Therapy session with child and mother

Attention Deficit Hyperactivity Disorder (ADHD) is a common, yet complicated behavioral disorder that affects millions of children and adults in the U.S. and around the world, according to the Centers for Disease Control and Prevention.

Ara Anspikian, MD, who serves as the medical director for the Youth Partial Hospitalization Programs at Loma Linda University Behavioral Medicine Center provides answers to some of the most common questions surrounding the disorder:

What is ADHD?

ADHD stands for Attention Deficit Hyperactivity Disorder. It is a neurodevelopmental disorder, meaning it is considered a “disturbance” in the nervous system. This disruption in the nervous system can cause chronic and pervasive difficulties in three areas: inattention, hyperactivity and impulsivity.

To be considered ADHD, some of these difficulties must begin in childhood and be present in two or more settings — such as in school and at home — and be present for at least six months. To be diagnosed with this disorder, the symptoms must have a negative impact on your child’s life and functioning. ADHD typically begins in childhood and continues into adolescence and adulthood.

What is the difference between ADD and ADHD?

ADD is a previously used diagnostic term, which is now referred to as ADHD “with a predominately inattentive presentation.” ADHD is now specified by three different presentations:

  • Predominately Inattentive is specified when a person demonstrates more symptoms of inattention.
  • Predominately Hyperactive/Impulsive is specified when a person shows more symptoms of hyperactivity and impulsivity.
  • Combined presentation is specified when a child presents with both symptoms of inattention and hyperactivity/impulsivity.

What causes ADHD?

ADHD is usually due to a combination of biological or hereditary factors and environmental or life experiences. Brain-imaging studies have found structural and wiring differences in the brain between children with ADHD and typically developing children. This difference in wiring is sometimes hereditary and often runs in families.

Other factors that might be considered as potential causes include, exposure to toxins during critical periods of in-utero development, maternal tobacco use, premature birth or low birth weight and brain injury.

What are the positive and negative qualities associated with ADHD?

People with ADHD often have high levels of energy and vibrant personalities. Individuals with ADHD are often full of ingenuity, creativity, imagination and spontaneity. Additionally, individuals with ADHD often provide a unique perspective with their ability to ‘think outside the box.’

There are also some struggles that people with the diagnosis may face, such as having difficulty in school and academic performances, social relationships or daily routines. Imagine your mind as a race car, but with the breaks of a bicycle. Symptoms of ADHD can make it difficult for people to inhibit responses or consider the consequences of actions in the moment. This presents a challenge for skills needed to organize or plan ahead.

ADHD is often stigmatized and misunderstood, so negative labels are often given to individuals struggling with this diagnosis. Unfortunately, the positive attributes often go unmentioned.

What do you find to be the most impactful element of successful treatment/management?

Early intervention is essential to achieving the most positive treatment outcomes. The sooner children with ADHD and their families are able to receive treatment and support, the more impactful treatment will be. A medication evaluation, which can be done by a variety of health professionals, should be included as part of a thorough assessment because medication has shown significant benefit to the treatment of ADHD symptomology. Children with ADHD also benefit more when receiving support in their different environments.

What does ADHD look like in adults vs. children?

ADHD affects individuals across the lifespan. For many years, ADHD was thought of only as a children's condition, but recent data shows that about one-third of children with ADHD continue to meet the criteria for an ADHD diagnosis as adults.

Many people may only learn they have ADHD in adulthood or find out after their children receive the diagnosis. Adults with ADHD often have significant problems with their work, difficulty with organizing items or paying bills on time, difficulty with maintaining relationships and poor regulation of emotions.

According to CHADD (Children and Adults with Attention-Deficit/Hyperactivity Disorder, a national non-profit organization in support of people with ADHD), ADHD affects between 3-7 percent of school-aged children and between 2-4 percent of adults.

What type of specialists should someone see for diagnosis and treatment of ADHD?

A pediatrician, pediatric neurologist or child psychiatrist can provide a diagnosis of ADHD, assist families with medication management and provide referrals for therapeutic intervention.

However, it is not uncommon for more than one professional to assess and treat a child for ADHD symptoms. Clinical and school psychologists, clinical therapists, speech-language pathologists, learning specialists and educators may each play an important role in the evaluation and treatment of ADHD.

Evaluation and treatment of ADHD should be considered when the problems caused by ADHD are impacting you or your loved one’s ability to function at home, work, school, in extracurricular activities or in relationships.

If ADHD is causing suffering in your life, or the life of someone you care about, visit our behavioral health services website and learn more about how Loma Linda University Behavioral Medicine Center can help. Request information on an ADHD diagnosis or treatments, or any behavioral health concerns, and one of our intake coordinators will contact you.