Attention-Deficit Hyperactive Disorder (ADHD)

ADHD affects both children and adults and can present with symptoms of inattention, hyperactivity, impulsivity—or a mix of all three. It’s not just about being "distracted" or "hyper"; ADHD can impact work, school, relationships, and daily functioning. The good news? There are effective ways to manage it.

Causes & Risk Factors

Biological Factors

  • Genetics: ADHD tends to run in families
  • Neurodevelopmental differences in brain structure/function
  • Low dopamine activity affecting reward and attention regulation

Prenatal & Birth Factors

  • Premature birth or low birth weight
  • Prenatal exposure to alcohol, tobacco, or drugs
  • Maternal stress or complications during pregnancy

Environmental Factors

  • Exposure to lead or other toxins early in life
  • Early trauma or neglect
  • Chaotic or overstimulating environments (may exacerbate symptoms—not cause them)

 

Common Symptoms


Hyperactivity

  • Fidgeting, squirming, or tapping
  • Inability to stay seated when expected
  • Talks excessively
  • Often "on the go" as if driven by a motor
  • Difficulty engaging in quiet activities

Impulsivity

  • Interrupts or intrudes on others
  • Has trouble waiting their turn
  • May blurt out answers before questions are completed
  • Acts without thinking about consequences

Note: ADHD can be predominantly inattentive, predominantly hyperactive-impulsive, or combined presentation.

Assessment


Clinical Interview

  • Gather detailed developmental, academic, and behavioral history
  • Discuss how symptoms present across multiple settings (home, school, work)
  • Assess functional impairment

Standardized Tools

  • Adult ADHD Self-Report Scale (ASRS v1.1)
  • Conners Rating Scales (parent, teacher, or self-report)
  • Vanderbilt Assessment Scales (commonly used for children)

Additional Considerations

  • Rule out other causes of attention issues (e.g., trauma, anxiety, sleep deprivation)
  • Include input from multiple sources (parent, teacher, employer, partner)
  • Assess for comorbidities (e.g., anxiety, depression, learning disabilities) 

Treatment

Medication

  • Stimulants (e.g., methylphenidate [Ritalin], amphetamine salts [Adderall]) – First-line treatment
  • Non-stimulants (e.g., atomoxetine, guanfacine, clonidine) – Helpful in certain cases or when stimulants are not tolerated
  • Short-acting vs. long-acting options tailored to daily routine

Therapy

  • Cognitive Behavioral Therapy (CBT) – Especially for adults with ADHD or co-occurring conditions
  • Parent training – Teaches behavioral management strategies
  • Skills coaching – Time management, organization, emotional regulation

Lifestyle & Supports

  • Set up consistent routines and reminders
  • Use planners, apps, and visual schedules
  • Exercise regularly (improves executive functioning)
  • Break tasks into smaller steps
  • Consider academic or workplace accommodations (504 plans, extended time, etc.)