Learn more about ADHD
What exactly is ADHD?
for Attention Deficit Hyperactivity Disorder. That basically means a person has
significant problems in paying attention, organizing their time and their
things to the point it is causing significant problems in their life. Also,
this can come with hyperactivity or impulsivity which also causes problems in
the person’s life.
some of the diagnostic criteria (from the DSM 5):
For inattention (difficulty
Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or during other activities. (e.g., overlooks or misses details, work is inaccurate)
- Often has difficulty sustaining attention in tasks or play activities (e.g., has difficulty remaining focused during lectures or lengthy reading)
- Often does not seem to listen when spoken to directly
- Often does not follow through on instructions and fails to finish schoolwork, chores or duties in the workplace (starts tasks but quickly loses focus and is easily sidetracked.)
- Often has difficulty organizing tasks and activities (difficulty in managing sequential tasks; difficulty keeping materials and belongings in order; messy disorganized work; has poor time management; fails to meet deadlines)
- Often avoids or dislikes, or is reluctant to engage in tasks that require sustained mental effort. (This includes schoolwork, reviewing lengthy papers, preparing reports)
- Often loses things necessary for tasks or activities such as school materials, wallets, keys, paperwork or mobile phones.)
- Is often forgetful in daily activities (chores, errands, returning calls, paying bills or keeping appointments.)
fidgets or taps hands or squirms in seat
- Will leave
seat in situations when remaining in seat is expected
- Unable to
play or engage in leisure activities quietly
- Acts as
driven by a motor
- Blurts out
answers or interrupts others
This criteria sounds like everybody
or every kid! If this is the case, shouldn’t everybody be diagnosed with ADHD?
This is why I conduct a
thorough interview. When I do the interview, I’m looking for the last ‘D’ in
Disorder. All of the above symptoms sound somewhat commonplace. Who actually likes to do a boring task? The
interview helps me to know if the person has these symptoms to the point it is
causing a significant impairment in their life and these are not just
personality quirks or even being normal.
What is the difference between ADHD and ADD?
According to the text
book, there really isn’t a difference. ADHD stands for Attention Deficit
Hyperactivity Disorder. A person can be diagnosed with ADHD, but not have
symptoms of hyperactivity or impulsivity. This is called Attention Deficit
Hyperactivity Disorder, Predominantly inattentive presentation per the Diagnostic
Statistical Manual Fifth Edition (DMS 5).
Adult ADHD, is there such a thing?
While there is no such
thing as adult onset ADHD, adults CAN have ADHD. Adults who have ADHD were kids
who had ADHD. A lot of the adults I’ve worked with and tested realized they
might have ADHD after their child/children were tested and diagnosed with ADHD.
When they’re telling the health care professional about the child’s symptoms,
they start to recognize a lot of their child’s symptoms as the same as what
they were going through when they were in school. Being ADHD is a brain
disorder and a phenomenon related to neuro transmitters, this doesn’t
necessarily change for an adult.
Is ADHD over diagnosed?
I used to say that ADHD is
both over diagnosed and under diagnosed.
I thought it was under
diagnosed because there are so many people out there struggling with attention
span and focus issues who are unaware or just too stubborn to get tested and
treated for ADHD.
I thought it was over diagnosed because
too many people were being prescribed medication and diagnosed with ADHD
without any formal testing or the testing methods were shoddy. Now the
percentage of school aged children on medication for ADHD is astronomical. This
is medication that has a street value and is considered a narcotic. When it
comes to children and adults, I can’t emphasize enough that proper testing is
extremely important. I’ve heard (second hand) some physicians saying, “oh you
sound just like my kid who has ADHD, you let me prescribe you some Adderal and
see how you feel.” In my mind that is quintessentially the problem and now
there is loads of Adderal for sale on the street level. This is not we need as
What is the test for ADHD?
There is no single test
for ADHD, but there are many tests for ADHD. Some of the testing includes
checklists which are subjective (based on opinions) and other testing uses more
“objective” measures. Objective measurement is when it can be the observation
can be measured and recorded. For instance, how fast a car goes, is an
objective measure. Calling it “fast,” is a subjective measure. Saying it’s top
speed is 120, is an objective measure. Saying it’s fast because it has a racing
stripe is a subjective measure.
Some physicians simply use
forms called the “Vanderbilt’s” which is a checklist for teachers and parents
to complete and this is a subjective measurement. Even worse than that, some
clinicians or pediatricians just diagnose the disorder without using any form
Fortunately, this is not
happening as frequently as the Drug Enforcement Agency and other government
agencies are cracking down on the amount of stimulant medications that are
being prescribed by physicians and actually expect the doctors to do some
testing prior to diagnosing and medicating the person.
How do you evaluate for ADHD?
In evaluating for ADHD, I
do a three part process. The first part is the interview. This is where I can
get information from the parents or the adult to find out where and what are
the problems in functioning. I can also try to disseminate if the problems are
related to a life stressor, anxiety, depression or some other situation which
may or may not be related to ADHD.
The second part is the
testing. I utilize two testing measurements. The first form of testing is the
TOVA. That is the Test OF Variables of Attention. This test is a continuous
performance test. It helps me to determine if the individual has a problem in processing
visual data. Also, it has a “symptom exaggeration index.” This can help me to
determine if someone is faking their symptoms.
The other form of
objective testing I use is the brief IQ test. With the brief IQ test, I can
compare and contrast subtest scores to see if the person has deficits in areas
that are usually correlated with ADHD.
The third part of the
evaluation is the results. I like to go over the results with my test takers
for several reasons. One is the test might give me more questions than answers.
This allows for me to go over some of the questions I might have about why they
performed the way they did. If my test takers score what I call a ‘slam dunk,’
in that their scores were well in the ADHD range. This gives me the opportunity
to explain their scores, the testing process and how to best treat their ADHD.
When a person finds out that they have ADHD, generally, there’s a lot of
questions (many of the m answered here) such as what will the doctor prescribe
me? are their side affects? Are there other options besides medications? What
does having ADHD mean for me and/or my family?
I also want to work with my client to find solutions to the problems that don’t
involve medications. This could include working with their school, employer or
even through coaching or therapy to find solutions to minimize the symptoms.
Can people grow out of ADHD?
functionally, Yes. Biologically and neurologically, No.
When people who were
diagnosed with ADHD graduate from high school, go to a technical school or find
themselves in a job more suited to their needs and strengths, they will
mistakenly believe “I’ve grown out of ADHD.” The reality is, they’re no longer
in a ‘chalk and talk’ setting as opposed to a hands on learning facility or a
career that is more stimulating to their interests. Also, sometimes people are
finding that when they have been treated for ADHD, some of the habits and
routines have been setting in and they no longer need the external help
(Medications/coaching/therapy.) So functionally, they no longer have the last
‘D’ (which is disorder, if you remember) of ADHD.
Can medications for ADHD be abused?
YES! Many of the
medications are psycho stimulants. This means they’re related to speed or
amphetamine based drugs. These types of drugs range from coffee to cocaine. Psycho
stimulant medication is considered a narcotic by DEA standards and there is a
street value to them. They are abused by people seeking a speed high and by
college students who buy it street level in hopes of it enhancing their test
Do these medications have side effects?
Yes. For the most part,
they’re safe, but every prescription medication has side effects. As with most
stimulants (caffeine, amphetamines ect..) there’s an appetite suppressant. When
the appetite is suppressed from a younger child, there’s a potential this child
will not grow to his or her full potential. That’s the number one side effect
I’d be concerned about if I was facing the possibility of placing my child on
medications. Other side effects that I’ve heard about include: dry mouth, headaches,
agitation and increased anxiety. This is not a full list of all side effects.
With any medication, I would encourage people to ask their doctors and in this
day and age of the internet, look up as much information as possible.
Are there neurotransmitters associated with ADHD?
These are Dopamine and Norepinephrine. These two
neurotransmitters are associated with ability to maintain attention and be able
to be stimulated. To the best of my
understanding, Dopamine is what helps us stay stimulated and Norepinephrine
helps us to stay focused.
What kind of help is available to people with ADHD?
For people with ADHD, help
comes in many forms. The one I’m crazy about is therapy and coaching. This
helps people with ADHD change some of their habits and add external cues to
their life to help them be more productive and efficient. The therapy and
coaching is tailored to the person’s needs. It uses their strengths to help
compensate for their weaknesses.
At school, 504 plans and
IEP’s or just a little help from the teacher can be available to help kids
better learn their material. Sometimes this means having tests verbally read to
the student, or being able to record lectures and/or having lecture notes made
available to the student. This could also mean being able to take tests in a
secluded environment, away from other distractions.
Medication therapy is also
a popular way to control symptoms (too popular, if you ask me.)
What is ADHD Coaching? How does it differ from
The coaching process is
more intensive and involved. With Coaching, me as your coach, I will work with
you in your home or at your work. I partner with my client on creating a more
efficient environment at home and/or work. If it’s a student, grade school thru
high school, I work with parents to help decrease the drama and increase the
productivity. I help to create
external cues for reminders and utilize the tools available within the school
What kind of medications are used to treat ADHD?
Popular medications for
ADHD include (but aren’t limited to): Adderal, Vyvanse, Ritalin, Concerta,
Stratera and Focalin. These medications (with the exception of Stratera) are
all psycho-stimulants. That means they are in the speed family. Just like
Caffeine (as in coffee and tea), nicotine, methamphetamine and cocaine. Unlike
the last two illegal drugs mentioned, if prescribed by a responsible physician,
these drugs have been immensely helpful in controlling the symptoms of ADHD.
Unlike caffeine and tea, the milligrams of the active ingredient are known,
controlled and are of pharmaceutical quality, not to mention FDA regulated. And
unlike cocaine and methamphetamine, the drugs are legal with a prescription and
come from a pharmacy, not from a drug dealer.
How do the drugs work?
From what is known, is
they stimulate the production of two neurotransmitters dopamine and Norepinephrine.
What is hyper focus?
Hyper focus is when a
person loses track of time and everything around him or her while they are 100%
focused on what they’re doing. For kids, this could mean video games and for
others, this could be a variety of activities, ranging from exercise to sewing.
In the ADHD realm, it’s often referred to in the aspect of dysfunction, more
like the video games that were supposed to last for 10 minutes that went on for
3 hours. But sometimes it’s a good thing, like when a person is very focused on
Do people with ADHD forget a lot of things?
Short term memory is often
impaired by ADHD. So it’s typical for someone with ADHD to forget where they
put their keys. And forgetting such items is a big cause in disorganization.
Does heredity play a part in ADHD?
In my evaluations, I
always ask if there’s someone in the family who’s been diagnosed with ADHD. If
that answer is ‘no’ I then ask if anyone in the family is suspected of having
ADHD symptoms. So to answer that question, YES. Being ADHD is a brain
phenomenon, this means there’s a genetic component to it.
What about people who use ADHD as an excuse?
If you think about it,
anyone can use anything as an excuse. I believe there’s a difference between an
excuse and a valid reason. In a class room setting, if a child with ADHD can
reach their capabilities if a test is read orally, that doesn’t sound like an
excuse. Say for example, an ADHD husband says to his wife, “I forgot your anniversary
because I have ADHD.” I think that sounds like an excuse, and a not a very good
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