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Types of ADHD
Understanding people with ADHD can be challenging. These short stories of a child, adolescent, and adult with ADHD may offer a glimpse into their worlds.
Children with ADHD can be a study in contrasts. Ben has trouble concentrating on schoolwork, but for soccer and video games, nothing breaks through.
ADHD often goes unrecognized in girls. Jasmine is well liked by her friends, but even though she is smart, teachers see her as 'ditsy' or a daydreamer.
Carmen's smarts and personality made it easy for her to get jobs. But as things became routine, details and deadlines started to slip, and she knew it was time to move on.
Ben's Story
No matter how hard Ben tried, it always seemed that the teacher's instructions went by too fast. At school and at home, completing homework assignments was a struggle, filled with distractions and frequent breaks to sharpen a pencil or just stare at a page.
On the flip side, if something interested Ben, his focus was intense. He knew all the words to commercials for his favorite toys, but not his math tables. He was great at being a goalie on the soccer team, but complained about playing forward. When it came to science projects, his creativity and effort were endless, yet report cards often read, 'needs more consistency.'
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Ben was exhibiting many of the classic symptoms of ADHD, a condition that according to the National Institutes of Health, is one of the most common neuro-behavioral disorders among children. Today, ADHD affects approximately 3 to 5 percent of the school-age population, with boys diagnosed three to four times more often than girls.
The symptoms of ADHD affect children in all aspects of their lives, not just academically. Without proper attention, a child with ADHD can feel alone, and have difficulty making and keeping friends, maintaining family relationships, and participating in activities outside of school. Left unmanaged, children with ADHD may have poor academic performance and can experience behavioral and emotional problems into adulthood.
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Because everyone shows signs of these behaviors at one time or another, the guidelines for determining whether a person has ADHD are very specific. Establishing a diagnosis of ADHD is complex and requires reports of characteristic behaviors from multiple sources, such as parents, physicians, and teachers. The diagnosis should also include input from the patient and a physician's physical examination.
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Learn more about the criteria for diagnosing ADHD.
Getting Help
Medical help may be needed if inattention or hyperactivity is causing significant problems at home, in school, and with relationships. Since the first step in getting help for ADHD is making a correct diagnosis, talk to your doctor if you have observed any of the behaviors described above. After the diagnosis is made, a number of different treatments, including medications and psychological counseling, can offer help.The Multimodal Treatment study of children with ADHD- 'MTA' for short-was sponsored by the National Institute of Mental Health.
The study brought together 18 nationally recognized authorities in ADHD at 6 different university medical centers and hospitals to evaluate the leading treatments for ADHD. The study, which is the largest-ever ADHD study, included nearly 600 elementary school children ages 7-9, and set out to measure results of various forms of behavior therapy and medication regimens. The patients were randomly assigned to receive one of four treatment modes over a 14-month period: (1) medication alone; (2) psychosocial/behavioral treatment alone; (3) a combination of both; or (4) routine medical care in the community. The MTA study demonstrates, for the first time, the safety and relative effectiveness of long-term medication and behavioral therapy combined.
Some of the Major Findings of This study
- A combination of medication and behavioral treatment showed greater efficacy than psychosocial/behavioral treatment alone.
- In terms of parent satisfaction, the combined approach, using both behavioral treatment and medication, was rated best.
- In terms of symptom management and overall efficacy, the routine medical care in the community was the least effective treatment regimen.
The children involved in the study will be tracked into adolescence, to document and evaluate their long-term health and treatment outcomes. Talk to your doctor about what option is best for your child.
Jasmine's Story
Jasmine has always been disorganized, from her bedroom and locker, to the handwriting she uses to take notes in school. In elementary school she was an honor student, but the pressures of middle school made her feel tired, and as a result, her grades suffered. As she grew into her early teens, arguing with her parents became a daily occurrence. Finally after her third car accident, Jasmine's parents scheduled an evaluation.
Although it is the most common neurobehavioral disorder in children, ADHD in adolescents has not been widely studied. Research shows that as many as 80 percent of children with ADHD exhibit persistent symptoms during adolescence, and 67 percent go on to display symptoms during adulthood. Left untreated, many teenagers with ADHD experience academic impairment, driving-related incidents, and are at risk of substance abuse, increased levels of antisocial activity, encounters with law-enforcement, and consequent negative impact within the family. As children with ADHD get older, the characteristics of the condition typically change. Some symptoms, including impulsivity, restlessness, excessive motor activity, inattention, and distractibility, may become less apparent. Hyperactivity levels may decline and attention span and impulse control may improve. Consequently, many adolescents who were first diagnosed with the combined type of ADHD no longer meet the criteria for that type. But impulsivity - and frequent behavioral outbursts - often remains a major problem for many teens, creating associated difficulties in school, work, family, and social relationships. Oppositional defiant or conduct disorders coexist in approximately 35 percent of children with ADHD. For girls and women, ADHD can be a hidden disorder, ignored or misdiagnosed by the educational and medical communities which may cause these girls and women to suffer in silence. (Learn more about ADHD in teenage girls at the National Center for Gender Issues and ADHD and National Women's Health Resource Center Web sites.)
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Getting Help
Growing older and becoming more independent can be an exciting adventure for teens. Especially for ADHD teens 16 and older, learning how to set goals and make good decisions will help give them the direction they need to stay on course. But it is important for the ADHD teen to learn that managing symptoms is a key part of developing life skills and handling everyday situations. A treatment plan often includes a balance of medication and behavioral therapy. When used as part of a comprehensive treatment plan, medication is one of the most effective tools to reduce ADHD symptoms. But not all medications are the same: doctors use different types of prescription medications, in combination with counseling to treat the different types of ADHD behaviors. Each treatment has a different way of helping to keep symptoms under control. Talk to your doctor if you have observed any of the behaviors described above. Working together with you and your teen, he or she can prescribe a customized treatment plan.
Carmen's Story
Carmen's humor, energy, optimistic outlook, and nonjudgmental personality draws admirers to her like a magnet. But following through on goals and commitments is another story. Over the years, she has learned that her 'live in the moment' philosophy has come at a high cost. Carmen's aptitude and job skills allow her to stay employed, but before advancement is possible, Carmen's impatience sabotages her. Her work-space is cluttered. Her sense of office politics is non-existent, making management positions out of the question. Just like jobs, men in Carmen's life seem to come and go. When things get serious, she deflects the subject with humor or changes the subject altogether.
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Attention Deficit Hyperactivity Disorder (ADHD) was once thought to affect only children. However, recent evidence suggests that ADHD often continues into adulthood. Estimates suggest that as many as 67 percent of children diagnosed with ADHD will continue to have symptoms of the disorder that significantly interfere with academic, vocational or social functioning in their adult lives. Growing up with undiagnosed ADHD may cause devastating effects in adulthood. Adults with ADHD often have negative perceptions of themselves as 'lazy,' 'stupid,' or even 'crazy.' Proper diagnosis and effective treatment can help improve self-esteem, work performance and skills, educational attainment and interpersonal relationships. For some, the recognition of ADHD and the understanding that follows an evaluation can be a source of healing, put difficulties in perspective, and offer a better understanding of the reasons for a variety of lifelong symptoms. For teenage girls and women, ADHD can be a hidden disorder, ignored or misdiagnosed by the educational and medical communities these girls and women to suffer in silence. (Learn more about ADHD in teenage girls at the National Center for Gender Issues and ADHD and National Women's Health Resource Center Web sites.)
Getting Help
ADHD in adults is sometimes viewed as a 'hidden disorder' because the symptoms of ADHD are often obscured by problems with relationships, organization, mood disorders, substance abuse, employment or other psychological difficulties. ADHD is first recognized in some adults because of problems with depression, anxiety, substance abuse or impulse control. Others recognize that they may have ADHD only after their child is diagnosed. Despite increased awareness and identification of the disorder in adults, many adults remain unidentified and untreated. Proper diagnosis and effective treatment can help adults with ADHD improve self-esteem, work performance and skills, educational attainment and social competencies. However, just as there is no single test to diagnose ADHD, no single treatment approach is right for everyone. A treatment plan should be tailored to the individual, and may include behavioral, social, academic, job-related, or relationship counseling. A physician may also recommend treatment with a medication.
Many adults with ADHD are offered protection under the Americans with Disabilities Act of l990, which prohibits discrimination in employment and public accommodations against any individual who has a physical or mental impairment that substantially limits one or more major life activities - including learning and working - or who has a record of such impairment.
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