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What Is ADHD?

SCIENCEALERT STAFF

Attention Deficit Hyperactivity Disorder (ADHD) defines a set of behaviors involving differences in focus, movement, and impulse control. It often presents without characteristics of hyperactivity under the increasingly outdated acronym ADD.

 

Though framed as a deficit, it's more accurate to describe ADHD core characteristic of inattentiveness as a difficulty in managing a sphere of awareness. While this is considered a disorder in many common contexts, in others an inability to be distracted could serve a purpose.

By some respects, there is an excess of attention that causes people to 'hyperfocus' on situations that might be seen as having less importance to those around them.

Though historically judged and dismissed as a moral failure - a sign of poor self control - ADHD is a serious neurobehavioral disorder that has a significant impact on childhood development and learning, one that may persist into adulthood.

According to the American Psychiatric Association's current criteria, a diagnosis of ADHD requires five (for older teens and adults) to six (for children under 16) signs of an aberrant level of inattention that persist for six months or more. For a diagnosis to include hyperactivity, a similar level of evidence needs to reflect signs of excessive actions or difficulty in managing responses.

Is ADHD overdiagnosed?

ADHD is currently diagnosed solely on how it's expressed as a behavior, meaning there are no unambiguous clinical markers that can be found in blood tests or brain scans that can be used to draw a clean line between disease and normality.

To make diagnosing the disorder even more challenging, whatever factors make it harder for an individual to divide their attention or maintain impulse control can evolve with time as the person learns to compensate and adapt, or even develops additional behavioral or neurological problems.

 

Opinions vary on whether there is strong evidence supporting claims that inaccurate diagnoses of ADHD are 'too' common. Recent research based on past studies suggest increases in ADHD diagnoses to include relatively mild cases could be resulting in unnecessary treatments that risk harm with few benefits. 

Yet the relationship between personal experience of difficulty with attention, diagnosing a disorder, and finding a suitable level of treatment is a complex one as well. 

There is still so little we know about the condition and its causes, neurological foundations, diverse subtypes, and potential environmental influences.

How is ADHD treated?

As with most neurobehavioral disorders, ADHD can be managed with a mix of medication and behavioral therapy. 

Most children with a ADHD diagnosis experience some benefit from pharmaceuticals, such as dextroamphetamine, that stimulate production of dopamine in areas that promote executive function and help regulate attention. While highly effective, they can also lead to unwanted side effects. Nonstimulant medications can take longer to act, but provide an alternative form of assistance for those who need it.

Therapies vary depending on the age of the person diagnosed and the nature of their condition and lifestyle. For children, behavioral counseling typically includes parents, providing them with ways to encourage skills that are useful for managing time, attention, and interactions with others. 

Perhaps the most useful, yet least discussed way to 'treat' ADHD is through broadening our appreciation of neurodiversity and modifying our expectations on focus in a time-poor, highly busy world.

 

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