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Features and Understanding of ADHD

Attention Deficit Hyperactivity Disorder

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ADHD is a behavioral disorder that causes a child or adult to have difficulty concentrating, and at times with impulse control. Distractibility and hyperactivity may also be present. With respect to children, these problems must be significantly out of the "normal range" for the child's age. That is, where it may be normal for a 4-year-old to become restless and fidgety after being read to for 10 minutes, it is inappropriate for a 15-year-old to be jumpy and squirming after 10 minutes of reading. For adults the criteria have more to do with having difficulty regulating behavior, deploying resources to organize and sustain attention to lengthy tasks, as well as being able to prioritize and evaluate tasks and activities that need to be accomplished.

There is no one "test" for ADHD. However, Dr. Howard can see how a child or adult behaves during various tasks, some of which demand concentration and focus, and some that do not. Likewise, there are good tests to measure distractibility, as well as the capacity to perform tasks involving mental flexibility, simultaneous processing, and divided attention. Other important neuropsychological tests look at an individual's visual organization, initiation and generation abilities, sustained visual attention, verbal memory, and auditory attention and concentration skills. 

ADHD is a serious disorder, which can have major consequences for learning and social skills. ADHD must be carefully diagnosed by an experienced and qualified professional. The diagnosis should be based on data gathered from a number of different sources (tests, behavioral observations, teacher reports, parent reports). The disorder must be closely monitored, especially if medication is prescribed, and teachers and parents must be given concrete strategies for helping the child.

Although there are some structural abnormalities in the brain, the most significant neurological feature of ADHD concerns the diminution of dopamine, which is a naturally occurring neurotransmitter in the frontal lobes of the brain. The medications given for ADHD enhance the availability of dopamine, thereby increasing the cognitive skills associated with frontal lobe functioning, including improving working memory, processing speed, mental flexibility, planning and organizational skills, and self monitoring capacities. The neuropsychological assessment can establish not only the presence of attentional difficulties, but can provide a benchmark or basis for charting improvement over the course of time.

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