Neurodevelopmental disorder that affects the attentional, organisational and planning abilities, as well as decision-making and inhibition. It is usually diagnosed in kids between 5 and 11 years old, and it affects up until a 15% of them.
There are three types of attention deficit and hyperactivity disorder (ADHD):
- Attention deficit is predominant
- Hyperactivity - impulsivity is predominant
- A combination of both
The attention deficit variant is characterised by difficulty paying attention to detail, following instructions or finishing tasks, organising, planning or maintaining the order and losing necessary objects.
The hyperactivity-impulsivity deficit variant is characterised by the person's excessive movement, their difficulty to stay seated in one place, their need to be occupied all the time, excessively talking, answering ahead of time, doing impulsive actions and without thinking about them (crossing the street without looking) as they don't consider or assess the consequences.
The exact cause is unknown, but it tends to be present in members of the same family, so there is a genetic component attributed to it. There is evidence in the dysfunction of the dopamine and noradrenaline systems.
It is manifested as a triad: attention deficit, hyperactivity and impulsivity. These are kids that struggle to listen actively, be quiet and stay in their place in silence but, at the same time, can do impulsive actions such as crossing the street without looking as they don't consider the consequences.
They tend to not tolerate well their frustration and can present irritability. They can experience sleeping problems, such as resisting going to bed or, when waking up, not wanting to get up from the bed. In a physical examination, they can show clumsiness and not well coordinated movements.
The diagnosis is reached through a guided questioning and the collection of the person's history to assess developmental, educational and psychological aspects. In this guided questioning, questions related to the perinatal period are frequently asked. A neuropsychological assessment is also performed to evaluate the altered executive functions.
The treatment is based on psychological therapy so that the person learns how to balance their symptomatology, realistic goals and objectives are set, as well as improving in the emotional management aspect. It can be complemented with pharmacological treatment, typically stimulants (methylphenidate, dextroamphetamine) but useful non-stimulants (atomoxetine or selective norepinephrine reuptake inhibitors) also exist.
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- Barkley RA, Fischer M, Smallish L, Fletcher K. The persistence of attention-deficit/hyperactivity disorder into young adulthood as a function of reporting source and definition of disorder. J Abnorm Psychol 2002; 111:279.
