What Is ADHD?
This and other questions of a similar vein are often asked by exasperated parents of children with Attention Deficit Hyperactivity Disorder (ADHD) when they find their child doing something other than what was asked. Although parents, in general, may experience these issues, parents of a child diagnosed with ADHD may find themselves absolutely confounded when their smart, caring, and energetic child can’t fulfill even the seemingly simplest of requests on a frequent basis.
These requests may take the form of find your shoes and put them on, brush your teeth, place your homework in your backpack, make your bed, clean up this area…there are almost an infinite number of requests that can be imagined yet derailed by distraction and impulsivity. When this happens, parents may look toward the source, the neurobiology of the child, as the reason. An alternative solution takes into an account the conditions under which distraction and impulsivity occur, and look to change the environment (including parent responses!) to produce different results. Before heading into that direction, let’s discuss ADHD and symptoms.
The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5, 2013), published by the American Psychiatric Association, lists features and criteria for the diagnosis of ADHD.
ADHD is considered a neurodevelopmental disorder, meaning that the onset of the condition occurs during the developmental period.
The DSM-5 identifies ADHD as consisting of three types: Predominately Inattentive Presentation, Predominately Hyperactive/Impulsive Presentation, and Combined Presentation. Previous editions of the DSM identified the disorder as Attention Deficit Disorder or ADD. While this condition is no longer diagnosed, it is most similar to ADHD Predominately Inattentive Presentation.
Depending on the type, there may be inattentive, hyperactive/impulsive, or both types of symptoms present. Inattentive symptoms include difficulties with organization and attention that are not aligned with a person’s age or developmental level. These symptoms can include: low tolerance of repetitive/monotonous tasks, unintentionally losing important items, becoming easily sidetracked, excessive daydreaming, and difficulty following through with tasks. If you refer to the parent request situation above, you can begin to see how the symptoms manifest even in what are considered straightforward, daily life tasks.
In contrast to inattentive symptoms, hyperactive/impulsive symptoms include overactivity (excessive fidgetiness, squirminess) and challenges with delayed gratification (taking a smaller payoff now, such as receiving a gift of one dollar, instead of waiting for a larger payoff later, receiving five dollars two days from now). There can be social skills deficits as well, such as interrupting or intruding on others’ conversations. Other symptoms consist of trouble remaining seated, restlessness, difficulty remaining quiet while playing, excessive talking, trouble with waiting for one’s turn, and challenges with inhibiting either inappropriate comments or comments made at inappropriate times. As ADHD is a neurodevelopmental disorder, behavioral symptoms must manifest before the age of 12. ADHD symptoms can remain elevated into adulthood, particularly when untreated.
For our next installment, we’ll examine how evaluators diagnosis ADHD.
ADHD Series by Dr. Glenn Sloman
Continue reading using the links below:
- What Is ADHD? Part 1
- ADHD Symptoms Part 2
- Who is Diagnosed with ADHD? Part 3
- Executive Functioning Part 4
- Another Way of Looking at Impulsivity Part 5
- Promoting Success with ADHD Part 6
References
Attention-Deficit / Hyperactivity Disorder (ADHD). (2017, July 18). Retrieved October 02, 2017, from https://www.cdc.gov/ncbddd/adhd
Biederman, J. et al. (April 2010). Adult Psychiatric Outcomes of Girls with Attention Deficit Hyperactivity Disorder: 11-Year Follow-Up in a Longitudinal Case-Control Study. American Journal of Psychiatry 167(4):409-417.
Biederman, J. at al. (July 2012). Adult outcome of attention-deficit/hyperactivity disorder: a controlled 16-year follow-up study. Journal of Clinical Psychiatry 73(7):941-50.
CHADD – The National Resource on ADHD. (n.d.). General Prevalence of ADHD | CHADD. Retrieved October 02, 2017, from http://www.chadd.org/understanding-adhd/about-adhd
Diagnostic and statistical manual of mental disorders DSM-5. (2013). Arlington, VA: American Psychiatric Association.
Najdowski, A. C. (2017). Flexible and focused: Teaching executive functioning skills to individuals with autism and attention disorders. San Diego, CA: Academic Press.
Thapar A, Cooper M, Jefferies R, et al. What causes attention deficit hyperactivity disorder? Archives of Disease in Childhood 2012; 97:260-265.
The Understood Team. (n.d.). 3 Areas of Executive Function. Retrieved October 02, 2017, from https://www.understood.org/en/learning-attention-issues/child-learning-disabilities/executive-functioning-issues/3-areas-of-executive-function
About The Author
Glenn M. Sloman, Ph.D., BCBA-D, NSCP is a Licensed Psychologist in New Jersey and Pennsylvania and a Board Certified Behavior Analyst at the Doctoral level. Dr. Sloman is also a Nationally Certified School Psychologist and a Certified School Psychologist in New Jersey. He earned his undergraduate degrees with honors in Psychology and Anthropology at the University of Florida. Dr. Sloman attained his Master’s in Education and Ph.D. in School Psychology at the University of Florida where he specialized in Behavior Analysis. He previously served as a program coordinator for Douglass Developmental Disabilities Center Outreach Program and supervisor of home staff in programming for individuals with an Autism Spectrum Disorder (ASD). Dr. Sloman has worked in New Jersey school districts as a case manager and school psychologist on a child study team developing and implementing individualized education programs (IEPs) and behavior improvement plans (BIPs), providing individual and group psychotherapy, social skills training, and staff and parent consultation.
Dr. Sloman is skilled in conducting psychological and psychoeducational evaluations, and functional behavior assessments (FBAs). He has experience providing outpatient psychotherapy to children, adolescents, and adults from ethnically and economically diverse backgrounds, and providing parent support and training.
Dr. Sloman has extensive experience in the treatment of children through adults who present with symptoms of anxiety, depression, ADHD, ASD, learning disabilities, oppositional defiant disorder, obsessive compulsive disorder, mood disorders, and social skills deficits. He also has expertise assisting individuals transitioning from high school to college life.
Dr. Sloman’s professional interests include Acceptance and Commitment Therapy (ACT) and applying Behavior Analysis in treatment and consultation. Dr. Sloman’s goals for his clients are to increase their psychological flexibility in pursuit of doing what matters to them and creating meaningful behavior change. He is a member of the American Psychological Association, the New Jersey Psychological Association, and the Association for Contextual Behavioral Science.
