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  • Writer's pictureMelissa Paulsen, MA, LMFT, RPT-S

A Closer Look At: ADD / ADHD

"I prefer to distinguish ADD as attention abundance disorder. Everything is just so interesting… remarkably at the same time.”

— Frank Coppola

I can almost guarantee that you know someone with Attention-Deficit Disorder (ADD) or Attention-Deficit/Hyperactivity Disorder (ADHD), someone who has a kid with ADD or ADHD, or someone who takes medication for it…or all three. ADD & ADHD are commonly misdiagnosed and over-diagnosed because according to the American Psychiatric Association (APA) only about 5 percent of children and 2.5 percent of adults have ADD or ADHD. So do we really know what ADD and ADHD are or what the difference between the two is?

The short-answer is that ADD means the person has an extremely difficult time focusing or paying attention. ADHD means not only does the person have an extremely difficult time focusing but they also struggle with hyperactivity and impulsivity as well.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) lists the following symptoms for ADD & ADHD:

Criteria A) Inattention – 6+ of the following symptoms:

  1. Often fails to give close attention to details or makes careless mistakes.

  2. Often has difficulty paying attention to tasks or activities.

  3. Often does not seem to listen when spoken to directly.

  4. Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (starts a task but loses focus or is easily sidetracked).

  5. Often has difficulty organizing tasks and activities.

  6. Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort.

  7. Often loses things necessary for tasks or activities.

  8. Is often easily distracted by extraneous stimuli.

  9. Is often forgetful in daily activities.

Criteria B) Hyperactivity & Impulsivity – 6+ of the following symptoms:

  1. Often fidgets with or taps hands or feet or squirms in seat.

  2. Often leaves seat in situations when remaining seated is expected.

  3. Often runs about or climbs in situations when it is inappropriate.

  4. Often unable to play or engage in leisure activities quietly.

  5. Often “on the go” or acting as if “driven by a motor.”

  6. Often talks excessively.

  7. Often blurts out answers (completes people’s sentences, cannot wait for turn in conversation).

  8. Often has difficulty waiting his or her turn.

  9. Often interrupts or intrudes on others (butts into conversations, games, or activities).

These symptoms can look very different in children vs. adults. If Criteria A is met without Criteria B, this may qualify for ADD. If Criteria B only or A & B both are met this may qualify for ADHD. These symptoms should occur before age 12 and they should occur in more than one place (i.e. at home and at school). Typical age at onset is 7. There should be clear evidence that these symptoms cause impairment in functioning. These symptoms should not be better explained by another mental health disorder like mood disorder, anxiety disorder, oppositional defiant disorder, or substance intoxication or withdrawal. ADHD is twice as likely in boys than in girls while girls are more likely to deal with inattention than boys.

Treatment for ADD & ADHD may include medication, therapy, education and training, or a combination. While a pill seems like a quick fix for this problem, it can have side effects just like any other medication can. Therapy can help you and your child to understand ADD or ADHD better and teach you techniques for handling these behaviors more effectively. Teaching kids how to monitor his or her behavior can be helpful as can learning how to give praise for desired responses. Having clear rules, chore lists, and a structured routine can also be helpful. In therapy, your child may also learn and practice social skills such as how to wait their turn or how to ask for a toy instead of taking it. They may also learn how to identify feelings, express their feelings, and recognize other people’s feelings by reading their facial expressions and tone of voice. Your therapist may make a referral if they feel medication might be helpful in conjunction with therapy. Talk to your doctor to see if medication is right for your child.

If you think your child has several of the symptoms listed above and you would like to work on addressing these issues, please give me a call!

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