Attention Deficit Hyperactivity Disorder (ADHD): Symptoms, Causes, Risks, Complications, Diagnosis and Treatment

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child with sign of Attention Deficit Hyperactivity Disorder

1Overview & Facts

Children are naturally and innately active. However, some of these kids have trouble with paying attention to a certain task. It’s just normal for people, young and old, to have a problem with sitting still, paying attention and controlling impulsive ideas or actions. When these actions happen often that they already interfere with daily activities, they could signal a neurodevelopmental condition called attention deficit hyperactivity disorder (ADHD).

Attention Deficit Hyperactivity Disorder (ADHD) is a mental disorder characterized by a persistent pattern of three major problems of inattention, hyperactivity, and impulsivity that can interfere with development and functioning.

What is inattention? Inattention is when a child wanders off task and could not concentrate. He or she may have a problem maintaining focus and may become disorganized. Hyperactivity, on the other hand, is when a person moves around continuously, even in inappropriate circumstances. He or she may constantly talk or fidgets around. Lastly, impulsivity happens when a person has abrupt actions without thinking first.

ADHD has become a worldwide problem. The US Census Bureau reports that there are an estimated 1,795,734,009 people aged 5 to 19 years old in the world in 2013. About 7.2 percent may have ADHD, based on the meta-analysis of 175 kinds of research across the globe. Hence, 7.2 percent of the estimated number is 129 million, a rough estimate of children who may have ADHD.

In the United States, the Centers for Disease Control and Prevention (CDC) reports that an estimated 11 percent of children aged 4 to 17 years old or roughly 6.4 million have ever been diagnosed with ADHD between 2011 and 2012.

2Symptoms

Attention deficit hyperactivity disorder has three group of symptoms:

Inattention

When a child or teenager has inattention, he or she wanders off tasks, procrastinate, and move from one uncompleted task to another. Other signs of inattention include:

  • Being disorganized
  • Difficulty paying attention
  • Lack focus
  • Tendency to make mistakes
  • Messy work or outputs
  • Wanders off tasks
  • Has a hard time to stay on one topic while talking
  • Doesn’t want to listen to others or follow social rules
  • Forgets activities such as missing appointments
  • Easily distracted
  • Losing things

Hyperactivity

The signs and symptoms of hyperactivity include:

  • Unable to sit still
  • Constantly fidgeting
  • Inability to concentrate on tasks
  • Excessive physical movements and talking
  • Run or climb even if it’s inappropriate
  • Having trouble staying quiet
  • Unable to wait their turn
  • Interrupting conversations
  • Little or no sense of danger

Impulsiveness

The signs of impulsiveness include:

  • Acting without thinking
  • Hard time waiting to talk
  • Impatience

3Causes

The exact cause of ADHD is still unclear and until today, it isn’t fully understood. However, many people see ADHD as a behavioral problem among kids caused by the parent’s inability to discipline their kids. They do not understand that ADHD is a medical disorder and it can also be caused by a number of factors that influence how the brain develops and functions.

Brain Functioning

Current research has shown the link between brain anatomy and functioning to the development of ADHD. The frontal lobe, caudate nucleus, cerebellum and basal ganglia play a pivotal role in the disease process. This is because these are complex brain processes that control behavior.

Fetal Exposure To Toxic Substances

Another factor seen by doctors as a major cause of ADHD is the exposure of the fetus to toxic substances during pregnancy such as alcohol, tobacco, and lead. Moreover, brain trauma from head injury or disease could also lead to the development of this brain disorder.

Several studies suggest that fetal exposure to alcohol and tobacco may lead to ADHD. In fact, fetuses who were exposed to tobacco smoke prenatally are about 2.4 times more likely to have ADHD compared to those who are not. Lead, a toxic chemical, plays a major role in the development of ADHD. It’s a neurotoxin that has been linked to ADHD because a study has found that children with the brain disorder had higher blood levels of lead than other children.

Pesticides

A major study in 2010 published in the journal Pediatrics shows that when children have higher levels of organophosphate in their urine, which is a pesticide used in crops and produce, had higher rates of ADHD. Moreover, the same study has shown that women with higher levels of this substance in their urine are more likely to have kids with ADHD.

Food Additives

Aside from toxic chemicals, there are many studies that have linked certain food additives and artificial food coloring to ADHD.

Genetics

Like many other brain disorders, familial genes are always part of the culprits. In fact, ADHD also runs in families and in most cases, children diagnosed with ADHD had parents or siblings who are more likely with the disorder themselves.

Other Causes

The other possible causes of ADHD are:

  • Being born prematurely before the 37th week age of gestation
  • Low-birth weight babies
  • Brain damage during pregnancy or in the early years of life

4Risk Factors

Risk factors may influence how ADHD symptoms are expressed but they do not directly cause the disorder. The risk factors of ADHD include:

Socioeconomic Risk Factors

  • Non-intact family
  • Single-parent household
  • Maternal depression
  • Lower maternal education
  • Belonging to the lower social class
  • Young maternal age at birth
  • Paternal history of antisocial behavior

Environmental Factors and Contaminants

  • Lead exposure
  • Pesticide exposure
  • Dopaminergic genes
  • Young maternal age at birth
  • Paternal history of antisocial behavior8-

5Complications

When ADHD is not treated, there are many possible complications that the child may experience including:

Emotional Problems

Children or teens with ADHD, especially those who also have anxiety and depression, may suffer from emotional problems in the long run such as low self-esteem and lack of confidence.

Social Problems

Children with ADHD are more likely to suffer from social problems such as anti-social behavior and high-risk behavior. They are the ones who may suffer from antisocial behaviors and they may not get along well with others. They are the ones who may be bullied or spend time alone.

Since one hallmark of ADHD is impulsivity, they are the ones who may engage in high-risk behaviors. They may act without thinking about the consequences of their decisions leading to dropping out of school, being suspended and teenage pregnancy in girls.

Substance Abuse

People with ADHD are at a higher risk of substance abuse and it starts in younger ages. They may use illicit drugs or drink alcohol at a very young age, particularly those with mood or conduct disorders.

Learning Problems

Children with ADHD have learning problems, not because they are not intelligent, but because of inattention. In fact, children with ADHD have the same IQ score as the general population. However, because they wander off tasks and become inattentive, they may fail their subjects in school.

6Diagnosis

There is no single test to determine the presence of attention deficit hyperactivity in children and adults. However, the doctor may diagnose the illness when the person shows all of the symptoms of ADHD on a regular basis for more than six months.

The doctor or psychiatrist may diagnose the disorder by using the DSM-5 Criteria for ADHD.

Those with ADHD should show a regular and persistent pattern of inattention and/or hyperactivity-impulsivity that can affect and interfere with functioning or development. For children, there should be six or more of the symptoms that persist for at least six months.

7Treatment

The treatment of ADHD revolves around reducing the symptoms and make the daily lives of the children as normal as possible. There are two major treatments for ADHD – medical and therapy, but a combination of these two are often prescribed as one of the most effective ways to manage ADHD. The medicines, however, must be prescribed only by a licensed doctor.

Most Commonly Used Medications:

  • Methylphenidate (Ritalin) – This medicine is the most commonly used medication for ADHD. It works by stimulating and increasing activity in the brain, specifically the areas that work on controlling behavior and attention. There are two types of the medication – immediate release and modified-release tablets. The immediate-release tablets are taken in small doses for about two to three times a day while the modified-release tablets are taken only in the morning and work throughout the day.

The common side effects of this medication are increased heart rate, a small increase in blood pressure, difficulty in sleeping, headaches, loss of appetite, weight loss or poor weight gain, mood swings, and abdominal pain.

  • Dexamfetamine (Dexedrine)- Just like Ritalin, Dexamfetamine is a stimulant medication for people with ADHD. This medicine can be used by both children and teenagers. However, it should be taken under a strict supervision of the doctor. The side effects of this medication include decreased appetite, mood swings, aggression, headaches, diarrhea, nausea and vomiting; dizziness, and agitation.

Therapy

Various therapies can be used to manage the symptoms of ADHD such as:

  • Behavior Therapy
  • Psychoeducation
  • Parent Training
  • Social Skills Training
  • Cognitive Behavior Therapy

8Living With ADHD

ADHD can be draining for both the patients and their caregivers. The various symptoms of inattention, hyperactivity, and impulsivity make everyday living hard and stressful.

Parents and teachers should help the children cope with the condition through guiding them on their daily activities. This will ensure that they will finish their tasks and cope with their learning problems.

Planning the day with the child is important so he or she knows what to expect. Setting a routine can also help to show a child with ADHD on how to cope with everyday life. You should also set clear boundaries on what behaviors are expected in school or at home. By reinforcing a positive behavior, the child will be motivated to work harder.