Why attention deficit disorder with or without hyperactivity?
ADHD comes in many forms. Some children suffer primarily from attention deficit disorder, while others are morehyperactive and impulsive.
Behavior in children
For children with ADHD, this disorder can lead to learning difficulties at school, disrupt family harmony at home and cause rejection by their peers.
These attention and hyperactivity problems can also lead your child to devalue himself or herself and develop low self-esteem.
Adolescent behavior
In adolescence, hyperactivity often disappears, giving way to behavior that appears calmer (nonchalant, in fact), but often remains impulsive.
In addition, he is often disorganized, impulsive in his reactions, excessive in his actions, and appears immature in his judgment.
Teenagers with untreated ADHD are at greater risk of dropping out of school, alcohol and drug abuse, car accidents and unwanted pregnancies.
Resources on ADHD with or without hyperactivity
Consultez "Le TDAH - texte de vulgarisation" sur le site de l'Association Québécoise des Neuropsychologues. Un article rédigé par le Dr Hammarrenger, Neuropsychologue et Directeur Général du CERC.</p></div></div>
Pour toutes les réponses à vos questions sur le TDAH, procurez-vous le livre «10 Questions sur le TDAH chez l’enfant et l’adolescent», écrit par notre directeur, Dr Benoît Hammarrenger, neuropsychologue.
What treatments and medications are available for ADHD?
Before you consider administering medication (Ritalin, Concerta, etc.) to a child showing signs of ADHD, make sure you have the right diagnosis.
For children, adolescents and adults alike, there are several pharmacological treatments available for ADHD with or without hyperactivity. In addition, they help improve attention and the efficiency of the brain's filter.
This filter helps inhibit hyperactive and impulsive behavior. Although the neuropsychologist cannot prescribe medication, his or her report enables the doctor to better develop the treatment plan.
In Laval, CERC collaborates with general practitioner Dr. Anne-Marie Landry for prescriptions and follow-ups in ADHD and mental health.
You may have heard of Ritalin, but many alternatives exist to minimize side effects and optimize therapeutic efficacy. Medications are divided into three categories:
- Methylphenidate-based medicines (Ritalin, Concerta, Biphentin, Foquest)
- Amphetamine-based medicines (Adderall, Vyvanse, Dexedrine)
- Non-stimulant drugs (Strattera, Intuniv)
The importance of a proper diagnosis for Attention Deficit Hyperactivity Disorder (ADHD)
Before you consider administering medication (Ritalin, Concerta, etc.) to a child showing signs of ADHD, make sure you have the right diagnosis.
Attention difficulties in the classroom may, in fact, be caused by an emotional disturbance, such as an anxious, preoccupied or sad child.
On the other hand, organizational problems can be linked to other syndromes, such as VDS. In addition, hyperactivity may be part of a picture of Gilles-de-la-Tourette syndrome, or even appear as part of an oppositional disorder.
Sometimes, a child with an early-onset language delay will still have problems with oral comprehension. Receptive language disorder makes the child seem inattentive, when in fact he can't make sense of the teacher's complex sentences and explanations.
A comprehensive neuropsychological evaluation will not only determine whether or not inattention and/or hyperactivity are present, but also the cause of these difficulties, so that the appropriate intervention can be applied.
In addition, this assessment helps avoid false ADHDs who are prescribed medication.
To find outmore about medication to treat ADHD, click here.
6 rules to follow to ensure a proper diagnosis of ADD/ADHD:
Unfortunately, false diagnoses are regularly made as a result of overly cursory and incomplete assessments.
To give you confidence in your diagnosis, here are the 7 golden rules that should be followed during any ADHD evaluation:
- A history with the parents: Parents must be interviewed in order to build a complete developmental history of the child with the professional in charge
This developmental history must also be taken during an adult assessment. This part of the process usually takes around 45 minutes.
- Questionnaires for parents and teachers: Beware, these questionnaires are essential, but a diagnosis of ADHD should NEVER be based solely on the results of these questionnaires.
Symptom questionnaires are frequently used and enable the professional to understand what the manifestations are in everyday life.
- Attention tests : In order to properly assess a child's attention and make appropriate recommendations, it is useful to administer specific tests.
- Tests measuring other cognitive abilities: These are used to make a differential diagnosis. This helps determine whether attention difficulties might be better explained by a language or learning disorder, for example.
Neuropsychological tests provide a complete cognitive profile of the child, not just an attentional profile.
- A psycho-affective investigation : A child suffering from emotional disturbances, such as anxiety or sadness, will also be inattentive in class. However, this does not mean that he has ADHD, as treating sadness or anxiety can solve attention problems.
Conversely, treating these children with ADHD medication may increase anxiety or sadness as a side effect.
Because of this, it's important that the professional in charge of your child is also able to investigate the affective and emotional aspects.
- One or two long evaluation session(s): In short, one-hour sessions, the child's attention can easily be mobilized. Under these conditions, it is more difficult for a professional to detect potential deficit disorders.
For this reason, a long session, reproducing the attention required during a school day or half-day, enables us to better observe the child's attentional fluctuations during prolonged periods of cognitive effort.
Read also: Dr Benoit Hammarrenger, Director of CERC, speaks out in the media about false ADHD diagnoses:
"Rentre dans le rang" (La Presse)"
"Le grand nombre de faux diagnostics de trouble de déficit d'attention" (Le Devoir)
Symptoms of Attention Deficit and Hyperactivity Disorder
Inattention (DSM 5, 2013)
- Fails to pay attention to detail, makes careless mistakes;
- Has difficulty sustaining attention at work or play;
- Often doesn't seem to listen when spoken to;
- Does not follow instructions and fails to complete tasks;
- Has trouble getting organized;
- Avoids or dislikes tasks requiring sustained mental effort;
- Loses his objects;
- Easily distracted by external stimuli;
- Has frequent forgetfulness.
Hyperactivity/impulsivity (DSM 5, 2013)
- Moves on his seat, often stirs.
- Stands up in situations where he must remain seated.
- Runs or climbs everywhere (for teenagers or adults: feeling of motor impatience).
- Has trouble keeping still.
- Often talks too much.
- Often on the edge or acting as if "on springs".
- Answers questions before they're finished.
- Has difficulty waiting his turn.
- Often interrupts others or imposes his presence.