Lesson 1: Common Childhood Disorders

Attention Deficit Hyperactivity Disorder

Attention deficit hyperactivity disorder (ADHD) is a condition characterized by an unusually short attention span, problems with impulsivity and/or hyperactivity, and heightened distractibility. Although many children experience these symptoms occasionally, a child suffering from ADHD experiences these symptoms much more frequently. Because of this, individuals with ADHD often have difficulty in school as well as with social interaction in general.

It is estimated that 4-6 percent of young people between the ages of 9 to 17 have ADHD.  In adults, approximately 2.5 percent of the population has ADHD.  Boys are two to three times more likely then girls to develop ADHD.  Some children with ADHD experience a reduction in symptoms later in life although others remain socially and educationally disadvantaged into adulthood.

Approximately 50% of ADHD cases can be explained by genetics.  However, other causes or contributing factors could include:

• exposure to toxins (such as lead)
• injuries to the brain
• delayed brain maturation

ADHD can be classified into three types based on an analysis of the two main groups of symptoms – inattention and impulsivity/hyperactivity. Please see Table 7.1 for a analysis of the two groups, and table 7.2 for descriptions of the three types of ADHD.  For  a diagnosis of ADHD to be made, there must be symptoms from each of the clusters below plus a duration of six months where the individual demonstrates maladaptive behaviours and trouble functioning at a level that is that is consistent with their level of development.

Table 7.1: Cluster Symptoms of ADHD

Inattention Symptoms

Impulsivity/Hyperactivity Symptoms

- failure to give close attention or many careless errors in work requiring sustained attention (such as school work) - difficulty sustaining attention in tasks or play - does not seem to listen when spoken to directly. - does not follow through on instructions - has difficulty organizing  tasks and activities - avoids tasks that require sustained attention (such as homework). - lose things needed for tasks and activities - easily distracted by the environment - forgetful in daily activities

Hyperactivity: - fidgets or squirms while seated. - leaves seat in classroom or when is supposed to be seated. - runs about or climbs excessively when not appropriate. - has difficulty in solitary play or quiet activities - is usually on the go, as if motor driven - often talks excessively Impulsivity: - blurts out comments or answers to questions before he/she should - has difficulty waiting for his/her turn - often interrupts or intrudes on others

Table 7.2: Types of ADHD

Types	Description
Primarily Inattentive Type (sometimes referred to as attention deficit disorder or ADD)	most common form of ADHD seen in schools - majority of symptoms fall into the inattentive group - daydreaming is common in children with this form of ADHD - children are not overly impulsive
Primarily Impulsive/ Hyperactive Type	least common form of ADHD - this form of ADHD is characterized by excessive movement and low impulse control - inattention is not usually a problem
Combined Type	- most common form of ADHD observed in clinics - includes symptoms from both groupings in table 7.1.

Video:  ADHD:  What is it and what's the Difference with ADD?

Symptoms of ADHD range from mild to severe, but for any diagnosis of ADHD to be made, the following questions must be answered positively (with a “yes”).

1. Did some of the problems begin before the age of seven and have the problems continued over time? 2. Do the symptoms and behaviours damage the child’s educational or social functioning? 3. Are the problems encountered affecting the child’s achievement in more than one setting (such as school and home)?

In addition to general educational and social problems, individuals with ADHD may experience difficulties and behaviour problems including, but not limited to the following:

- low self-esteem - depression - defiance of authority figures - negativism - anxiety - aggression - lying

The cause of ADHD has not yet been determined. What has been learned, however, is that boys are more likely to have ADHD than girls. Regarding treatment, behavioural modification in conjunction with medication is recommended. Treatment is usually long-term and requires parents, teachers, and health care professionals to work together with the child. For an example of ADHD, please review Case Study 22.

For further information on ADHD please refer to the web site below:

Teen Mental Health ADHD