What causes ADD/ADHD?
The causes of ADD/ADHD remain relatively unknown. However, researchers have discovered that the biological factors are major contributors to the disorder. ADD/ADHD tends to run in families, thereby indicating a strong genetic origin. Moreover, neuroimaging research shows that brains of individuals with ADD/ADHD differ fairly consistently from those without the disorder. The brain areas that control attention (i.e., pre-frontal cortex, basal ganglia, and cerebellum) have been found to be slightly smaller and demonstrate less activity in individuals with ADD/ADHD. Although researchers have been unable to pinpoint the exact genetic or biological origins of ADD/ADHD, they have been able to rule out most environmental causes. ADD/ADHD is NOT caused by poor parenting, family problems, ineffective teachers or schools, or food allergies, though environmental factors can interact with an individual’s genetic/biological propensity to develop the disorder.

Is ADD/ADHD more common in boys than in girls?
It is a common belief that ADD/ADHD is far more prevalent in boys than in girls. Research suggests that 5 to 10 percent of school-aged children in the United States will be diagnosed with ADD/ADHD, and boys are three or four times more likely to be diagnosed than girls. However, recent research indicates that ADD/ADHD is under-diagnosed in girls. Boys are more likely to display the hyperactive/impulsive symptoms of ADD/ADHD, whereas girls are more likely to experience only the inattentive symptoms. Hyperactive and impulsive behaviors (e.g., fidgeting, getting out of their seats in school, blurting out answers) typically make the disorder more noticeable at home and in the classroom and lead to a far greater referral rate for boys. However, the inattentive symptoms (e.g., poor attention to details, forgetfulness, distractibility) can be just as detrimental to educational success, self-esteem, and social relationships. Often ADD/ADHD in females goes unrecognized until school work becomes more difficult (4th grade to middle school).

Is there a specific test to diagnose ADD/ADHD?
No. ADD/ADHD is a clinical diagnosis, and there is not a specific test that determines whether an individual has ADD/ADHD. The best method of assessing for ADD/ADHD is to have a qualified mental health professional, such as a Licensed Psychologist, conduct a comprehensive assessment. A comprehensive assessment is important given that many problems and disorders (e.g., depression, anxiety, dyslexia, sleep deprivation, working memory deficits) can cause attention deficits. Such an evaluation typically includes a thorough review of history, behavioral observations, interviews, behavioral checklists from multiple informants (parents, teachers, self), a computerized test of attention, and standardized testing of cognitive abilities and academic skills. A more thorough evaluation can lead to a more accurate diagnosis, a better understanding of strengths and resources, and individualized treatment recommendations.

Are there treatment options other than medication?
There are a variety of treatment options for treatment besides medication. Various types of therapy have been shown to be helpful. Specifically, cognitive-behavioral therapy (CBT) can be effective for individuals. A main focus in CBT is to decrease impulsivity and to practice skills that help the individual stop and think before acting. Individual therapy can also be beneficial in addressing social skills deficits and self-esteem concerns. Family therapy and parent training are also common treatment options for children and teens with ADD/ADHD. These techniques can address family dynamics, introduce effective behavioral modification methods, and concentrate on creating a structured and supportive environment. For many individuals, a combination of therapy and medication has been found to be an effective treatment approach. Although the stimulant medications that are commonly prescribed for ADHD/ADD (e.g., Ritalin, Adderall) are fairly well tolerated, individual responses to medication vary, and some people prefer not to pursue medication due to side effects or personal reasons.

I’m an adult and can’t concentrate or focus anymore. What’s wrong?
Numerous problems other than ADD/ADHD can cause concentration and focus problems. If the lack of concentration and focus is a new difficulty for you, it is unlikely that you have ADD/ADHD. ADD/ADHD is a neurological condition that begins in childhood, though it not always diagnosed during that time period. Difficulty with concentration and focus can be caused by a number of other factors including day-to-day stress, anxiety, depression, sleep deprivation, grieving, as well as medical conditions and the side effects of medications. Receiving a full physical from you medical doctor can be helpful in ruling out problems of a medical nature. Consulting directly with a psychologist and/or psychiatrist regarding your symptoms can ensure that you receive the correct diagnosis and treatment.

What does sleep have to do with ADHD?
Sleep Loss Worsens Symptoms of ADHD – A recent Australian study found that children with Attention-Deficit/Hyperactivity Disorder (ADHD) often suffer from sleep problems, which has implications for both the children and their caregivers. The study included 239 families of children with ADHD ages 5-18 years. Researchers found moderate to severe sleep problems affected 72.3% of the children. Specific problems included difficulty falling asleep, tiredness when waking up, and resisting going to bed.

According to the study’s authors, sleep problems of this nature impact a child’s “psychosocial quality of life and daily life functioning,” often because these children miss school more frequently than children without sleep problems. Furthermore, the caregivers of children with ADHD and sleep problems tend to have poorer mental health and are more often late for work. Sleep problems are also associated with poorer overall family functioning.

Researchers underscore the importance for healthcare providers to discuss sleep routines with families of children with ADHD. If sleep problems are present, intervention can improve outcomes of children with the disorder and may even allow them to reduce their medication dosage.

Importantly, sleep deprivation in and of itself is not thought to cause ADHD. However, the research points to an interactive relationship between sleep problems and ADHD that merits additional research.

A comprehensive psychological assessment by a Licensed Psychologist at the ApaCenter can help determine whether ADHD and/or other problems underlie your child’s attention difficulties. Often children with disabilities, such as ADHD, who are struggling in school are eligible for educational accommodations through special education or 504 services.

Elizabeth Minne, Ph.D. (Article from APA website)
SOURCE: Archives of Pediatrics and Adolescent Medicine, April 2008.