Symptoms and Diagnosis of ADHD

As mentioned in an earlier blog, there are a number of symptoms associated with Attention Deficit Hyperactivity Disorder (ADHD). Depending on the severity and nature of the symptoms, they are categorized and presented in many variations; they often are described as one of the following:

1. Inattention;
2. Hyperactivity; and
3. Impulsivity 

Inattention is the inability of the child to pay attention, and can include moderate to relatively severe variations of the following, as adapted from the National Institute of Mental Health (1):

·        Be easily distracted, miss details, forget things, and frequently switch from one activity to another

·        Have difficulty focusing on one thing

·        Become bored with a task after only a few minutes, unless they are doing something enjoyable

·        Have difficulty focusing attention on organizing and completing a task or learning something new

·        Have trouble completing or turning in homework assignments, often losing things (e.g., pencils, toys, assignments) needed to complete tasks or activities

·        Not seem to listen when spoken to

·        Daydream, become easily confused, and move slowly

·        Have difficulty processing information as quickly and accurately as others

·        Struggle to follow instructions.

Hyperactivity is described as over-activity during activities that generally require sublime tasks, and can include the following:

·        Fidget and squirm in their seats

·        Talk nonstop

·        Dash around, touching or playing with anything and everything in sight

·        Have trouble sitting still during dinner, school, and story time

·        Be constantly in motion

·        Have difficulty doing quiet tasks or activities.

Finally, impulsivity is described as a lack of patience, but can also include the following:

                                  ·        Blurting out inappropriate comments, showing their emotions without restraint, and acting without regard for consequences

·        Having difficulty waiting for things they want or waiting their turns in games

·        Dashing around, touching or playing with anything and everything in sight

Although the aforementioned behaviors may be observed in all children, the factor that separates children diagnosed with ADHD is the frequency and severity of the behaviors. There is no set test to determine whether or not a child has ADHD. To properly diagnose ADHD (2), a physician will typically ask the child’s parents, school and caregivers about the child’s behaviors.

In order to diagnose the child, the physician will determine whether the child’s behavior is significantly obtrusive relative to other children from a questionnaire (see image) usually adapted from the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM). Usually if the child expresses multiple behaviors from one of the symptoms of ADHD, they will be diagnosed with it.

Ultimately it is the physician’s best judgment to determine whether or not the child has ADHD. Check back next week to learn about the prognosis of ADHD, or how it progresses in the individual.

1) "Attention Deficit Hyperactivity Disorder." NIMH RSS. N.p., n.d. Web. 23 Sept. 2013.

2) "Diagnosing ADHD: Tests for Kids and Adults." WebMD. WebMD, n.d. Web. 23 Sept. 2013.

Physiology of ADHD

Physiology is defined as the study of the function or mechanism of how a biological system works. In order to understand the onset and proliferation of ADHD, we must understand how a normal patient’s brain functions, or the patient’s physiology, before we can understand the differences that occur within a patient diagnosed with ADHD.

In one study conducted in 2004 using an MRI scanner at Yale University (2), the brains of 27 children (11 girls and 16 boys) with ADHD and those of 46 children of equal age and sex proportion were scanned and analyzed at UCLA. Elizabeth Sowell, MD and Bradley Peterson, MD observed significant differences in the brain structure of children with ADHD versus those who had not been diagnosed. Children with ADHD were observed to have brains with reduced size in the anterior temporal lobes on both sides of their brain. In areas of the brain previously identified as being regions which control attention and impulsive control, such as the posterior temporal and inferior parietal cortices, children with ADHD were found to have relatively larger increases in volumes of grey matter as compared with those who were not diagnosed. The following images show the differences in sizes of anatomy in healthy individuals brains compared with those diagnosed with ADHD.

In another study conducted by Julie Schweitzer (3), brain scans were taken in six men diagnosed with ADHD and compared with the control, which consisted of six healthy men of matched age and health characteristics. “What we’ve seen is that more areas of the brain are involved”, said Schweitzer (1), who used the latest brain technology (MRI) to reveal the brain’s inner workings. In the table shown, the relative anatomy sizes of the different regions of the men’s brains are compared.

Ultimately what the research conducted shows is that more activity is observed in brains of those with ADHD while completing tasks as compared with those who are healthy. This is thought to be caused by increased grey matter density in brains of patients diagnosed with ADHD, as well as reduced temporal lobe sizes. Check back next week for a more in depth discussion of the symptoms associated with ADHD. 

(1) "Establishing a Comprehensive ADHD Research and Treatment Program." UC Davis Health System Feature Story: Establishing a Comprehensive... N.p., n.d. Web. 16 Sept. 2013.

(2) Rosack, Jim. "Brain Scans Reveal Physiology of ADHD." Psychiatryonline.com. N.p., n.d. Web.

(3) Schweitzer, Julie, PhD. "Alterations in the Functional Anatomy of Working Memory in Adult Attention Deficit Hyperactivity Disorder." N.p., 1 Feb. 2000. Web.

Attention Deficit Hyperactivity Disorder (ADHD): An Introduction

Attention Deficit Hyperactivity Disorder (ADHD), also known as ADD, is the most commonly studied and diagnosed psychiatric disorder. It presents symptoms that begin most often in children between the ages of 6-12, but these symptoms can continue into adolescence and adulthood. Approximately 5-6% of children have ADHD(3). Some of these symptoms include difficulty staying focused, paying attention and controlling behavior, as well as hyperactivity (or over-activity).

There is no definitive cause for the development of ADHD (1), but researchers believe that there are certain factors that may induce the disorder, such as:

• genetics;
• environmental factors;
• brain injuries; and 
• consumption of sugar or food additives.
  
   As more and more research has been conducted on the mechanism of ADHD, researchers have developed treatment options including counseling, lifestyle changes and medications (2); these treatments are often applied simultaneously.

 Throughout the following weeks, we will take a more in depth approach to how ADHD affects the lives of those diagnosed and their families. Check back next week for a discussion on the difference in physiology of a patient diagnosed with ADHD versus an individual without a diagnosis.

1.) "ADD and ADHD Center: Symptoms, Types, Causes, Tests, and Treatments." WebMD. WebMD, n.d. Web. 02 Sept. 2013.
2.) "Attention Deficit Hyperactivity Disorder (ADHD)." NIMH RSS. N.p., n.d. Web. 02 Sept. 2013.
3.) Willcutt, Eric G. "The Prevalence of DSM-IV Attention-Deficit/Hyperactivity Disorder: A Meta-Analytic Review - Springer." The Prevalence of DSM-IV Attention-Deficit/Hyperactivity Disorder: A Meta-Analytic Review - Springer. N.p., 01 July 2012. Web. 02 Sept. 2013.
Image: http://img2.timeinc.net/health/images/gallery/condition-centers/causes-of-adhd-400x400.jpg