Attention Deficit Hyperactivity Disorder
The IQ in Attention Deficit Hyperactivity Disorder is likely to be in the normal range.
Attention Deficit Hyperactivity Disorder [ADHD] is characterised by inattention, over activity and impulsivity. ADHD affects about 1% of the population. The male to female ratio is 9:1. It occurs in all cultures and all social classes.
Proposed causes of ADHD include genetic and social factors, lead intoxication and food additives and zinc deficiency.
A person with ADHD is likely to have normal intelligence although 20% of children have learning disability combined with speech, language, social and relationship problems.
People with ADHD tend to be creative and intuitive but their full potential may not be achieved due to poor concentration. If untreated, ADHD interferes with educational and social development and predisposes to mental illness.
The core symptoms of ADHD are:
- Inattention
Easily distractible, forgetful and difficulty sustaining tasks such as play, learning and work.
- Over activity
Fidgety, reckless, socially dis-inhibited, inappropriately active and talking excessively
- Impulsivity
Interrupts and intrudes, unable to “wait their turn”
People with ADHD tend to be clumsy, accident-prone and get into trouble with parents and teachers. Others learn to avoid them so they may become socially isolated.
People with ADHD frequently experience other forms of psychiatric illness in addition to ADHD. The commonest are depression and anxiety, antisocial personality disorder, alcohol and substance abuse
Treatment with Ritalin [methylphenidate], an amphetamine-like stimulant has the paradoxical effect of decreasing activity level and increasing attention. It helps to improve academic performance and relationships. It tends to produce a short lived improvement after each dose but is not a permanent cure.
Other treatment options include:
- Dexamphetamine, an amphetamine-like stimulant
- Antidepressants e.g. bupropion, desipramine, for those who do not respond to methylphenidate or who are unable to tolerate the stimulant side effects of methylphenidate
- Psychotherapeutic techniques including cognitive behavioural therapy (CBT), behaviour management strategies, individual and marital counselling
- Vocational counselling, education, rehabilitation and workplace accommodations
- Treatment for co-existing substance abuse or depression/ anxiety disorders.
Medication can be prescribed to both adults and children.
ADHD is usually recognised after the child has started school, unless it is very severe when it may be diagnosed earlier.
By the second decade the problems of impulsivity and inattention tend to improve even without treatment. However the learning difficulties caused by ADHD in childhood have long-term consequences. About 60% of adults continue to experience problems.
Adults with ADHD are most likely to succeed in employment when it provides a stimulating, yet structured environment.
People with ADHD would normally be able to care for themselves, have no difficulty in walking nor have difficulty in finding their way around outdoors in the absence of any coexisting psychiatric disorder.
A detailed psychiatric evaluation or involvement of a mental health team is usually necessary for a diagnosis of ADHD to be confirmed. The Decision-Maker would not be advised to evaluate claimed needs without some further evidence, even if the condition has been diagnosed and treated before the age of 16 or in childhood. Customers with a formal childhood diagnosis are likely to have improved to some extent as they enter their late teens.
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Amended April 2008
