Attention-Deficit/Hyperactivity Disorder (ADHD)
What Is ADHD?
ADHD manifests as ongoing problems with attention, hyperactivity, and impulsive behavior that are inconsistent with developmental level and impair daily functioning. The Centers for Disease Control and Prevention’s ADHD Facts note that the condition begins in childhood but can persist into adulthood.
Signs and Symptoms
ADHD symptoms typically fall into three presentations:
| Presentation | Examples |
|---|---|
| Inattentive | Difficulty sustaining attention, disorganization, forgetfulness, easily distracted |
| Hyperactive-Impulsive | Fidgeting, can’t stay seated, excessive talking, blurting out answers, impatience |
| Combined | Symptoms from both inattentive and hyperactive-impulsive domains |
Children and adults may struggle with completing tasks, following instructions, waiting turns, and maintaining relationships.
What Causes ADHD?
ADHD is believed to arise from a combination of factors, including:
Genetic Influences: Family studies suggest heritability rates of up to 74%.
Brain Structure and Function: Altered activity in areas of the brain governing attention, impulse control, and inhibition.
Prenatal & Environmental Risks: Premature birth, low birth weight, prenatal exposure to tobacco or alcohol, and early adversity.
Neurochemical Imbalances: Involving dopamine and norepinephrine pathways critical for executive functioning.
For a detailed overview, read the National Institute of Mental Health’s What is ADHD?.
How Is ADHD Diagnosed?
Dr. Budhwar conducts:
Clinical Interview: Detailed developmental, academic, and behavioral history from multiple sources.
Standardized Rating Scales: Parent, teacher, or self-reports (e.g., Conners’ Rating Scales, ADHD Rating Scale).
DSM-5 Criteria: Symptoms present before age 12, in more than one setting (home, school, work), and interfere with functioning.
Screening for Comorbidities: Such as learning disabilities, anxiety, or mood disorders.
Treatment Options
A tailored, multi-modal approach yields the best results:
1. Behavioral Therapies
Parent Training and Behavioral Management: For young children, coaching caregivers in reinforcement, structure, and clear expectations.
Classroom Interventions: Routine, break large tasks down, reminders, and organizational supports for students.
Cognitive Behavioral Therapy (CBT): Especially for older children, teens, and adults to build organizational, planning, and coping skills.
2. Medications
Stimulant Medications: Methylphenidate and amphetamine derivatives, highly effective for most with proper monitoring.
Non-Stimulants: Atomoxetine, guanfacine, and clonidine for those who do not tolerate stimulants or have coexisting conditions.
Dosing and Monitoring: Start with low doses, titrate gradually, and monitor for side-effects and effectiveness.
Refer to the American Academy of Pediatrics’ ADHD Clinical Practice Guidelines for more information.
3. Educational and Social Support
Individualized Education Programs (IEP): Accommodations in school or college to support attention and organizational skills.
Social Skills Training: Helps with peer relationships and conflict resolution.
Self-Help Strategies
Establish a structured daily routine with consistent meals, sleep, and activity times.
Use visual planners, checklists, and reminders for organization.
Break large tasks into manageable steps and reward goal completion.
Practice mindful breathing and relaxation to manage impulsive reactions.
Engage in regular physical activity to improve focus and emotional regulation.
Seek support from family, teachers, or support groups for encouragement and accountability.
For practical tips and resources, visit Understood’s ADHD Resource Center.
When and How to Seek Help
If you or your child exhibit persistent inattention, hyperactivity, or impulsivity that interfere with daily life, consult Dr. Budhwar:
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ADHD is manageable. With a comprehensive treatment plan and proactive support, patients can harness their strengths, improve concentration, and build satisfying, productive lives.