Attention Deficit Hyperactivity Disorder (ADHD)
Definition
Attention-deficit/hyperactivity disorder (ADHD) is a brain disorder marked by an ongoing pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development.
- Inattention means a person wanders off task, lacks persistence, has difficulty sustaining focus, and is disorganized; and these problems are not due to defiance or lack of comprehension.
- Hyperactivity means a person seems to move about constantly, including situations in which it is not appropriate, excessively fidgets, taps, or talks. In adults, it may be extreme restlessness or wearing others out with their activity.
- Impulsivity means a person makes hasty actions that occur in the moment without first thinking about them and that may have high potential for harm; or a desire for immediate rewards or inability to delay gratification. An impulsive person may be socially intrusive and excessively interrupt others or make important decisions without considering the long-term consequences.
Signs & Symptoms
Inattention and hyperactivity/impulsivity are the key behaviors of ADHD. Some people with ADHD only have problems with one of the behaviors, while others have both inattention and hyperactivity-impulsivity. Most children have the combined type of ADHD.
In preschool, the most common ADHD symptom is hyperactivity.
It is normal to have some inattention, unfocused motor activity and impulsivity, but for people with ADHD, these behaviors:
- are more severe
- occur more often
- interfere with or reduce the quality of how they functions socially, at school, or in a job
Treatment & Therapies
While there is no cure for ADHD, currently available treatments can help reduce symptoms and improve functioning. Treatments include medication, psychotherapy, education or training, or a combination of treatments.
Medication
For many people, ADHD medications reduce hyperactivity and impulsivity and improve their ability to focus, work, and learn. Medication also may improve physical coordination. Sometimes several different medications or dosages must be tried before finding the right one that works for a particular person. Anyone taking medications must be monitored closely and carefully by their prescribing doctor.
Psychotherapy
Adding psychotherapy to treat ADHD can help patients and their families to better cope with everyday problems.
Behavioral therapy is a type of psychotherapy that aims to help a person change his or her behavior. It might involve practical assistance, such as help organizing tasks or completing schoolwork, or working through emotionally difficult events.
Family and marital therapy can help family members and spouses find better ways to handle disruptive behaviors, to encourage behavior changes, and improve interactions with the patient.
Intensive ADHD Evaluation
1. Comprehensive Intake (1 hour)
- Detailed review of medical, psychiatric, developmental, and educational history.
- Exploration of current symptoms and their impact on daily functioning (e.g., work, relationships, academics).
- Review of family history for ADHD or other mental health conditions.
2. Behavioral & Symptom Assessments
- Administration of standardized ADHD rating scales (e.g., ASRS, Conners’ Adult ADHD Rating Scales).
- Collateral information from family members, teachers, or significant others via questionnaires or interviews if relevant.
3. Objective Testing
- Computer-based Qb Check to measure hyperactivity, attention and impulsivity.
4. Observational & Contextual Data
- Consideration of symptoms across different settings (e.g., work, school, home).
- Gathering evidence of ADHD-related challenges in multiple environments.
5. Screening for Comorbid Conditions
- Evaluation for co-occurring disorders such as anxiety, depression, learning disabilities, and autism spectrum disorders.
- Differential diagnosis to rule out conditions that might mimic ADHD symptoms.
6. Feedback Session
- Comprehensive review of findings and diagnostic impressions.
- Discussion of next steps, including treatment recommendations (e.g., medication, therapy, coaching).
7. Written Report
- A detailed report summarizing the evaluation process, findings, and recommendations.
8. Optional Follow-Up
- Review progress after implementing treatment or interventions.
- Adjustments to the management plan as needed.
This intensive approach ensures a thorough understanding of the client’s challenges, leading to tailored support and effective interventions.