ADHD. Attention Deficit Hyperactivity Disorder. What is it? How to test for ADHD? Treatment? 

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What is ADHD?

It is a neurological disorder that impairs the brain's regulation of:

  • Attention span.
  • Impulsivity.
  • Motor activity.

What ADHD is not.

  • Lack of will power.
  • Inadequate parenting.
  • Lack of motivation.
  • Lack of intelligence.
  • Laziness.

ADHD's Impact on the Brain's Executive Functioning Abilities.

  • Diminishes working memory and ability to recall.
  • Inhibits ability to plan efficiently.
  • Hampers ability to organize.
  • Limits problem solving skills.
  • Chokes ability to start and stop activities, i.e. to concentrate.
  • Thwarts ability to self-manage behavior, i.e. to make conscious choices among alternatives.
  • Negative influence on the ability to manage frustration and modulate emotions.

Types of ADHD

  • ADHD, Inattentive Type
  • ADHD, Hyperactivity-Impulsive Type
  • ADHD, Combined Type (most children and adolescents have this type).
  • ADHD, NOS

DSM-V Criteria: 6 of 9 Inattentive Symptoms 

  • Forgets to do daily activities.
  • Easily distracted.
  • Challenged to listen.
  • Sporadic attention span. 
  • Does not follow through on instructions.
  • Struggles to organize tasks.
  • Loses things necessary for tasks.
  • Fails to pay close attention to details.
  • Avoids tasks requiring sustained mental effort.

Hyper-Active Impulsive Type

  • Fidgets with hands or feet or squirms in seat.
  • Leaves seat in classroom inappropriately.
  • Runs about or climbs excessively.
  • Has difficulties playing quietly.
  • Is on the go or “driven by a motor”.
  • Talks excessively.
  • Blurts our answers before questions are completed.
  • Has difficulties awaiting turn.
  • Interrupts or intrudes on others.

Why is there an increase in individuals with ADHD?

  • Greater public awareness and diagnoses improvement.
  • Increased recognition in girls, adolescents, and adults.
  • Increase in survival of pre-maturely born children.
  • Increase in utero substance exposure.

ADHD and Other Disorders

  • 50-70% of cases with ADHD are further complicated by one or more psychiatric or learning disorders (common in order of occurrence).
    • Conduct
    • Mood
    • Learning
    • Anxiety
    • Oppositional Defiant

Impact on Children's Ability to Socialize

  • About 50% of children with ADHD experience social problems.
  • Social difficulties tend to be significant and chronic.
  • Social issues can directly impact the child’s self-esteem and happiness.
  • Often are seen as too hurried, too intense, clueless, and too isolated.

Impact on Education and Employment

  • Compared to individuals without ADHD, young adults with ADHD may show:
    • Increased rates of school suspension, detention, and expulsion.
    • Score 7-15 points lower, on average, on standardized achievement and/or intelligence tests.
    • Lower rates of high school graduation and entering college.
    • Higher rates of being fired or switching jobs.
    • Lower work performance ratings.

Treatment: What does Dr. Silva do?

  • Conduct oral and written assessments in English or Spanish.
  • Treatment recommendations for home and school.
  • Meet and collaborate with teachers and school staff to implement treatment plan.
  • Suggest accommodations for learning differences in school. 
  • Collaborate with psychiatrists, who are authorized to prescribe medications such Ritalin, Concerta, and Adderall.  This joint effort to manage medication helps reduce the risk of adolescents with ADHD of developing a substance abuse problem by 84%.