Attention Deficit Disorder is a neurobiological developmental disability. It affects up to 5% of the school age population. No one knows exactly what causes it but scientists suggest that it is genetically transmitted in many cases and results from a chemical imbalance. Children with this disorder are deficient in certain neurotransmitters that help the brain regulate behavior. In addition, a landmark study showed that the rate at which the brain uses glucose, its main energy source, is lower in them than in subjects without the disorder.
There are three subtypes of this disorder depending on the main features – inattentiveness, impulsivities and hyperactivity, associated with it:
I. – Predominantly Inattentive Type: Here the examiner can see multiple symptoms of inattention with few, if any, of hyperactivity-impulsivity. Children of this subtype have little or no trouble sitting still or inhibiting behavior, but may be predominantly inattentive and, as a result, have great difficulty getting or staying focused on a task or activity.
Symptoms of Inattention:
- Often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities;
- Often has difficulty sustaining attention in tasks or play activities;
- 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 (not due to oppositional behavior or failure to understand instructions);
- Often has difficulty organizing tasks and activities;
- Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework);
- Often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools);
- Is often easily distracted by extraneous stimuli;
- Is often forgetful in daily activities.
II. – Predominantly Hyperactive-Impulsive Type. Here the examiner can see multiple symptoms of hyperactivity-impulsivity with few, if any, of inattention.Children of this subtype may be able to pay attention to a task but lose focus because they may be predominantly hyperactive-impulsive and, thus, have trouble controlling impulse and activity.
NB! It is important to note that hyperactivity and impulsivity are no longer considered as separate features – hyperactivity-impulsivity is taken as a pattern stemming from an overall difficulty in inhibiting behavior.
Symptoms of hyperactivity-impulsivity:
- Often fidgets with hands or feet or squirms in seat;
- Often leaves seat in classroom or in other situations in which remaining seated is expected;
- Often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feeling of restlessness);
- Often has difficulty playing or engaging in quiet leisure activities;
- Is often “on the go” or often act as if “driven by a motor”;
- Often talks excessively.
- Often blurts out answers before questions have been completed;
- Often has difficulty awaiting turn;
- Often interrupts or intrudes on others (e.g., butts into conversations or games).
III. – Combined Type: Here the examiner can see multiple symptoms of both inattention and hyperactivity-impulsivity.
NB! In addition to problems with inattention or hyperactivity-impulsivity, the disorder is often seen with associated features. Depending on the child’s age and developmental stage, parents and teachers may see low frustration tolerance, temper outburts, bossiness, difficulty in following rules, disorganization, social rejection, poor self-esteem, academic underachievement, and inadequate self-application .
OTHER ESSENTIAL DIAGNOSTIC FEATURES TO DEFINE ATTENTION-DEFICIT/HYPERACTIVITY DISORDER:
- Symptoms of inattention, hyperactivity, or impulsivity must persist for at least six months and be maladaptive and inconsistent with developmental levels. From time to time all children will be inattentive, impulsive and overly active. In case of ADD/ADHD these behaviors are the rule, not the exception.
- Evidence of clinically significant impairment is present in social, academic, or occupational functioning;
- Some of the symptoms causing impairment must be present before the age of 7 years;
- Some impairment from the symptoms is present in two or more settings (e.g., at school/work, and at home).
No simple test such as a blood test or urinanalysis exists to determine if a child has this disorder. Diagnosing AD/HD is complicated and much like putting together a puzzle. An accurate diagnosis requires an assessment conducted by a well-trained professional (usually a developmental pediatrician, child psychologist, child psychiatrist, or pediatric neurologist) who knows a lot not only about AD/HD but also about all other disorders that can have symptoms similar to those found in it. As for all developmental disorders, early diagnosis is crucial in order to provide the adequate early interventions for the child and prevent or, at least, minimize the negative long-term effect on their life.
GENERAL INFORMATION ABOUT DEVELOPMENTAL PROBLEMS
BONITATIS site does not intend to provide neither a comprehensive view on all developmental disorders, nor detailed information about every one of them. It does aim, though, at letting the public know about the newest and not widely known yet but very effective shared therapies and treatments for those disorders. Moreover, BONITATIS aspires to make them available to Bulgarian children.
WHY SHARED THERAPIES AND TREATMENTS?
It is no news that Autism, Attention Deficit Disorder/Attention Deficit and Hyperactivity Disorder (ADD/ADHD), Dyslexia and Dyspraxia considerably overlap. Approximately half of the dyslectic children are dyspraxic too and about 30% of children diagnosed with ADHD have dyslexia. Many autistic children are hyperactive and have dyspraxia and dyslexia. A good number of children, diagnosed earlier with ADHD, after a year or two, receive the diagnosis of autism.
No doubt, more research must be done, but there is enough evidence, by now, that almost all the children with the above-mentioned conditions share similar learning difficulties and at least two serious physical problems – digestive abnormalities and neuro-developmental delay. It is beyond the scope of BONITATIS to join the discussion whether the latter are part of the cause of the disorders or their co morbidities. The important thing to have in mind is that the children with all these disorders get better on an appropriate nutritional protocol and a specialized exercise program, aimed at overcoming the neuro-developmental delay. BONITATIS strongly supports the combination of both strategies as part of an even more holistic approach.