This post summarizes the podcast titled “Recognition & Diagnosis of ADHD” in the series “Training on ADHD in Children and Adults” by Pocket MD. Pocket MD is a podcast hosted by CHADD (Children and Adults with Attention-Deficit/Hyperactivity Disorder).
“Recognition & Diagnosis of ADHD” (PD4457-040121AR)
What is ADHD (Attention Deficit Hyperactivity Disorder)?
- ADHD: neurodevelopmental disorder characterized by difficulties in regards to attention, hyperactivity, impulsivity, or any combination of those
- Inattention: failure to listen, short attention span for tasks, poor attention to detail (may result in errors on academic and other tasks), forgetting/losing things, lower tolerance for tasks that require effort
- Hyperactivity: restlessness, fidgetiness, difficulty remaining seated (“driven by a motor”)
- Impulsivity: difficulty waiting, taking turns, interrupting, intruding on other activities (“impatient”)
- Impulsivity and hyperactivity highly correlated
- Lifespan: decrease of ~25% of overall prevalence in adolescence
- ~60% are still experiencing some impairment in adulthood (maturity = fewer symptoms)
- For many years it was believed that ADHD spontaneously disappeared around adolescence
- At risk for limited higher education, un/under-employment, problems with inter-personal relationships (professional and personal)
- More likely to have comorbidity with anxiety (1/2) and depression (1/3); result of accrued negative feedback and failure experiences through lifetime
- Higher rates of alcohol and drug abuse
- Shorter life expectancy
- Cause: primarily genetic, but environmental factors play a part
- How parents respond to the child can have positive or negative impact on behavior manifestations, but parents do not “cause” ADHD
- Criticisms, over-control, and negative feedback can have negative impact
- Parent behavior training programs help support parents with effective strategies to help children better manage behavior
Impact on students’ functioning
- Academically: difficulty concentrating and completing seat work and homework, pay less attention to teacher
- Lower scores on standardized tests (“not working to potential”)
- Receive more negative feedback and penalties from teachers
- Socially and emotionally: issues with attention, self-control (impulsivity and hyperactivity) can have negative impact on relationships with peers
- Those with primary issue of inattention tend to be too quiet and withdrawn, which also impact social relationships with friends
- “Sluggish cognitive tempo”: appears withdrawn, doesn’t respond immediately, takes time to process information, has difficulty relating to others
Diagnosing ADHD
- Issues with attention, hyperactivity, and impulsivity must be exhibited at rate/frequency higher than for other kids of same gender and age
- Difficulties have persisted for at least 6 months (not just a response to change in environment/stressor)
- Symptoms of impairments before or at age 12
- Behaviors must manifest at both home and in school (work for adults), resulting in some impairment as a result in both environments
- These problems are not better explained by other difficulties or disabilities (like sensory issues, anxiety, learning disability)
- “Diagnosis of quantity, rather than quality”
Extra Notes on Diagnosing ADHD
- Diagnosing ADHD (CDC): there is no single test to diagnose ADHD
- DSM-5 Criteria for ADHD:
- For children up to 16 years, must have 6 or more symptoms of inattention and/or hyperactivity-impulsivity
- For ages 17 and older, must have 5 or more symptoms of inattention and/or hyperactivity-impulsivity
- NIH National Library of Medicine: Table 7 DSM-IV to DSM-5 Attention-Deficit/Hyperactivity Disorder Comparison
Manifestations of ADHD
- ADHD manifests in different ways, and it can be difficult for parents to determine if their children’s behaviors are due to ADHD or “typical behavior” for their age
- Can be recognized as early as preschool
- Early Childhood: difficulty sitting still, does not comply when asked to do or stop doing something, intrusive with other children’s space or aggressive
- Childhood: behaviors that affect academic and social behavior, issues with self-control, attention, and organization
- Adolescence: procrastination, difficulty managing materials and tasks, sleep deprivation, social issues
- Smarter children may not be diagnosed until later because they do not have to be fully attentive in order to learn
- Positive support may allow children to function well for longer
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