Attention Deficit Disorder with Hyperactivity

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ADHD kid

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ADHD and Dyslexia

Attention Deficit Disorder with Hyperactivity (ADHD) is a prevalent neurobehavioral disorder predominantly identified during childhood but can continue into adolescence and adulthood. It's characterized by pervasive patterns of inattention, impulsivity, and hyperactivity.

Overview

ADHD stands out as one of the most common neurobehavioral disorders during childhood. In many cases, its symptoms persist through adolescence and can extend into adulthood. Despite its prevalence, the precise etiological factors remain unidentified.

Individuals diagnosed with ADHD frequently display a chronic degree of inattention, impulsive hyperactivity, or both. These symptoms often compromise daily functional activities and are more pronounced than what is typically anticipated for the individual's developmental stage. This can lead to challenges across various settings, such as at school or home, and may affect interpersonal relationships and performance in critical areas.

Epidemiology

The American Psychiatric Association's Diagnostic and Statistical Manual-IV, Text Revision (DSM-IV-TR) cites that ADHD affects approximately 3%-7% of children. However, community-based studies have occasionally projected higher rates. The disorder is diagnosed in boys approximately three times as frequently as in girls.

Classification

ADHD can be classified into three primary subtypes based on predominant symptoms:

• Predominantly Inattentive Type:
  • - Difficulty in organizing or completing tasks.
  • - Challenges in paying attention to details or sustaining attention in tasks or conversations.
  • - Tendency to be easily sidetracked and to forget routine activities.

• Predominantly Hyperactive-Impulsive Type:
  • - Excessive fidgeting or talking.
  • - Difficulty remaining seated.
  • - In younger children, constant movement can be observed.
  • - Impulsivity manifests as interrupting others, inappropriateness in speaking, or inability to wait for one's turn.

Combined Type:

• - This form of ADHD exhibits significant symptoms from both the inattentive and hyperactive-impulsive criteria.

Comorbidities

ADHD often co-exists with other mental health disorders, making diagnosis and treatment more complex. Recognizing and addressing these comorbidities is vital for a holistic therapeutic approach.

Diagnosis

DSM-IV-TR, used by mental health professionals, provides standardized criteria for ADHD diagnosis. This ensures consistency in diagnosis and treatment across different communities, helping to ascertain the public health implications of ADHD.

DSM-IV Criteria for ADHD

The DSM-IV-TR criteria, presented in a user-friendly manner below, is exclusively for professional use. They are:

Inattention:

• - Often neglects details or is careless.
• - Struggles to sustain attention.
• - Seems not to listen.
• - Often fails to complete tasks or follow instructions.
• - Difficulty in organizing tasks.
• - Avoids mentally demanding tasks.
• - Habitually misplaces items.
• - Easily sidetracked.
• - Regularly forgetful in daily tasks.

Hyperactivity:

• - Habitually fidgets.
• - Finds it hard to remain seated.
• - Runs or climbs inappropriately.
• - Struggles with quiet leisure activities.
• - Is constantly in motion.
• - Talks excessively.

Impulsivity:

• - Answers prematurely.
• - Cannot wait for their turn.
• - Interrupts or intrudes on conversations or games.

Other criteria include:

• Some impairing symptoms must be present before the age of 7.
• These symptoms must manifest in more than one setting.
• There should be substantial evidence of considerable impairment in social, academic, or occupational functioning.
• The manifestations must not be exclusive to certain disorders like Pervasive Developmental Disorder or Schizophrenia and should not be better explained by another mental disorder.

Treatment

Therapeutic interventions for ADHD may include a combination of medical and behavioral therapies. The chosen treatment plan should be individualized based on the patient's unique needs and symptomatology.

References

• American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC, American Psychiatric Association, 2000.

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