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Understanding Attention Deficit-Hyperactivity Disorder

Attention Deficit-Hyperactivity Disorder (ADHD) is a life long disorder, usually first diagnosed in childhood. Extremely disruptive children who are very hyperactive and impulsive are easy to identify. However, many children with the disorder are not disruptive or hyperactive. These children have an “Inattentive Type” of ADHD and their problems frequently are not recognized as symptoms of the disorder. Some symptoms observed in children with ADHD include:

• Forgetfulness and losing important items
• Problems prioritizing and managing time
• Difficulties sustaining attention and focus
• Being easily distracted
• Difficulties organizing, prioritizing, and completing tasks
• Problems with motivation, sustaining effort, and “getting started”
• Excessive activity, fidgetiness, hyperactivity, and impulsivity
• Interrupting, intruding on others, and excessive talking

Confusion surrounds ADHD because behaviors observed in children with the disorder occur in all children to some degree. The key difference is that children with ADHD experience these problems more severely and in a variety of settings. A child with the disorder, despite being highly intelligent, may underachieve in school and experience frustration and depression as a result. Misunderstanding also occurs because the symptoms are chronic but not constant. A child with the disorder may be chronically unable to sustain focus at school or when doing homework, but may easily focus for hours playing video games or some other intrinsically enjoyable activity. Children with ADHD have difficulties sustaining attention and effort in tasks that are not naturally interesting or stimulating to them. These children are not simply lazy or apathetic; the problem is a deficiency in certain brain processes.

Neuropsychological evaluation of ADHD involves a comprehensive approach in which behaviors, emotions, personality, and brain functions are assessed. The clinician distinguishes ADHD problems from other developmental, emotional, behavioral, or learning disorders. In fact, about 50% of children diagnosed with ADHD have another behavioral, emotional or learning disorder. These co-occurring disorders are carefully considered and evaluated.

Individuals with Attention Deficit-Hyperactivity Disorder can lead happy, productive lives. The key to success is early identification, accurate diagnosis, and appropriate treatment. The diagnostic process should not only establish the diagnosis, but also identify specific processing deficits in the brain, assess other co-occurring disorders, and provide specific information and a solid basis for intervention strategies.

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Robert P Tepley, PhD, is a neuropsychologist affiliated with Norwalk Hospital. For more information, contact Neuropsychology Consultants at 203-855-9691.