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95 Washington Street,

Suite 588, Canton, MA 02021

Phone: (781) 713-4001 

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Attention-Deficit/Hyperactivity Disorder

 

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder marked by an ongoing pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development. ADHD often begins in childhood and can persist into adulthood. In fact, about 30 to 70% of children with ADHD will continue to struggle with symptoms in adulthood.

 

According the National Institute of Mental Health, ADHD affects approximately 4.1% of individuals between the ages of 18-44. Individuals with ADHD can be very successful in life. However, without identification and proper treatment, ADHD may have serious consequences, including school failure, family stress and disruption, depression, problems with relationships, substance abuse, delinquency, accidental injuries and job failure. There are three presentations of ADHD: Predominantly Inattentive, Predominantly Hyperactive-Impulsive, and Combined. In making the diagnosis, children should have six or more symptoms of the disorder present (6 symptoms of inattention for ADHD Predominantly Inattentive Presentation, 6 symptoms of impulsivity/hyperactivity for ADHD Predominantly Hyperactive-Impulsive Presentation), adolescents 17 and older and adults should have at least 5 of the symptoms present.

SYMPTOMS

ADHD Predominantly Inattentive Presentation

  • Overlooking or missing details, making careless mistakes in schoolwork, at work, or during other activities

  • Having problems sustaining attention in tasks or play, including conversations, lectures, or lengthy reading

  • Not appearing to listen when spoken to directly

  • Not following through on instructions and failing to finish schoolwork, chores, or duties in the workplace or starting tasks but quickly losing focus and getting easily sidetracked

  • Having problems organizing tasks and activities, such as what to do in sequence, keeping materials and belongings in order, having messy work and poor time management, and failing to meet deadlines

  • Avoiding or disliking tasks that require sustained mental effort, such as schoolwork or homework, or for teens and older adults, preparing reports, completing forms or reviewing lengthy papers

  • Losing things necessary for tasks or activities, such as school supplies, pencils, books, tools, wallets, keys, paperwork, eyeglasses, and cell phones

  • Being easily distracted by unrelated thoughts or stimuli

  • Being forgetful in daily activities, such as chores, errands, returning calls, and keeping appointments

ADHD Predominantly Hyperactive-Impulsive Presentation

  • Fidgeting with hands or feet or squirming in chair 

  • Difficulty remaining seated 

  • Running about or climbing excessively in children; extreme restlessness in adults

  • Difficulty engaging in activities quietly 

  • Acting as if driven by a motor; adults will often feel inside as if they are driven by a motor

  • Talking excessively 

  • Blurting out answers before questions have been completed 

  • Difficulty waiting or taking turns. Interrupting or intruding upon others 

ADHD Combined Presentation

The individual meets the criteria for both inattention and hyperactive-impulsive ADHD presentations.


TREATMENT

ADHD is usually treated with medications, psychotherapy, or a combination of the two. Stimulant and nonstimulant medications are the first line treatment for ADHD. However, research shows that Cognitive Behavioral Therapy (CBT) - which is an empirically supported treatment that focuses on modifying problematic thoughts and behaviors that contribute to and/or maintain ADHD - can provide benefit whether or not the person is being treated with medication. Whereas medication helps to control the core symptoms of distractibility, short attention span and impulsivity, CBT is more effective at increasing the habits and skills needed for executive self-management and may also serve to improve emotional and interpersonal self-regulation. CBT for ADHD focuses on behavioral coaching techniques such as keeping routines, making lists for different tasks and activities, using a calendar for scheduling events, using reminders, breaking down large tasks into more manageable, smaller steps so that completing each part of the task provides a sense of accomplishment, and reducing distraction. 

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