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ADHD

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Attention Deficit Hyperactivity Disorder

Or ADHD, is a condition in which a person has significant problems with not being able to focus or pay attention, being overactive, and being unable to control impulsive behavior. These three problems can exist in varying combinations and with different degrees of severity. There are three sub-types of the condition: predominantly inattentive; predominantly hyperactive-impulsive; and combined inattentive and hyperactive-impulsive.

ADHD Typically Starts in Childhood

At age 7 on average, and can extend into adolescence and adulthood. As many as 50% of adults with ADHD had it when they were children. According to the National Library of Medicine, ADHD is the most frequently diagnosed behavioral disorder in children. Boys are diagnosed with it much more often than girls and are four times more at risk. While most if not all kids display symptoms of ADHD at times, in order for a child to be diagnosed with the disorder the symptoms must be out of the range of what would be considered normal for someone of the child’s age and developmental level.

The behaviors exhibited by those with ADHD can significantly impair their daily activities, affecting schoolwork, work duties, and social interactions. People with ADHD frequently do poorly in school or employment and have problems with relationships. Obviously, the condition can be frustrating not only for the affected person but for those around him or her. With children who have ADHD, discipline is often an issue for both teachers and parents.

What Causes ADHD is Unknown

but most likely it is a combination of both genetic and environmental factors. Studies involving brain imaging indicate that the brains of children with ADHD may be different than the brains of those without it.

Here are some of the major symptoms in the three different categories of ADHD:

Inattentiveness

  • Does not pay close attention to details and/or tends to make careless errors in schoolwork or workplace duties
  • Seems not to listen when being spoken to directly
  • Has trouble staying on task, following through with instructions, and completing schoolwork, chores, or other tasks
  • Forgetful in terms of daily activities
  • Has disorganized work habits
  • Often loses needed items like school assignments, books, pencils, and tools
  • Easily gets distracted by irrelevant sounds or other stimuli that other people ignore
  • Frequently shifts from one task or activity to another without completing them
  • Avoids or doesn’t want to do things that require a lot of sustained mental effort, such as studying
  • Makes frequent shifts in conversation, doesn’t pay attention to what other people are saying

Hyperactivity

  • Fidgets and squirms in their seat
  • Leaves their seat when they are expected to stay seated
  • Talks excessively or nonstop
  • Constantly moving around or “on the go”
  • Runs around, climbs on things, touches and plays with everything
  • Has problems doing quiet play or work activities

Impulsivity

  • Often impatient
  • Blurts out inappropriate comments, gives answers before questions are completed, shows emotions without restraint
  • Interrupts other people’s conversations or intrudes on their activities
  • Has a hard time waiting their turn for things

There is a Computerized Neuropsychological evaluation known as Qb Test, that can be used as an adjunct in Diagnosis and Treatment of ADHD.

QbTest (K040894) was cleared by the FDA in 2004 to aid in the clinical assessment of ADHD in children aged 6-12 years old. An updated version of QbTest (K122149) was cleared October 17, 2012 and expanded the indication for use to include the clinical assessment of ADHD In adolescents and adults (aged 12-60). In April 2014, QbTest was cleared to aid in the treatment interventions and follow up for ages 6-60. Cleared as a Class II device by the FDA, QbTest has demonstrated strong and sufficient evidence for positively identify an ADHD individual from the non ADHD cohort as well as identifying individuals as not having ADHD. In short, the testing with interpretation by a trained professional has a very high sensitivity and specificity and strong balance between the two.

QbTest is today the only ADHD test that is cleared and registered by regulatory authorities in both the US as well as in Europe. More than 170,000 patients in 10 countries have performed a QbTest as a part of their assessment and/or treatment evaluation.

Benefits of using QbTest

At the present, ADHD is primarily identified on the basis of self-reports, parent, teacher and clinician ratings of the presence or absence of a list of symptoms and judgments about functional impairment1. Behavioral ratings are problematic because they are subjective in nature with potential biases and individual inconsistency in perceived meaning of items. This results in poor inter-rater reliability, with parents generally less accurate than teachers when compared to objective test

QbTest has high clinical validity and has shown significant results in several publications and audit studies (see Clinical Documentation included). The test also has several other initial advantages:

  1. The test is time efficient for the patient and the data is available to the physician in real time allowing for diagnosis and treatment to begin on the same day. Getting the diagnosis right at the beginning leads to fewer visits for evaluation
  2. The test is non-invasive and non-language based. It is designed to reduce the impact of confounding factors, such as problems differentiating from left to right, dyslexia and underlying anxiety. Patients with dyslexia and anxiety are commonly misdiagnosed as having ADHD because there is significant symptom overlap. To confound the issue further, both dyslexia and anxiety are common ADHD comorbidities, existing side by side with the neurology of ADHD.

1 Taylor, E., DOpfner, M.,Sergent, J.,Asherson, P.,Banaschewski, T.,Buitelaar,J.,Coghill,D.,Danckaerts,M.,Rothenberger,A.,Sonuga-Barke,E.,Steinhausen,H.,&Zuddas,A. (2004).European clinical guidelines for hyperkinetic disorder – first upgrade. Eurpean Child & Adolecent Psychiatry, 13(suppl 1), 17-130

There Are a Variety of Treatment Options Available

These can involve medications, behavioral therapy, or a combination of the two.

The use of medications depends on the severity of the condition. Many people have heard of some of the common medications prescribed for ADHD, such as Ritalin and Adderall. These and other medications have proven effective in reducing symptoms in many cases, especially with children. But they can also be of limited effectiveness over the long term, and in the case of children there is some concern that treating ADHD with medication is simply stopping undesirable behaviors as a way for parents and teachers to deal with a frustrating situation. It’s important to remember that medications don’t cure the condition, they only treat the symptoms; if you stop the medication, the symptoms return.

For this reason, a combination of medication and therapy is usually the best course of action for treating ADHD in a more complete and long-lasting way. We can bring problematic symptoms under control with one or more medications, which then allows the individual to focus on and make progress in behavioral therapy. When the patient is a child, such therapy often involves the cooperation of the parents as well.

Behavioral Therapy Can Help in Many Ways

In addition to helping both children and parents understand the stressful emotions that come with ADHD and gain control over them, therapy can help an individual manage disruptive behaviors and develop organizational skills, study techniques, and improved functioning in social situations.

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