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What You Need to Know about Attention Deficit Disorder

written by: maryalene • edited by: Paul Arnold • updated: 6/24/2011

Although common, attention deficit disorder is often misunderstood by parents and teachers alike. Learn more about this disorder, including its history, causes and treatment.

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    As one of the most common neurobehavioral disorders among children, chances are you know someone with ADHD. You may even have the disorder yourself. Despite its widespread prevalence, this condition is often misunderstood. The stereotypical ADHD child may be of a wild boy with permissive parents, but the available research and information about attention deficit disorder paints a very different picture. Read on for the basics everyone should know about ADHD.

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    Attention deficit disorder is not a modern phenomenon

    According to the International Congress on ADHD, attention deficit disorder can be found in medical records dating back to 1798. It was in that year that Alexander Crichton described a condition similar to the inattentive type of ADHD. A hundred years later, in 1899, Scottish psychiatrist Thomas Smith Clouston described children with over-excitability and mental explosiveness.

    Despite references to conditions that could be ADHD during the 18th and 19th centuries, the disorder wasn’t named until 1932. During that year, German researchers Franz Kramer and Hans Pollnow described a syndrome that fits what is today considered ADHD. At the time, the disorder was named the Kramer-Pollnow Syndrome.

    However, it wasn’t until the second edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), published in 1968, that ‘hyperkinetic reaction of childhood’ was officially defined. Then, in 1980, the third edition of the DSM first referenced ‘Attention Deficit Disorder, with or without hyperactivity.’

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    ADHD and ADD are the same thing

    Anyone looking for information about attention deficit disorder is likely to find numerous references to ADHD. As mentioned above, attention deficit disorder was the term used in the third edition of the DSM. However, with the publication of the fourth edition of the DSM, the term was changed to attention deficit/hyperactivity disorder. As a result, ADHD is the only ‘official’ term for the disorder although both ADD and ADHD are used interchangeably by lay people.

    Despite the use of the word hyperactivity in ADHD, not all instances of the disorder are marked by increased activity. The DSM differentiates between three types of ADHD:

    1. Predominately inattentive type: This is the type of ADHD that may be most closely associated with the term attention deficit disorder. Children with the predominately inattentive type of ADHD have difficulty paying attention for extended periods of time. They may be disorganized and are often described as forgetful.
    2. Predominately hyperactive/impulse type: Children with this type of ADHD often fit the stereotype of overactive students. They fidget, talk excessively and have difficulty waiting their turn.
    3. Combined type: As its name implies, children with the combined type of ADHD demonstrate both inattention as well as hyperactivity. The National Alliance on Mental Illness (NAMI) reports that the combined type is the most common type of ADHD.
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    The cause of ADHD is unknown

    Although ADHD has been the subject of extensive study, scientists have yet to determine what causes the disorder. The Centers for Disease Control and Prevention (CDC) state that research indicates genetics likely plays a role in the development of ADHD. Other risk factors identified by the CDC include:

    • Premature birth
    • Maternal alcohol and tobacco use during pregnancy
    • Low birth weight
    • Exposure to environmental toxins such as lead
    • Brain injury

    Other theories about the causes of ADHD include poor diet and nutrition as well as the idea that ADHD is the result of expecting too much of children too quickly. The CDC argues that some factors such as parenting and diet may make ADHD symptoms worse but says there is insufficient research to indicate these are the main cause of the disorder.

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    There are chemical and natural treatments for ADHD

    Just as there is no one cause of ADHD, there is no one standard treatment. While medication is a popular treatment for ADHD, there are also natural options available. Some parents find success in treating ADHD symptoms with natural remedies alone while others may combine them with prescription medication.

    Natural treatments include neurofeedback, dietary changes, essential oil supplements and behavioral therapies. Meanwhile, medications for ADHD include both stimulants and non-stimulants. Since everyone responds differently to medication, finding the right prescription and dosage often requires a period of trial and error.

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    ADHD isn’t just for kids

    Although it is often considered a childhood ailment, ADHD affects adults as well. The American Academy of Family Physicians reports that 30-50 percent of children with ADHD will continue to have symptoms into adulthood. In addition, a 2006 study conducted by the Harvard Medical School estimated 4.4 percent of U.S. adults between the ages of 18-44 experience ADHD symptoms.

    However, for many adults, ADHD is unrecognized and a missed diagnosis. In a May 2011 New York Times story, Dr. Russell Barkley indicated that only 10 percent of adults with ADHD have received a formal diagnosis. In many instances, parents searching for information about attention deficit disorder see themselves in the descriptions of typical behavior.

    One distinction between childhood and adult cases of the disorder is the prevalence of hyperactivity. While most children have the combined type of ADHD, a 2010 article in the Archives of General Psychiatry indicates that most diagnosed adults have the predominately inattentive type.

    Information about attention deficit disorder will undoubtedly change as new research about ADHD continues to be pursued. Until science can more definitely answer the question of what causes ADHD and how best to treat it, parents would be well advised to continue monitoring this issue closely for the latest developments.

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    References:

    Kessler, Ronald et al. (2010) “Structure and Diagnosis of Adult Attention-Deficit/Hyperactivity Disorder." Archives of General Psychiatry

    Alderman, Lesley. “Speed Bumps on the Way to an A.D.H.D. Diagnosis," New York Times. May 13, 2011

    “Harvard Study Suggests Significant Prevalence of ADHD Symptoms Among Adults," National Institute of Mental Health. April 1, 2006

    Searight, H. Russell et al. (2000) “Adult ADHD: Evaluation and Treatment in Family Medicine," American Family Physician

    Attention-Deficit/Hyperactivity Disorder," National Alliance on Mental Illness (Accessed June 22, 2011)

    Neumarker, KJ. (2005) “The Kramer-Pollnow syndrome: a contribution on the life and work of Franz Kramer and Hans Pollnow." History of Psychiatry

    Short History on ADHD," 3rd International Congress on ADHD (Accessed June 22, 2011)

    Facts About ADHD," Centers for Disease Control and Prevention (Accessed June 22, 2011)