One of the first things we all associate with ADHD is hyperactivity—the kid you see running around like he’s wearing a jetpack with a frantic mother chasing him. While hyperactivity does occur in many children with ADHD, the fact that a person is very active does not necessarily warrant a diagnosis. The Diagnostic and Statistical Manual of the American Psychiatric Association contains three subtypes of ADHD, including Hyperactive, Inattentive, and Combined. ADHD is a constellation of symptoms and behaviors that cannot be explained by any other cause (such as anxiety, learning disability, or a thyroid disorder). Contrary to what many people assume, ADHD is not just having a short attention span. Many parents (or spouses in the case of adults) are confused by the fact that people with ADHD can happily spend two hours playing a video game, yet can not complete a short homework worksheet or remember to meet a deadline. ADHD is a neurological disorder that has a significant, pervasive impact on learning and behavior.
There are two major characteristics of children with ADHD that make life harder for them and the people who love them. One is a weakness with ‘Executive Functioning.’ Executive functioning is our ability to work efficiently, strategically, and to execute our plans mindfully. For example, writing and reading comprehension tend to be the downfall of many students with ADHD, because successful reading and writing depend on executive functioning. Another problematic symptom is difficulty with impulse control (also known as behavioral disinhibition). Individuals with ADHD find it harder to control their impulses, and may routinely violate rules, irritate other people, make careless mistakes, or complete tasks in a haphazard manner.
ADHD is known as a ‘diagnosis of exclusion,’ meaning that the psychologist or physician making the diagnosis must make sure that nothing else could be causing the symptoms. Doing a quick parent/client interview or a couple of symptom checklists is not adequate. Additionally, it is currently estimated that as many as 50% of individuals with ADHD also have specific learning disabilities. They are at higher risk for anxiety, depression, and self-destructive behaviors. Not only are individuals with ADHD at risk for underachievement at school and in their professional lives, they are far more likely than peers to have significant levels of anxiety, depression, or behavioral problems. Many benefit from treatments such as cognitive behavioral therapy and ‘coaching.’ Researcher Dr. Russell Barkley has described children with ADHD as being several years less emotionally mature than typical peers. This means that both parents and child are likely to need additional support to help the child make wise choices. Once you have an accurate diagnosis, your medical, psychological and educational team can be most effective in helping your child achieve his potential. A thorough psychological evaluation is the key to successfully taking control of ADHD symptoms.
Rachna Varia, PhD
Licensed Clinical Psychologist
Director, Testing and Diagnostics