Attention Deficit/Hyperactivity Disorder - ADD/ADHD

Originally this disorder was considered two separate problems: ADD, or attention deficit disorder, and ADHD, attention deficit and hyperactivity disorder. Nowadays, the National Institute for Mental Health just refers to it as ADHD for simplicity.

ADHD is the most commonly diagnosed behavioral disorder of childhood, affecting as many as five percent of school-aged children. It is diagnosed much more often in boys than in girls.

ADHD is a problem with inattentiveness, over-activity, impulsivity, or a combination. For these problems to be diagnosed as ADHD, they must be out of the normal range for the child's age and development.

This is one reason why ADHD can go undiagnosed for a fairly long period of time - parents, educators and doctors may be unsure what "the normal range" for their child is.

Also, some children with ADHD may not display the hyperactivity and impulsivity aspects of the syndrome, also referred to as childhood hyperkinesis. Parents may observe their child sitting calmly for hours on end when presented with "pleasurable" activity such as watching television or playing video games. They conclude that their child couldn't possibly be hyperactive - look, he's just a couch potato!

It helps to understand the idea of hyperactivity a little better. Our brains are constantly in need of stimulation - it's what keeps us breathing and digesting and basically staying alive. Did you that many scientists now believe that dreaming is one way of keeping our brains stimulated while we are sleeping?

So the interesting thing is that people who seem to be hyperactive, are actually people who are craving more stimulation. There is some chemical process created by the brain wanting more. That is why one of the treatments for children who are hyperactive is Ritalin, which is basically an amphetamine, or "speed." It does seem counterintuitive that you would give a kid who is bouncing off the walls a drug that most adults use to make them more stimulated. But in reality, by giving these children a chemical stimulant, we are removing the need for them to get that stimulant through activity, which allows them to be more calm.

So television or video games, which require intense focus but have lots of images moving about constantly, are actually a form of stimulus.

In fact, children who are very quiet and withdrawn may actually be overstimulated - they may be more sensitive to sound or motion or emotion - and so they "shut down."

Scientists have been learning more and more about how our brains work and one thing studies have shown is that the brains of children with ADHD seem to be different from those of other children. Those with ADHD do not process certain brain chemicals, called neurotransmitters, in the same way as their peers.

Another problem in diagnosing ADHD is that there are number of other disorders that have similar symptoms, like depression or learning disabilities. Some of these disorders may also have their root the processing of neurotransmitters.

Finally, scientists have also learned that the part of the brain that deals with controlling impulsivity and understanding the idea of long-term consequences, the pre-frontal cortex, is not fully developed until well after puberty.

Any child suspected of having ADHD deserves a thorough evaluation to identify exactly what is going on because often you may find there are multiple challenges requiring different types of treatment.