Sunday, February 21, 2010

What is ADHD / ADD?

The letters ADHD / ADD can be confusing. The current diagnostic term is ADHD for all forms of ADD. ADHD stands for attention deficit hyperactivity disorder and it comes in three types: the inattentive type, the hyperactive type, and the combined type in which both inattention and hyperactivity are present.

Attention deficit hyperactivity disorder is not a very good way to label the syndrome. ADHD inattentive type is actually a compilation of several executive function symptoms. These can include: getting started on important (but boring) tasks, planning, organization, sustained mental effort (again on something that is important but not terribly interesting), attention, concentration, freedom from distractibility, being able to check one's work for legibility and careless mistakes, and finally, working memory.

Working memory is the human equivalent of RAM memory on a computer. It is the ability to take in multiple pieces of information, hold onto them, and plan a series of responses to each one without losing track of the other ones. It is central to being able to follow a set of instructions, to multi-task, to remember a phone number briefly, and to compute math problems in one's head. Having low working memory is like a computer that has limited RAM memory. Applications are processed in a more sluggish and inefficient manner.

The hyperactive side of ADHD can include fidgety behaviors, restlessness, impulsivity, and feeling like one is being driven by a motor.

A good work-up for ADHD includes interviews, taking a thorough family history (ADHD appears to be inherited), using current and valid rating forms to compare the person to others of the same gender and age, and using performance measures of ADHD to measure directly such things as attention, concentration, and working memory. It is also important to check for things which can mimic ADHD such as anxiety problems, depression, motivational problems, learning disabilities or other processing problems, and even underlying psychotic conditions. Finally, very bright children (especially boys) can be mis-diagnosed with ADHD. Hence the need for a comprehensive evaluation.

For a good ADHD evaluation in the Chicago area, see one of our diagnosticians at Heritage Professional Associates. Outside of the Chicago area, ask someone whom you trust for the name of a reputable mental health care professional who is equipped to do these kind of evaluations.