A condition that may occur in both children and adults who consistently display inattention, hyperactivity, and impulsivity. People who are inattentive may have trouble keeping their minds focused and may get bored with a task after just a few minutes. Those who are hyperactive seem to feel restless and are constantly in motion, finding it hard to sit still. People who are impulsive have a problem with curbing their immediate reactions and tend to act before they think. other symptoms may include problems in school, with friends, and with behavior.
ADHD and learning disability frequently occur together, but they are not the same. Learning disabilities include difficulty with receiving, organizing, processing, understanding, remembering, and offering information. ADHD involves difficulty with paying attention to information. Between 10 percent and 20 percent of all school-age children have learning disabilities. Of those with learning disabilities, between 4 percent and 12 percent of all school-age children will also have ADHD, making it the most common childhood neurobehavioral disorder.
Although ADHD is a common childhood behavioral disorder, it can be difficult to diagnose and even harder to understand. Once viewed as a disorder of childhood primarily involving hyperactiv-ity and the inability to pay attention, ADHD is now seen as a lifelong condition that may not include physical restlessness or hyperactive behavior at all. It may also be the source of unusual talents or gift-edness in specific areas.
In recent years there has been growing interest in ADHD as well as concerns about possible overdiagnosis. In surveys among pediatricians and family physicians across the country, wide variations were found in diagnostic criteria and treatment methods for ADHD. Indeed, the definition and treatments of ADHD continues to evolve; since the early 1990s there has been an extraordinary surge in the level of focus on ADHD and in the incidence of diagnosis among children and adults. It is likely that the present level of understanding of the disorder, as well as current methods of diagnosis and treatment, will continue to develop rapidly in the coming years.
Once thought to be a disorder primarily affecting young hyperactive boys, ADHD is both more complicated and more pervasive. In particular, experts now know that children do not typically "outgrow" the condition, nor does it affect only boys. The present gender ratio ranges from three to one to seven to one boys to girls, but this is hampered by inconsistent standards for diagnosis and insufficient research samples.
ADHD is presumed to be a brain condition that affects between three percent and seven percent of the population. since the early 1990s scientists have worked to pinpoint the differences found in brain scans between the normal brain and the ADHD brain. Recently, scientists have been able to localize the brain areas involved in ADHD, finding that areas in the frontal lobe and basal ganglia are reduced by about 10 percent in size and activity in children with ADHD.
studies in the past few years have shown that boys with ADHD tend to have brains that are more symmetrical. Three structures in the brains of boys with ADHD were smaller than in non-ADHD boys of the same age: prefrontal cortex, caudate nucleus, and the globus pallidus. The prefrontal cortex is thought to be the brain's "command center"; the other two parts translate the commands into action.
There is also evidence that not only are some of the structures slightly varied, but the brain may use these areas differently. Watching brain scans, researchers discovered that boys with ADHD have an abnormal increase of activity in the frontal lobe and certain areas below it. These areas work in part to control voluntary action. This meant that the ADHD boys were working harder to control their impulses than non-ADHD boys. Once given Ritalin, this abnormal activity quieted down. This effect was not seen in the non-ADHD boys. This means that Ritalin may act differently on ADHD brains compared to "normal" brains.
Although a brain scan (called functional magnetic resonance imaging or fMRI), is expensive and may not be covered by insurance, it may provide a more accurate way to diagnose ADHD. As scientists explore more of the brain, ADHD may be thought of more as a disorder than a behavioral problem.
Dopamine pathways in the brain, which link the basal ganglia and frontal cortex, also appear to play a major role in ADHD. The National Institute of Mental Health has released the results of a major clinical trial focusing on ADHD that found that medication that boosts the level of dopamine in the brain is the most successful type of treatment.
Experts believe that at least some cases of ADHD may be inherited, and that it may involve both brain structures in the frontal lobe related to attention, impulse control, and executive functions, as well as neurotransmitters and subtle imbalances in brain chemistry. Other children may experience abnormal fetal development that affects the areas of the brain controlling attention and movement.
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