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Attention Deficit Hyperactivity Disorder

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By Charmaine McIntosh

ADHD is a neurodevelopment disorder with inattention (unable to sustain focus), hyperactivity (excessive movements that does not fit the environment), and impulsivity (acting hastily in the moment without thinking) symptoms.  Many individuals who have ADHD also experience emotional dysregulation (difficulty controlling or regulating behaviour - i.e., overly emotional, easily angered). This disorder impacts many areas of a person’s life such as academics, home, social, and work settings.

According to the Centre for ADHD Awareness Canada, ADHD “is one of the most common neurodevelppmental disorders in Canada, affecting 4-6% of adults and 5-7% of children, or approximately 1.8 million Canadians.  In other words, 1 of every 21 people in the country has the disorder.”  There are three main categories of ADHD: (1) Hyperactive-Impulsive, (2) Inattentive, and (3) Combined.

The American Psychiatric Association uses the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to diagnose an individual with Attention-Deficit/Hyperactivity Disorder. They describe ADHD as follows:

ADHD Hyperactive-Impulsive Presentation

Hyperactivity pertains to excessive movement such as being fidgeting, talkative, excessive energy, and unable to sit still. Impulsivity pertains to acting or making decisions without thinking through the consequences. There needs to be six (or five for people age 17 years and older) of these symptoms occurring frequently for there to be a diagnosis of this type:

  • Fidgeting hands or feet or squirms in seat
  • Unable to stay seated (i.e., classroom, office)
  • Runs about excessively or climbs (children); extreme restlessness (adults)
  • Difficulty engaging in leisure activities quietly
  • Always “on the go,” acting as if driven by a motor
  • Talking too much/excessively (i.e., social situations)
  • Blurts out the answer before a question has been completely asked (i.e., finish people’s sentences, can’t wait to speak when in a conversation)
  • Difficulty waiting for/taking his or her turn
  • Interrupts when they are busy or intrudes on others (i.e., use people things without permission)

ADHD Inattentive Presentation

Inattentive pertains to problems focusing, remaining on task, and organization. There needs to be six (or five for people age 17 years and older) of these symptoms occurring frequently for there to be a diagnosis of this type:

  • Does not give close attention to details or makes careless mistakes 
  • Trouble staying focused on tasks or activities (i.e., conversations, lengthy reading, lectures)
  • Does not seem to be listening (i.e. difficulty focusing, mind appears to be elsewhere)
  • Struggle following through with instructions (i.e., does not complete chores, job tasks, schoolwork, start a task but then quickly lose focus)
  • Problems with organization (i.e., difficulty with time management, disorganized)
  • Avoids or dislikes tasks that require sustained mental effort (i.e., completing a form)
  • Often loses things (i.e., eyeglasses, cellular phone, keys) at home, school, or work.
  • Easily distracted
  • Forgetful in daily tasks or activities (i.e., chores, errands, appointments, pay bills)

ADHD Combined Presentation

This is diagnosed when the individual meets the criteria for both hyperactive-impulsive and inattentive type.

Causes of ADHD

There has been many research conducted; however, researchers the specific of ADHD has not yet been identified.   It has been discovered that there has been a strong genetic link (with several genes linked to the disorder) due to the fact that ADHD can run in families. Also, there has been non-genetic or environmental components connected to ADHD such as exposure to toxins (alcohol, smoking, lead) during pregnancy, low or premature birth weight, as well as severe stress during pregnancy.

Co-Existing Disorders

Many children with ADHD have another co-existing condition, and there appears to be some disorders that occur more commonly.  They include the following: anxiety and mood disorders, conduct and oppositional defiant disorders, obsessive compulsive disorders, tic disorders, substance use disorders, autism spectrum disorders, and learning disabilities.

Treatments

The treatment modalities for ADHD include medication, psychotherapy (for example,  cognitive-behavioural therapy, couples and family therapy, parent education, school interventions such as academic accommodations, skills training group, and neurofeedback training.


***If you are interested in an ADHD assessment, contact us at hello@peelcounselling.com or 416.258.8441.


References

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