Attention-Deficit/Hyperactivity Disorder (ADHD)

Attention Deficit/Hyperactivity Disorder (ADHD) is a disorder that is diagnosed based on behavioral presentation. Inattention, hyperactivity and impulsivity may have a variety of underlying causes that are neurodevelopmental. People with ADHD struggle to pay attention and to inhibit their impulses. They may struggle with emotion regulation and hyperactivity. ADHD has the following three sub-types: 1) inattentive type, 2) hyperactive/impulsive type, and 3) combined type. Individuals with ADHD might have challenges with schoolwork, with homework, or with interacting with others. It is considered the most common disorder of childhood. Behavior problems associated with the disorder present significant challenges to schools and parents. For example, not handing homework in, having incomplete work, and missing directions are common teacher and parents complaints of children with ADHD. These challenges continue into adulthood, with many adults with ADHD experiencing challenges with attention at work.

What are Attention-Deficit/Hyperactivity Disorder (ADHD)?

Children who have significant problems in this area may have any of the following potential disability. *Note, this does not serve as a diagnosis in any way. See Where to Go for Help With ADHD for professionals who can diagnose or provide a referral.

Attention-Deficit/Hyperactivity Disorder (ADHD) is a highly prevalent neurobehavioral disorder. It is marked by pervasive inattention, hyperactivity and impulsivity that often result in significant impairments in both school and social settings. Common symptoms in school-aged children include distractibility, variable attention, unable to complete tasks and assignments, chronic fidgeting and more. The current Diagnostic and Statistical Manual (DSM-5) reports a 5% population prevalence rate for children and identifies the following three subtypes of ADHD: predominantly inattentive type, and predominantly hyperactive/impulsive type and combined type. ADHD is more often diagnosed in males than in females; the ratio is approximately 2:1 in children. Although ADHD is traditionally thought of as a childhood disorder, challenges continue into adulthood for most people with the disorder.

Individuals with ADHD may be extremely bright or gifted (IQ scores that fall in the top 5% of individuals). Some people with ADHD may have exceptional fluid reasoning (solving new problems), visual spatial skills (seeing how objects fit together) or verbal knowledge.

What are the signs and symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD)?

At least one of the two areas of symptoms (inattention and/or hyperactivity/impulsivity) must be present and causing challenges in multiple environments (home, school, extracurriculars, etc.). If symptoms are present for inattention only, the individual is diagnosed with the Inattentive presentation. If symptoms are present for hyperactivity/impulsivity only, the individual is diagnosed with the Hyperactive/impulsive presentation. If both sets of symptoms are present, the individual is diagnosed with the Combined presentation.

Symptoms of Inattention: makes careless mistakes, difficulty sustaining attention, does not seem to listen to directions or follow instructions fully, loses focus easily/ distracted, disorganized, forgetful, loses important items, poor time management, avoids tasks that require a lot of focus and attention

Symptoms of Hyperactivity/impulsivity: fidgets, squirms, is often out of his seat, moves while in line, speaks out of turn, interrupts, running and climbing when not appropriate, appears to be sensory seeking

How is Attention-Deficit/Hyperactivity Disorder (ADHD) treated?

Although many interventions are available, only a few have been validated with enough research to be named as Tier 1 “Best Support” by the American Academy of Pediatrics. Those interventions include the following options: Medication, Behavior Therapy, Parent Management Training, Biofeedback, and Self-verbalization. A combination of these therapies has been known to help many children and adults with ADHD. For many children, intervention becomes the difference between success and failure in school.  Further, the ability or inability to stay on task and to hold back impulses is not unique to school; in fact, it often carries over to social settings. For many children, interventions help their self-esteem and socialization.

Research has shown the challenges inherent in significant attention problems. The largest scale study ever to be conducted (to date) by the National Institute of Mental Health (NIMH) investigated the impact of ADHD on children and families. The study involved over 600 students with attention problems in six sites across the country [10]. Findings were as follows:

  • “Two-thirds of these children had at least one other disorder such as depression, anxiety, or learning disabilities.
  • Medication alone was more effective than behavioral interventions alone.
  • Medication alone was almost as effective as the combined treatment of medication plus behavioral interventions.
  • Many students may be receiving medication doses that are too low for maximum improvement in school work and behavior.” [10]

The authors of this article have been involved in a meta-analysis of ADHD interventions.  This meta-analysis, a report on a group of studies, found that although many behavioral interventions for ADHD are effective, the individual studies themselves were typically not as systematically conducted (that is, involving pre and post testing, ‘dosage levels,’ and effect size) as were the medication studies. This difference may be the reason that it sometimes appears medication alone can be more effective than combined treatment. Most psychologists generally agree that combined behavioral and pharmaceutical intervention is best. However, the science has yet to yield these results due to the lack of availability of well-designed research studies. Taken together, it is important for parents to be aware that attention problems can have a significant impact on a child’s functioning and that the provision of accurate diagnosis, psychological and medical intervention with a psychiatrist and/or pediatrician can bring lasting positive change.

Although ADHD presents a myriad of challenges to children and families, interventions tend to be successful at treating many of the challenged associated with the disorder. Indeed, for many children, medication and organizational support allow them to be successful in school and beyond. That said, most people continue to have some impairments in adulthood. Early intervention can help individuals develop strategies and systems to manage their inattentive symptoms and to curb their impulsivity. Such supports allow for gainful employment and interpersonal success as an adult.

How can Clear Child Psychology help with Attention-Deficit/Hyperactivity Disorder (ADHD)?

If your child is struggling with this symptom to the point that it is getting in the way of his learning, relationships, or happiness, it’s time to seek professional help.

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Our Free Discovery Session is a 20-minute consultation where we can talk one-one-one about the concerns and questions you have about your child.

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We Help Determine Next Steps

Our Initial Consultation allows us to get a deeper understanding of your child’s needs and determine if an assessment is appropriate.

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Our Assessments allow us to determine your child’s specific strengths and challenges. We can use this information to develop a customized support plan which includes: referrals

We Connect you with the Right Professionals

Once we understand your child’s needs, we will help families get connected to the right specialists. No more guesswork, no more wasted time and resources.

We Provide Ongoing Coaching and Support

Our Coaching Packages allow us to continually support families as they continue their journeys. Parental coaching, clinical referrals and school advocacy are just a few examples of ways we help.

Helpful resources for Attention-Deficit/Hyperactivity Disorder (ADHD)

For Parents:

[1] Evidence-Based Child and Adolescent Psychosocial Intervention: 

[2] How does Behavior Therapy Work?

[3] Dawson and Guare (2009). Smart but scattered: The revolutionary “executive skills” approach to helping kids reach their potential. The Guilford Press, NY.

[4] Dawson and Guare (2010). Executive skills in children and adolescents: A practical guide to assessment and intervention, second edition. The Guilford Press, NY.

[5] Barkley, Russell A. (2013) Taking Charge of ADHD, Third Edition: The Complete, Authoritative Guide for Parents. 

[6] Zeigler Dendy, Chris A (2003). Teaching teens with ADD and ADHD. Woodbine house.

[7] Zeigler Dendy, Chris A. (2011). Teaching Teens With ADD, ADHD & Executive Function Deficits: A Quick Reference Guide for Teachers and Parents.

[8] Giler, Ph.D., Janet Z. Socially ADDept: A manual for parents of children with ADHD and / or Learning Disabilities (2000). 

[9] Giler, Ph.D., Janet Z. Socially ADDept: Teaching social skills to children with ADHD, LD, and Asperger’s. 

[10] Barkley, Russell A. (2013) Taking Charge of ADHD, Third Edition: The Complete, Authoritative Guide for Parents. 

[11] ADDItude Editors (n.d.) Focus the Attention of Distracted Children 

[12] Zeigler Dendy, Chris A (2003). Teaching teens with ADD and ADHD. Woodbine house.

[13] Zeigler Dendy, Chris A. (2011). Teaching Teens With ADD, ADHD & Executive Function Deficits: A Quick Reference Guide for Teachers and Parents

For Kids:

[14] Cook, Julia (2012). Personal Space Camp. National Center for Youth Issues. 

[15] Esham, Barbara (2015). Mrs. Gorski, I think I have the Wiggle Fidgets. (New edition) Adventures of Everyday Geniuses. Mainstream Connections. 

[16] Smith, Bryan & and Griffen, Lisa M. (2016). What were you thinking? A story about controlling your impulses. National Center for Youth Issues. 

[17] Cook, Julia & Hartman, Carrie (2006). My mouth is a volcano. 

[18] Stein, David Ezra (2011). Interrupting Chicken. 

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