Causes of ADHD
The exact cause of ADHD has not been determined, however, ADHD is thought to have a genetic component as it tends to occur among family members. Close relatives of people with ADHD have about a 5 times greater than random chance of having ADHD themselves, as well as a higher likelihood for such common accompanying disorders as anxiety, depression, and learning disabilities. An identical twin is at high risk of sharing his twin’s ADHD, and a sibling of a child with ADHD has about a 30% chance of having similar problems.
Boys are three times more likely to be diagnosed with ADHD as children, though this ratio seems to even out by adulthood. It is likely that girls are sometimes overlooked when diagnosing ADHD. Symptoms of ADHD can present differently in females, but doctors and other healthcare professionals are becoming better at recognizing, diagnosing and treating girls and women with ADHD.
Ongoing studies are focusing on identifying genes that may cause a person to be more susceptible to ADHD. Research continues to study the link between ADHD and brain structure, brain chemistry especially related to the neurotransmitters dopamine and norepinephrine (which regulate attention and activity), and differences in function of parts of the brain that affect attention and impulse control.
There is more clarity on what does not cause ADHD. It is not the result laziness or lack of motivation and discipline. It is not caused by poor parenting, poor teaching, too much television, or too much time spent on fast paced video or computer games. It has been suggested, though, that refined sugars or food additives may increase the risk of ADHD. Nutrition and diet can affect mood and behavior, as well as brain development in early life.
The Difference Between ADD and ADHD
Attention Deficit Disorder (ADD) is a general term frequently used to describe individuals that have Attention Deficit Hyperactivity Disorder (ADHD) without the hyperactive and impulsive behaviors. The terms ADD and ADHD are often used interchangeably for both those who do and those who do not have symptoms of hyperactivity and impulsiveness.
Attention Deficit Hyperactivity Disorder (ADHD) is the official name used by the American Psychiatric Association, and it encompasses hyperactive, impulsive, and / or inattentive behaviors. The Diagnostic and Statistical Manual of MentalDisorders, Fourth Edition (DSM-IV) actually includes three different types of ADH
1. ADHD, Predominantly Inattentive Type
Symptoms are primarily related to inattention. The individual does not display significant hyperactive/impulsive behaviors. Most people refer to the predominantly inattentive type of ADHD simply as ADD. These individuals may have trouble paying attention, finishing tasks, or following directions. They may also easily become distracted, appear forgetful, careless and disorganized; and frequently lose things. Individuals with the predominately inattentive type of ADHD are not only not hyperactive, they can tend to be rather sluggish and slow to respond and process information. They often have difficulty sifting through relevant and irrelevant information. They may seem daydreamy, spacey or as though they are in a fog and may be shy or withdrawn. Their symptoms are less overt compared to an individual with hyperactive and impulsive symptoms. Unfortunately, as a result, many individuals with the predominately inattentive type of ADHD are often overlooked.
2. ADHD, Predominantly Hyperactive-Impulsive Type
Symptoms are primarily related to hyperactivity and impulsivity. Individuals do not display significant attention problems. Those with the predominantly hyperactive-impulsive type of ADHD may appear restless, fidgety, overactive and impulsive. They “act before thinking” and often “speak before thinking” by blurting out and interrupting others. People with these hyperactive / impulsive behaviors may play and interact loudly. They have difficulty staying in their seat, talk excessively, and have trouble waiting turns. They may seem to be perpetually “on the go.”
3. ADHD, Combined Type
Individuals display both inattentive and hyperactive / impulsive symptoms.
Diagnosing ADD and ADHD
What is involved in diagnosing ADHD? Lots of information must be gathered in order for the doctor or mental health professional to make the diagnosis of ADHD. A good portion of this information is obtained through clinical interviews. You will be asked to complete behavior checklists or questionnaires to give the professional more detailed information about the problematic behaviors. Further evaluations may occur through observation and psychological and educational testing. If your child is being evaluated, you and his teachers (or other important adults who observe your child’s behavior in various settings) may be interviewed. A physical exam may be recommended in order to rule out any medical causes for the symptoms. A family medical history is also helpful.
Questions to Ask During the ADHD Evaluation Process
Could something else be causing the behavior problems?
- Are there other medical or psychological conditions that may be the cause?
- What about learning disabilities?
- Are there any environmental or situational factors that may exacerbate the problem?
It is helpful to ask any questions that educate you and the doctor about what may be going on to cause the problematic behaviors. Once a diagnosis of ADHD is made you will have a list of additional questions related to treatment options, ADHD education, and support services.
Information to Have Available for the Health Care Provider During the ADHD Evaluation
Bring copies of any appropriate records such as medical, psychological, school/employment records. Bring copies of any previous evaluations. Be prepared to give a detailed developmental and social history including pregnancy and birth history. Have information available about any other involved professionals – physicians, pediatricians, psychiatrists, psychologists, counselors, social workers, therapists, and teachers, including any special education teachers. Many health care providers will send you a questionnaire to complete before the appointment. Be sure to bring the completed forms with you to the appointment.
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