Attention Deficit (Hyperactivity) Disorder (ADD/ADHD)
According to the Centers for Disease Control and Prevention (CDC), about 4.4 million children of all ages have been diagnosed with ADHD in the US. Half of them are taking medication for their condition.
Although diagnosing ADHD is not too difficult, understanding the cause of it is more problematic. According to the DSM IV (The American Psychiatric Association) the diagnosis is based on symptoms related to inattention, hyperactivity and impulsivity.
Attention Deficit Disorder is mostly genetics. It is definitely not a result of bad parenting, or laziness. Diet, toxicity, food allergies and watching too much TV have also been mentioned as causes for ADD/ADHD. However, genetics is still considered the most dominant cause. In a twin study, 90% of children with a full diagnosis of ADHD shared it with their twin.
From a neurobiological perspective, levels of dopamine and norepinephrine, both common neurotransmitters in the brain, have been found abnormal in individuals with ADHD.
Low levels of dopamine inhibit frontal lobe functions. This region of the brain is responsible for regulating attention, concentration as well as inhibition. Abnormalities in brain wave activity have also been measured using EEG technology.
Cognitive-behavioral therapy, learning strategies and social skills training have all proven effective in improving coping abilities – providing new forms of ADHD treatment options. Still, addressing the problem at its source requires more than that. Since at the root, the problem is neuro-cognitive, all versions of attention deficit, both with or without hyperactivity, require improvement in frontal lobe function, improvement of brain wave ratios and improvement in overall cognitive skills.
DSM IV Criteria for Diagnosis of ADD/ADHD
A diagnosis of ADD/ADHD depends on answering the criteria of either 1 or 2, as listed below:
1. Six or more of the following symptoms of inattention have persisted for at least six months to a degree that is maladaptive and inconsistent with developmental level:
- Often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities
- Often has difficulty sustaining attention in tasks or play activities
- Often does not seem to listen when spoken to directly
- Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions)
- Often has difficulty organizing tasks and activities
- Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as school work or homework)
- Often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools)
- Is often easily distracted by extraneous stimuli
- Is often forgetful in daily activities
2. Six or more of the following symptoms of hyperactivity/impulsivity have persisted for at least six months to a degree that is maladaptive and inconsistent with developmental level:
- Often fidgets with hands or feet or squirms in seat
- Often leaves seat in classroom or in other situations in which remaining seated is expected
- Often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness)
- Often has difficulty playing or engaging in leisure activities quietly
- Is often “on the go” or often acts as if “driven by a motor”
- Often talks excessively
- Often blurts out answers before questions have been completed
- Often has difficulty awaiting turn
- Often interrupts or intrudes on others (e.g. butts into conversations or games)
- Some hyperactive, impulsive or inattentive symptoms that caused impairment were present before 7 years of age
- Some impairment from the symptoms is present in two or more settings (e.g., difficulty functioning in the workplace, at school or at home)
- There must be clear evidence of clinically significant impairment in social, academic, or occupational functioning
- The symptoms do not occur exclusively during the course of a pervasive developmental disorder, schizophrenia, or other psychotic disorder, and are not better accounted for by another mental disorder (e.g., mood disorder, anxiety disorder, dissociative disorder, personality disorder.)