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ADHD 101: The Basics and Beyond

ADHD 101: The Basics of ADHD and Beyond

By David A. Morris, LCSW

You’ll often see this definition provided by researchers and doctors for ADHD – “Attention-deficit/hyperactivity disorder is a neurobehavioral disorder characterized by a combination of inattentiveness, distractibility, hyperactivity, and impulsivity.”

What does that mean in our everyday life or for our kids? It means every little thing that most people tune out becomes very interesting to someone with the symptoms of ADHD. It means you can remember a memory from a year ago but can’t recall what you just studied the night before. It means sitting down for an extended period is more akin to a punishment then a chance to relax.

More and more children (up to 7%) and adults are being diagnosed with ADHD or Attention Deficit Hyperactivity Disorder. Is it a true developmental disorder or a naturally occurring set of behaviors that our new system and culture does not tolerate? This blog/article is not meant to challenge those tough questions but to provide you information that is currently available.

How do they measure ADHD?

It is measured by:

  • Lack of Impulse Control – verbal and physical acting without thinking
  • Increase in Hyperactivity – disregard for future, cannot defer gratification
  • Decrease in Attention – distracted, low attention span, not alert

Which part of the brain does it impact?

ADHD brain scan

Reduced frontal lobe ADHD brain activity

When they scan the brain, it appears there’s a lack of electronic impulses in the frontal lobe. Notice in the scans to the right, the control group participating in a typical frontal lobe activity (e.g. short term memory, focusing, retelling a story, etc.) has a  lot of activity (notice the “i” shaped features signaling brain activity in frontal lobe). But when the person whom has symptoms of ADHD is given the same task, the frontal lobe activity is much less and seems to be shifting the function to a temporal lobe. This could be a problem for that person because the frontal lobe is our game controller. It operates our executive functioning.

What are our Executive Functions?

That’s a good question because it is not something people typically have conversations about. Our current executive functions as we understand them today are:

  • self awareness / insight
  • inhibition / impulse control
  • working memory (short term memory)
  • emotional self-regulation
  • problem solving
  • preplanning and organization

Delays in these executive functions exposes why people with symptoms of ADHD have trouble in relationships, work and school.

What are the treatment recommendations?

Russel A. Barkley, PhD., one the world’s most renowned experts on ADHD, describes it as a “Point of Performance Disorder”. Interpretation: they know the skills; just don’t know when to use them. He recommends in his many books to treat ADHD symptoms with:

  • Immediate consequences (both punishment and reinforcement)
  • Don’t skill build – they already know the skills
  • Learn when and where to use the skills
  • Behavior point system in the home – positive token economy
  • Medication management

If you believe yourself or someone you know has symptoms of ADHD that are impacting their enjoyment of school, work or life, please contact New Directions Counseling Services. We can provide a full evaluation and all of the recommended treatments with our collaborative therapists and knowledgeable doctors. Call now using the number in the right hand column > or 724.934.3905