ADHD (ADD) Description by M. L. Glaser, MD
A.D.H.D.(ADHD) stands for attention deficit
hyperactivity disorder. In the 1960's and
early 1970's, ADHD was called A.D.D. This
stood for Attention Deficit Disorder with or
without hyperactivity. The name officially
changed in the late 1970's to ADHD. ADHD
has two subtypes. One is combined
inattention plus hyperactivity and the other is
inattention only without hyperactivity. They
are both called ADHD.
While there may be societal factors that
contribute to the large number of children
diagnosed with ADHD, the fact of the matter
is the number of children (and teenagers)
with ADHD has remained consistent over the
last several decades. However, the number
of children treated for ADHD with medication
has increased. This is probably due to
greater awareness of the severe lifelong
problems ADHD causes and of the benefits of
The main difficulties a person with ADHD has
centers around three areas or domains. A
person must have significant problems in at
least one domain to qualify for ADHD. The
first domain is inattention. This means the
person can not stay focussed during tasks
that require sustained attention. The ability
to watch TV or play video games for long
periods does not matter towards the
diagnosis. Inattention in ADHD refers to
tasks that are more monotonous, like school
work, reading, household chores.
The second domain is hyperactivity. This
means unable to sit still, fidget, move about
constantly. A child in school may be out of
his seat a lot, or talking to their neighbor in
class. Younger children will have a motor
that won't shut off.
The third domain is impulsivity. This means
acting first without forethought. A child may
dart out into traffic, an adult may make poor
choices with great risk taking without
The above symptoms must cause significant
problems in the person's life to meat criteria
for the diagnosis. Also, symptoms must be
present since childhood. Sometimes,
symptoms don't show up till a person is
older like in 6th grade when school work
requires much greater attention spans.
People with ADHD have very little patience.
They can get angry very easily. Also, doing
tasks that require sustained attention, like
cleaning their room, is a much bigger deal to
an ADHD person. Therefore they can be
oppositional and defiant of authority.
Children who have untreated ADHD are at
much greater risk to have serious life
problems as they grow older. Persons with
untreated ADHD are more likely to have
troubles with all the things an irresponsible
person would have trouble with. They are
more likely to drop out of school, use illegal
drugs, get divorced, get into car accidents,
get sexually transmitted diseases, and the
list goes on. Those who are treated are close
to having the same risk for the above as
people without ADHD.
What are the other illnesses a person with
inattention and hyperactivity must be
Since ADHD must be present since early
childhood, adult onset ADHD is likely due to
another reason. Depression and anxiety can
cause inattention. Poor sleep can cause
inattention and hyperactivity. Bipolar
disorder and schizophrenia can have early
symptoms that resemble ADHD especially in
Is there a test for ADHD?
There is no test for ADHD. ADHD is
diagnosed only on the basis of symptoms
described to the psychiatrist by the patient
and other observers of the patient.
Computer tests called TOVA or psychological
testing can provide useful information but
they can not make the diagnosis.
Psychological testing can rule out learning
disorders or mental retardation.
The great news is that ADHD is a treatable
condition. In my practice, I get great
satisfaction seeing an ADHD patient go from
suspensions and failing grades to honor role.
Mitchell L. Glaser, MD. Chicago Il