What is ADHD?
Attention deficit-hyperactivity disorder (ADHD) is a neurobehavioral disorder that affects about three to five percent of American children and adults. ADHD is usually diagnosed in childhood, and the condition can continue into the adult years. Many individuals with ADHD are undiagnosed until adulthood.
The common characteristics of ADHD are impulsivity, inattention, and/or over-activity. Failure to listen to instructions, inability to organize oneself and work tasks, fidgeting with hands and feet, talking too much, inability to stay on task, leaving projects, chores and work tasks unfinished, and having trouble paying attention to and responding to details are the primary symptoms of ADHD. Although individuals may have inattention and hyperactivity symptoms, many individuals predominantly display one symptom more than another. There are three main variants of ADHD:
- ADHD predominantly hyperactive-impulsive type: The major characteristics are fidgeting, talking excessively, interrupting others when talking, and impatience.
- ADHD predominantly inattentive type: The major characteristics are distractibility, organization problems, failure to give close attention to details, difficulty processing information quickly and accurately, and difficulty following through with instructions.
- ADHD combined type: The individual with combined type meets the criteria for both hyperactive-impulsive and inattentive type.
Some Problems Encountered with ADHD
Time Management: Individuals with ADHD may experience difficulty managing time, which can affect their ability to mark time as it passes incrementally by minutes and hours. It can also affect their ability to gauge the proper amount of time to set aside for certain tasks. It may be difficult to prepare for, or to remember, work activities that occur later in the week, month, or year. Here are some ideas to reduce the impact of ADHD on time management:
- Divide large assignments into several small tasks
- Set a timer to make an alarm after assigning ample time to complete a task.
- Provide a checklist of assignments.
- Supply an electronic or handheld organizer, and train on how to use effectively.
- Use wall calendar to emphasize due dates– develop a color-coded system (each color represents a task, or event, or level of importance).
Memory: Individuals with ADHD may experience memory deficits, which can affect their ability to complete tasks, remember job duties, or recall daily actions or activities. Here are some ideas to help with short-term memory:
- Provide written instructions
- Allow additional training time for new tasks
- Use flow-chart to indicate steps in a task
- Provide verbal or pictorial cues
- Use post-it notes as reminders of important dates or tasks
Concentration: Individuals with ADHD may experience decreased concentration, which can be attributed to auditory distractions (that can be heard) and/or visual distractions (that can be seen). People with ADHD report distractions such as hallway traffic outside a classroom and student chatter, opening and closing of doors, and common noises such as ringtones and text alerts. Some ideas to improve concentration include:
- Relocate individual’s desk or workstation away from audible distractions
- Provide a “white noise” machine in work area or study area to reduce auditory distractions
- Reduce clutter which can become a visual distraction
Organization and Prioritization: Individuals with ADHD may have difficulty getting or staying organized, or have difficulty prioritizing tasks at work. Here are some ideas to help with organizational skills:
- Develop color-code system for files, projects, or activities
- Use weekly chart to identify daily work activities
- Assign new project only when previous project is complete, when possible
- Provide a “cheat sheet” of high-priority activities, projects, people, etc.
Ideally, assessment of ADHD involves a multidisciplinary team of professionals that capitalize on the strengths of medical and mental health professionals both in schools and in the larger community. Such a team can make important recommendations to the classroom teacher, school administrators, parents, and other key adults within the identified child’s educational circle about the formulation of academic and behavioral interventions that will better accommodate the student. Because ADHD is associated with relatively high rates of comorbidity (the simultaneous presence in the child with ADHD of other syndromes such as Conduct Disorder or Mood Disorder), particularly complex cases may require additional consultation with, or assessment by, a clinical psychologist who specialize in child psychopathology. Finally, parents may be encouraged to review the results of the ADHD evaluation with their family physician or a board certified child & adolescent psychiatrist to determine whether psychostimulant medication is indicated to improve attending and reduce hyperactive or impulsive behaviors. The physician should also play a central role in monitoring both beneficial and unintended effects of prescribed medications.