ADHD

Definition

Attention-Deficit Hyperactivity Disorder (ADHD), as defined by the DSM IV-TR, is a persistent pattern of inattention and/or hyperactivity-impulsivity that is more frequently displayed and more severe than is typically observed in individuals at a comparable level of development. While there is often confusion surrounding the differences of ADHD and ADD, they are basically two subtypes that falls under the broad disorder of ADHD.

Three specific subtypes:

1)ADHD, Predominantly Inattentive Type – consists primarily of symptoms associated with inattention which have persisted at least 6 months and across settings (not ONLY in school, or ONLY in home). Inattentive symptoms include: difficulty sustaining attention in activities, difficulty remaining organized, forgetful in daily activities, easily distracted.

2)ADHD, Predominantly Hyperactive-Impulsive Type – consists primarily of symptoms associated with hyperactivity or impulsivity which have persisted at least 6 months and across settings. Includes: frequent fidgeting or squirming, excessive running or climbing in inappropriate situations, bluring out answers, frequent interruption.

3)ADHD, Combined Type – pretty much self-explanatory… the individual shows characterstics of each of the aforementioned subtypes.

So What If I Have ADHD?

According to the Centers for Disease Control and Prevention website (http://www.cdc.gov/ncbddd/adhd/data.html), 9.5% of children ages 4-17 were diagnosed with ADHD as of 2007. This number is even higher when looking specifically at boys within that age-range (13.2%). So what do we do?

From my own perspective and experience, there are many positive characteristics that are present in a student with ADHD: they may be better multi-taskers (especially later in life), they are often curious students who are eager to learn, they love hands-on activities. To a certain extent, there may not be a need for significant intervention; however, educators and parents should be more concerned when a child is unable to access the educational curriculum. More specifically, if you have a bright student who is becoming aware that they cannot focus enough to look at a book for more than 10 seconds, academic frustration and a negative view of reading/school are major risks. As a result, medications are often recommended. Medication allows an individual to basically have a baseline that allows them to remain more attentive to tasks, or reduce his/her energy level enough, to access that information which he/she could not access prior to medication. With this being said, medication in itself will not teach a student organizational skills or how to read; though it helps the student reach a readiness level in order to do so – intervention will still be necessary in most cases regardless of medication.

Common types of medication for the symptoms of ADHD.

Methylphenidates (like Concerta, Ritalin LA, Focalin XR, etc.): 
These are stimulants which block the reuptake (see Anxiety notes for explanation) of dopamine (neurotransmitter involved with reward-driven learning) and norepinephrine (hormone/neurotransmitter which affects the amygdala and other parts of the brain where attention, memory, and other abilities are controlled). The medication also stimulates the direct release of the neurotransmitters. ADHD is thought to be associated with decreased dopamine and norepinephrine, so stimulating these neurotransmitters is the approach with these drugs.

Amphetamines (Adderall, Vyvanse, Dextrostat, etc.):
Similar to the Methylphenidates, Amphetamines affect dopamine and norepinephrine int the brain; however, they affect these neurotransmitters differently. They focus on increasing the release of dopamine and norepinephrine from their storage sites into the synapses (gaps between cells in which electronic impulses pass to send signals back and forth)… so these first two medications impact the same things, but in different ways – which explains why one class might work more effectively with different individuals.

Atomoxetine (Strattera):
This is the most common type of non-stimulant medication for ADHD. It functions as a selective norepinephrine reuptake inhibitor (does not directly impact dopamine). One reason why many prefer Atomoxetine over the stimulants is because it has a low abuse potential.

There are more and more medications being released that treat the symptoms of ADHD (including drugs like Intuniv, which was reportedly used for treating high blood pressure, initially) and medical professionals will be able to provide more information about these.

There are definitely pros and cons to each type of medication – and you never 100% know how each one may affect you or your child. As previously mentioned, talking to your doctor or pediatrician will provide you much more information than this blog post. Also, medication never fixes an academic problem and magically teaches an individual to read; rather, medications such as these should be used in significant cases in order to help an individual reduce inattention or hyperactivity so that they are able to focus on appropriate intervention and instruction.

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