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James J. De Santis, Ph.D.
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What is Attention-Deficit/Hyperactivity Disorder?

Attention-Deficit/Hyperactivity Disorder, or "ADHD," is a condition composed
of one or both of two main elements--inattention and disinhibition.

1. Inattention

While people with ADHD can pay attention, they have difficulty sustaining
attention. They have difficulty focusing, holding attention continuously, and
selectively shifting the focus of attention. Often such individuals have
difficulty concentrating for long periods of time. They are easily distracted,
especially when engaged in tasks that require persistence or vigilance. It's
hard to just stay "tuned in."

Occasionally, people with ADHD actually may find that they sometimes
"hyperfocus," or get too absorbed in an activity, because they cannot
easily or flexibly control their attention.

2. Disinhibition

Inhibition is the ability to restrain our inner impulses. Conversely, behavioral
disinhibition is an "inability to stop." Disinhibition can appear in either or both
of two ways--hyperactivity and impulsivity.

Hyperactivity involves motor restlessness. Individuals with ADHD can
experience this as constantly being "on the go." They may have difficulty
sitting still in meetings, often fidgeting or talking excessively, or leaving
their seat frequently. They may have difficulty engaging in quiet activities.

Impulsivity involves an inability to stop and think before taking action. Such
an individual may frequently speak before editing their thoughts, even
interrupting sometimes. They may also experience impulsivity around
planning, spending, or other behaviors.

What Causes ADHD?

Not much is yet known about the cause of ADHD. The disorder may in part
be genetic and may have a neurological or biochemical basis. We do know
that it tends to run in families. It may also be influenced by environmental
factors, like stress.

ADHD always begins in childhood. ADHD occurs in about 3-5% of elementary
school children. It occurs in 3-5 times as many males as females.

While it can sometimes be identified as early as age 3, ADHD may not
always be identified early. The disorder may be overlooked, especially when
the primary symptom is inattention.

In the past, ADHD was first thought of as a disorder only of childhood. More
recently ADHD has been recognized as frequently continuing into
adolescence and adulthood for many sufferers.

The course of ADHD may vary. Some people will experience more inattention
than hyperactivity or vice versa. For 15-30% of children with ADHD, their
symptoms may disappear as they grow up.

However, as many as 50-65% of children with ADHD will continue to exhibit
some symptoms into adolescence or adulthood. Frequently, adults with
ADHD may find their childhood symptoms of disinhibition have decreased
while their symptoms of inattention continue to cause them problems.

Some Signs of ADHD

Whether in children or adults, ADHD can have an adverse impact on
effectiveness in school, work, or interpersonal relationships. We all may
experience some inattention, restlessness, or impulsivity at times; however,
people with ADHD experience these in excess of what most people the same
age do. Some signs of ADHD are the following:

People with ADHD report a kind of mental "fuzziness." They may experience
inconsistency in their ability to recall facts, which makes them seem
forgetful. For example, they may have to read a paragraph several times to
understand it.

Individuals with ADHD may have trouble staying organized. They may have
trouble forming plans on their own. They may have trouble adhering to
established procedures or rules.

Such individuals can have trouble getting from point A to point B. They may
struggle with starting new tasks and may appear to procrastinate. They
may start too many projects, get swamped, and have difficulty following
through on everything they started, so they end up completing very little.
They may inaccurately be labeled as "lazy."

They may tend to get bored easily or seem chronically impatient. They may
have little tolerance for frustration and find their attention drifting from
tasks that are familiar, repetitive, tedious, or uninteresting, instead
functioning better on tasks that are highly stimulating, exciting, or novel.

Even though they may possess high potential for success, their actual
school or work performance may be inconsistent--they may do well some
days and poorly other days. Overall, they may be underachieving in life as a
result.

When To Seek Help

Evaluation for ADHD is warranted when prominent symptoms of inattention,
hyperactivity, or impulsivity are interfering with effectiveness with school,
work, or interpersonal relationships.

How is ADHD Diagnosed?

ADHD should be diagnosed only by a qualified professional. An in-depth
investigation is generally necessary to diagnose ADHD; no single interview
or test will conclusively diagnose ADHD.

A thorough evaluation usually will include a clinical interview, a review of
personal history, consultation with your physician or therapist, and
completion of a short set of structured questionnaires and objective
psychological tests.

Evaluation should rule out other difficulties that can mimic the symptoms of
ADHD, such as clinical depression, anxiety disorders, learning disabilities,
memory impairment, understimulating or chaotic environments,
addiction-related disorders, or medical causes.

What Can Help?

Although no permanent "cure" has yet been found, ADHD is definitely a
condition that can be treated effectively. A comprehensive plan of
treatment may include a number of recommendations, such as:

Education about ADHD
Training in self-control methods
Organization and time-management techniques
Classroom or workplace modifications
ADHD coaching
EEG neurofeedback
Medication
Exercise
Psychological or family counseling
Communication with loved ones
ADHD support groups

How to Locate a Psychologist for Assessment

Locating a psychologist who is right for you involves making an informed
choice. Do not hesitate to ask a psychologist any questions you may have.
Ask about their professional education and training as well as professional
licensure and certifications. Ask how the psychologist conducts their
assessment and how it potentially would be beneficial for your particular
situation.

The most current and comprehensive directory of psychological testing
services provided in the metropolitan Los Angeles area by licensed
psychologists is maintained on this website.

Click here to view the Los Angeles Psychodiagnostic Assessment Directory.

Identifying Attention Problems