ADHD (Attention Deficit Hyperactivity Disorder) is the current term for a specific developmental disorder seen in both children and adults that includes deficits in behavioral inhibition, sustained attention and resistance to distraction, and the regulation of one’s activity level to the demands of a situation including hyperactivity or restlessness. There are currently three subtypes of ADHD including Inattentive Presentation, Hyperactive Presentation, and Combined Presentation.
According to R. Barkley, a leading researcher in the field of ADHD, the predominant features of this disorder include impaired response inhibition, impulse control, or the capacity to delay gratification. These difficulties are often noted in an individual’s inability to stop and think before acting, to wait ones’ turn, to resist distractions while concentrating or working, and to work for larger, longer-term rewards rather than opting for smaller, more immediate ones. It also involves activity that is poorly regulated to the demands of a situation. Individuals with ADHD are noted to be excessively fidgety, restless, and “on the go.” Young children may engage in excessive running, climbing, or other gross motor activity; adolescents may be more restless than their peers; and adults may report a need to always be busy doing something and being unable to sit still. Poor sustained attention or persistence of effort to tasks often arises when the individual is required to complete boring, tedious, or repetitive tasks that lack interest to the person. Problems with completing routine assignments without direct supervision and being unable to stay on task during independent work are noted.
School-related problems of children with ADHD may include problems sustaining attention to effortful tasks, lack of attention to task instructions, poor test performance, deficient study skills, disorganized notebooks, desks and written reports, and a lack of attention to teacher lessons. Children with ADHD often disrupt classroom activities, and the learning of their classmates. Impulsivity may include frequent calling out without permission, talking with peers at inappropriate times, and becoming angry when confronted with reprimands or frustrating tasks. Students with ADHD are at risk for significant difficulties including academic underachievement, high rates of noncompliance and aggression, and disturbances in peer relationships.
Are you an adult who believes you may have an underlying attention problem? Adults with ADHD have always lived with their condition so they may not recognize their symptoms as being different from the normal population. They may be very confused as to why they are experiencing problems. Experiences from their childhood may lead them to believe that they are not very smart or capable. They may believe that they are lazy and unmotivated or suffer from other mental illnesses. Many adults seek out an ADHD assessment after their child has been diagnosed and they become familiar with the disorder.
Due to the frequency of associated disorders occurring with ADHD, the adult with ADHD will frequently arrive at the physician’s office complaining of symptoms of insomnia, unstable moods, anxiety, depression, lack of motivation, disorganization and procrastination.
Red Flags for Adult ADHD
- a lifelong history of difficulty with attention, disruptive or impulsivity
- organizational skill problems (time management difficulties, misses appointments, frequent late and unfinished projects)
- erratic work history (changs jobs frequently, unprepared for meetings, projects not completed on time, reports of coworkers, employers and clients being frustrated with them)
- Anger control problems (argumentative with authority figures, over controlling as a parent, fighting with coworkers or child’s teachers)
- marital problems (spouse complains that he/she does not listen, speaks without thinking, is impulsive, forgets important events)
- being over-talkative, interrupts frequently or inappropriately, speaks too loudly
- parenting problems ( difficulty establishing and maintaining household routines, inconsistency in dealing with the children)
- money management problems (making impulsive purchases, running out of money, failing to pay bills or do taxes, history of bankruptcy)
- substance use or abuse, especially alcohol or marijuana, or excessive caffeine use
- frequent accidents
- problems with driving (speeding tickets, serious accidents, license revoked, or being overly cautious when driving to compensate for attention problems)
- being a parent of a child with ADHD
- a college student who is frustrated, having to reduce their course load, or having difficulty completing assignments
- the adult may be successful but shows impairment when compared to their potential
- an adult who is expending more energy than others to do the same amount of work
- an adult who is using coping strategies to compensate for their weaknesses, but still experiencing problems with their career and work relations or becoming a workaholic
The Assessment Process
A typical ADHD assessment involves administration of the following measures to obtain a comprehensive assessment of an individual’s functioning:
– A measure of intelligence using the WPPSI-IV (ages 2.5 to 7), WISC-V (ages 6.5 to 17), or WAIS-IV (ages 18+)
– A measure of achievement using the WIAT-III (Wechsler Individual Achievement Test) that assesses reading, math, written language, and oral language abilities. This measure will assist in determining if the individual has any underlying learning difficulties typically associated with ADHD. Common academic problems include poor reading comprehension, difficulty putting words to paper, and poor math calculation skills.
– Behavioral checklists (BASC-3, Conners, CAARS)
– Computerized measures (CPT, CATA, IVA-AE-2)
– Measures of Executive Functioning (BRIEF)
– Measures of Neuropsychological Functioning (NEPSY)
– Measures of Adaptive Functionig (ABAS-3)
A typical ADHD assessment takes approximately 10 hours to complete.