individuals with ADHD?

The frontal lobe, responsible for executive functions like planning, decision-making, and organization, develops more slowly in individuals with ADHD. There is a delay in myelination, the process that aids advanced neuron development, which affects their ability to organize, plan, and maintain attention.

What should parents do if they suspect their child has ADHD?

Parents should seek a thorough evaluation if they suspect their child has ADHD. A professional assessment will help determine whether ADHD is indeed the cause of their child's symptoms or if other factors are contributing, allowing for a targeted treatment plan.