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Atlanta Therapy | Atlanta Attention Deficit Hyperactivity Disorder | depression | counseling | Peachtree Psychological Associates | GA |

Peachtree Psychological Associates' Offices

2045 Peachtree Rd., Suite 150
Atlanta, GA 30309

404-352-4348

Attention Deficit Hyperactivity Disorder

 

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Attention-deficit hyperactivity disorder (ADHD) is a common neurobiological condition affecting 5-8 percent of school age children with symptoms lasting into adulthood in as many as 60 percent of cases (i.e. approximately 4% of adults).  It is characterized by developmentally inappropriate levels of inattention, impulsivity, and hyperactivity.

Although individuals with this disorder can be very successful in life, without appropriate diagnosis and treatment, ADHD may have serious consequences, including school failure, family stress and disruption, depression, problems with relationships, substance abuse, delinquency, risk for accidental injuries and job failure.

The Symptoms

Typically, ADHD symptoms arise in early childhood, unless they are the result of a later brain injury. There are 3 types of ADHD.  Individuals must exhibit a significant number of symptoms of one of the following types of ADHD.  Most children are diagnosed with ADHD, combined type and have difficulty paying attention, as well as hyperactive and impulsive behaviors.

ADHD predominantly inattentive type: (ADHD-I)

  • Fails to give close attention to details or makes careless mistakes.
  • Has difficulty sustaining attention.
  • Does not appear to listen.
  • Struggles to follow through on instructions.
  • Has difficulty with organization.
  • Avoids or dislikes tasks requiring sustained mental effort.
  • Loses things.
  • Is easily distracted.
  • Is forgetful in daily activities.

ADHD predominantly hyperactive-impulsive type: (ADHD-HI)

  • Fidgets with hands or feet or squirms in chair.
  • Has difficulty remaining seated.
  • Runs about or climbs excessively.
  • Difficulty engaging in activities quietly.
  • Acts as if driven by a motor.
  • Talks excessively.
  • Blurts out answers before questions have been completed.
  • Difficulty waiting or taking turns.
  • Interrupts or intrudes upon others.

ADHD combined type: (ADHD-C)

  • Individual meets both sets of inattention and hyperactive/impulsive criteria.

Youngsters with ADHD often experience delays in independent functioning and may therefore behave in ways more like younger children. In addition, ADHD frequently co-occurs with other conditions, such as depression, anxiety or learning disabilities. A study by NIMH in 1999 found that two- thirds of children with ADHD have a least one other co-existing condition. When co-existing conditions are present, academic and behavioral problems, as well as emotional issues, may be more complex.

Teens with ADHD present a special challenge. During these years, academic and organizational demands increase. In addition, these impulsive youngsters are facing typical adolescent issues: discovering their identity, establishing independence, dealing with peer pressure, exposure to illegal drugs, emerging sexuality, and the challenges of teen driving.

Recently, deficits in "executive functioning" have emerged as key factors impacting academic and career success. "Executive functioning" refers to the functions within the brain that activate, organize, integrate and manage other functions. These processes allow individuals to consider the longer-term consequences of their actions and guide their behavior across time more effectively.  Individuals with ADHD often have less well-developed executive functioning skills.

The Diagnosis

Determining if a child has ADHD is a multifaceted process. Many biological and psychological problems can contribute to symptoms similar to those exhibited by children with ADHD. For example, anxiety, depression and certain types of learning disabilities may cause similar symptoms. In some cases, these other conditions may actually be the primary diagnosis; in others, these conditions may co-exist with ADHD.

There is no single test to diagnose ADHD. Often, a comprehensive evaluation is necessary to establish a diagnosis,  rule out other causes,  and determine if co-existing conditions are present. Such an evaluation should include a careful history and a clinical assessment of the individual's academic, social, and emotional functioning and developmental level. A careful history should be taken from the parents and teachers, as well as the child, when appropriate. Checklists for rating ADHD symptoms and ruling out other disabilities are often used by clinicians; these age-normed instruments help to ensure that the symptoms are extreme for the child's developmental level.

There are several types of professionals who can diagnose ADHD, most often psychologists, neurologists, psychiatrists and pediatricians. A medical exam by a physician is important and should include a thorough physical examination, including assessment of hearing and vision, to rule out other medical problems that may be causing symptoms similar to ADHD. Only medical doctors can prescribe medication if it is needed. Diagnosing ADHD in an adult requires an evaluation of the history of childhood problems in behavior and academic domains, as well as examination of current symptoms and coping strategies.

The Causes

ADHD is clearly a brain-based disorder. Research clearly indicates that ADHD tends to run in families and that ADHD is the product of multiple interacting genes which may be inherited. Other causal factors (such as low birth weight, prenatal maternal smoking, and additional prenatal problems) may contribute to other cases of ADHD. Parenting styles may make ADHD better or worse, but these do not cause the disorder.

Long-term Outcomes

The excess motor activity of children with ADHD tends to decrease as they get older.  However, teens with ADHD are at risk for potentially serious problems in adolescence: academic underachievement and school failure, problems in social relations, risk for antisocial behavior patterns, teen pregnancy, and adverse driving consequences.   Up to two-thirds of children with ADHD continue to experience significant symptoms in adulthood. Yet many adults with ADHD learn coping strategies and compensate quite well. A key to good outcome is early identification and treatment.

Multimodal Treatment

ADHD in children often requires a comprehensive approach to treatment called "multimodal" which includes:

  • Parent and child education about diagnosis and treatment
  • Behavior management techniques
  • Medication
  • School programming and supports

Treatment should be tailored to the unique needs of each child and family. Research from the landmark NIMH Multimodal Treatment Study of ADHD found that children who received carefully monitored medication, alone or in combination with behavioral treatment, showed significant improvement in their behavior at home and school plus better relationships with their classmates and family than did children receiving lower quality care.

Psychostimulants are the most widely used class of medication for the management of ADHD related symptoms. Approximately 70 to 80 percent of children with ADHD respond positively to stimulant medications. Significant academic improvement is shown by students who take these medications: increases in attention and concentration, compliance and effort on tasks, as well as amount and accuracy of schoolwork, plus decreased activity levels, impulsivity, negative behaviors in social interactions and physical and verbal hostility. Other medications that may decrease impulsivity, hyperactivity and aggression include some antidepressants and antihypertensives. However, each family must weigh the pros and cons of taking medication .

Behavioral interventions are also a major component of treatment for children who have ADHD. Important strategies include being consistent and using positive reinforcement, and teaching problem-solving, communication, and self-advocacy skills.

School success may require a variety of classroom accommodations and behavioral interventions. Most children with ADHD can be taught in the regular classroom with minor adjustments to the environment. Some children may require special education services if an educational need is indicated. These services may be provided within the regular education classroom or may require a special placement outside of the regular classroom that meets the child's unique learning needs .  Accomodations and remedial services are usually specified via a 504 Plan or Individual Educational Plan within the public school system.

Additional helpful information about ADHD can be accessed at www.help4adhd.org.

 
 
 
Atlanta Therapy Peachtree Psychological Associates is a certified Therapy specializing in Attention Deficit Hyperactivity Disorder, depression, counseling, therapist, rehabilitation and much more in Atlanta, GA. We also do Grief or Bereavement, Stress, Depression, Anxiety & Panic Attacks, Couples Counseling, Child and Family Therapy, Adult Psychotherapy, Social Anxiety Disorder, Anger Management, Addictions, Eating Disorders, Self Esteem - Life Transitions, Obsessive-Compulsive Disorder (OCD), Post Traumatic Stress Disorder and all work related in the 30309 area and surrounding areas in Atlanta