What Is ADHD/ADD?

The terms ADHD and attention deficit disorder (ADD) are frequently used interchangeably. You might even hear some healthcare providers use the term “ADD,” although it’s now outdated and not officially accepted. The official names for ADHD/ADD have changed over the years to reflect a better understanding and growing body of scientific knowledge about the disorder.

There are three major types of ADHD. They are:

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• ADHD, combined type: The combined type is the most commonly diagnosed form of ADHD. It involves inattentiveness, distractibility, and behaviors that are impulsive and hyperactive.

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• ADHD, impulsive/hyperactive type: This is the least commonly diagnosed form of ADHD. Children diagnosed with this type display impulsive and hyperactive behaviors, but not inattentiveness or distractibility.

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• ADHD, inattentive/distractible type: Children diagnosed with this type of ADHD display inattentiveness and distractibility, but not hyperactivity.

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When a clinician uses the term “ADD,” he or she is likely referring to the third type of ADHD.

The symptoms of ADHD can interfere with a child’s ability to succeed in school or an adult’s ability to take care of work responsibilities and family obligations. Although there is no cure for the disorder, there are effective treatment options available.

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Signs and Symptoms of ADHD/ADD

Every child is unique. The symptoms they display depend on the type of ADHD they have. In addition, ADHD can change over time, particularly as children grow into adults. For example, a child with predominantly hyperactive-impulsive ADHD may grow into an adult who has predominantly inattentive ADHD. Here’s a look at some of the possible presentations of inattentiveness and distractibility:

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• Makes careless mistakes or doesn’t pay attention to details

• Has trouble staying focused during lectures or activities

• Starts assignments or chores, but doesn’t finish them

• Appears to be daydreaming instead of listening during conversations

• Presents messy, disorganized work

• Has trouble with time management/frequently misses deadlines

• Frequently loses important things

• Neglects important tasks, like bringing home assignments or, for adults, paying bills

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Here’s a look at some of the possible indicators of hyperactivity and impulsiveness:

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• Frequently fidgets or squirms in one’s seat

• Gets out of seat at inappropriate times during class

• Runs, climbs, or plays in inappropriate places/times

• Could be described as being always on the go or “driven by a motor”

• Has trouble with quiet play

• Talks excessively

• Has trouble waiting for one’s turn in a conversation/blurts out answers before the question has been completely spoken

• Has trouble waiting in line

• Frequently interrupts others or intrudes on others’ activities without permission

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It can be tricky to identify the signs of ADHD in an adult, as they may be more subtle. Some adults with ADHD are workaholics who fidget a lot and talk excessively. Note that previously undiagnosed adults will generally have had ADHD since childhood. Adults might decide to get evaluated after a loved one or co-worker notices possible indicators of ADHD.

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Causes and Risk Factors of ADHD/ADD

It’s not known exactly what causes ADHD. Researchers currently believe that it may be due to a combination of factors, which might include genetics, exposure to neurotoxins like lead and pesticides, and problems with the development of the central nervous system.

Certain factors may increase the likelihood that a person will develop ADHD. These include being born prematurely, having a blood relative with ADHD, and being exposed to maternal drug use during pregnancy, such as smoking or alcohol.

There are a lot of myths about what causes or contributes to ADHD development. There is zero scientific evidence to suggest that playing video games, watching too much TV, or consuming too much sugar may contribute to it.

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Diagnosis of ADHD/ADD

There is no specific test that can diagnose ADHD. A medical professional may perform an exam to rule out other potential causes, such as thyroid disorders. This will likely be followed by extensive information gathering. Assessment tools such as the Conners Behavioral Rating Scale are often used to assess ADHD in children between 6 -18. The healthcare provider may also ask parents to distribute questionnaires to other individuals who know the child well, such as babysitters, teachers, and sports coaches. The parents and other family members can also expect to answer lots of questions about the child’s behavior.

In addition, the healthcare provider will compare the child’s symptoms to the diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). These diagnostic criteria consider how many symptoms the child has and how long they have been present. The diagnostic criteria also consider the age of the child.

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Treatment for ADHD/ADD

Every child is a little different. It may take a while—and require trial and error—before the family and healthcare provider identifies the correct treatment for any given child. The clinically accepted treatments for ADHD include behavioral therapy, parent training, and medications. In addition, children may require classroom modifications that support their academic success.

For children with ADHD, the goal of behavioral therapy is to positively reinforce desired behaviors and discourage problematic behaviors. Children may work one-on-one with a behavioral therapist. Parents can also undergo a training program with a behavioral therapist designed to teach them how to implement effective strategies in the home. In addition, a behavioral therapist can work with the child’s teachers, as well as recommend classroom modifications. It’s important that these behavioral modification techniques are implemented consistently across the home, classroom, and other environments frequented by the child. Some tips for parents include the following:

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• Have the child follow the same routine every day.

• Eliminate distractions when the child needs to focus on homework.

• Help the child develop an organizational system and ensure they stick to it.

• Provide clear, brief instructions.

• Limit the choices offered to the child to prevent feelings of being overwhelmed or overstimulated. For instance, ask the child to choose between just two meals or two activities.

• Nurture the child’s positive self-esteem by encouraging participation in favorite activities, like art, sports, or music.

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Some children with ADHD benefit from medication. The most commonly prescribed ADHD medications are stimulants, which are thought to work by boosting neurotransmitters in the brain. There are both short-acting and long-acting stimulant drugs available. However, stimulant drugs may not be appropriate for children at risk of heart problems or psychotic symptoms.

Other medications include non-stimulants and antidepressants. These may take longer to take effect compared to stimulants. However, there is a concern that antidepressants may lead to suicidal thoughts when taken by a child or adolescent. Parents should closely monitor their children’s response to medications and contact the doctor right away if there are any concerns.

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When to Seek Help for ADHD/ADD

Many parents resist seeking help for a child suspected of having ADHD. This may be because they worry about their young child being placed on medications, or they aren’t sure if it’s really ADHD or just normal childhood behavior. However, it’s important to note that medications aren’t always the first line of treatment for ADHD. In fact, the American Academy of Pediatrics recommends behavior management and parent training before medications are tried in children younger than six. Furthermore, if a child really does need medications for ADHD, those medications may make the difference between success in school or continued struggles.

Occasional impulsiveness, distractibility, or hyperactivity probably is just normal childhood behavior. However, if these undesirable behaviors persist or begin to cause problems with the individual’s personal life, relationships, or responsibilities, then it may be time to seek help. Parents should also consider seeking help if a teacher has suggested that the child might have a behavioral or neurodevelopmental disorder.