Definition

Attention deficit hyperactivity disorder (ADHD) is a disorder that affects behavior. It can cause hyperactive, impulsive behavior, and/or make it difficult to pay attention. These behavioral problems continue over a long period of time. ADHD affects children, adolescents, and adults.

There are three types of ADHD:

• Inattentive (classic “ADD”)
• Hyperactive-impulsive
• Combined—the most common type

Causes

The cause of ADHD is unknown. It most likely is caused by a chemical imbalance in the brain. There also appears to be a genetic factor since ADHD can run in families.

Risk Factors

This condition is more common in first-born males.

Factors that increase your chance of developing ADHD include:

• Premature birth
• Having a parent or sibling (especially an identical twin) with ADHD
• Having a mother who smoked cigarettes and/or drank alcohol, had a urinary tract infection, or had preterm labor during pregnancy
• Having a parent with certain conditions such as alcoholism and conversion disorder
• Other possible risk factors include:
  • Head injury at a young age—less than two years old
  • Being born with a serious heart condition
  • Epilepsy —especially when diagnosed under age 2 years
  • Having Turner syndrome
  • Being exposed to certain pesticides
  • Spending over two hours a day watching TV or playing video games when young

Symptoms

All children display some of the symptoms of ADHD. Children with ADHD have symptoms that are more severe and consistent. They often have difficulty in school and with their family and peers.

ADHD can last into adulthood. It can cause problems with relationships, job performance, and job retention. Symptoms can vary according to the type of ADHD:

• Inattentive (classic “ADD”)
  • Easily distracted by sights and sounds
  • Doesn’t pay attention to detail
  • Doesn’t seem to listen when spoken to
  • Makes careless mistakes
  • Doesn’t follow through on instructions or tasks
  • Avoids or dislikes activities that require longer periods of mental effort
  • Loses or forgets items necessary for tasks
  • Is forgetful in day-to-day activities
• Hyperactive-Impulsive
  • Is restless, fidgets, and squirms
  • Runs and climbs; not able to stay seated
  • Blurts out answers before hearing the entire question
  • Has difficulty playing quietly
  • Talks excessively
  • Interrupts others
  • Has difficulty waiting in line or waiting for a turn
• Combined ADHD—Combination of the symptoms above.

People with ADHD may also have:

• Depression
• Anxiety
• Seizures
• Conduct disorder —difficulty following social rules
• Oppositional defiant disorder —negative, angry, and defiant behaviors
• Learning and language disorders
• Physical conditions such as sleep apnea
• Substance abuse
• Trouble sleeping
• Cigarette use

Diagnosis

There is no standard test to diagnose ADHD. It is done by a trained health professional using information from the patient, family, caregivers, and teachers or other school professionals and patient observation.

During diagnosis, the following information may be gathered:

• Assessment of symptoms of ADHD in different settings—home, recreation/sports, and school
• Age at which symptoms started
• How much the behavior affects the child’s ability to function

Treatment

The goal is to improve the child’s ability to function. Doctors should work together with parents and school staff. Together, they can set realistic goals and evaluate the child’s response.

Treatments include:

Prevention

There are no guidelines for preventing ADHD because the cause is unknown. Proper treatment can prevent problems later in life.

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