ADHD: Myths vs. Reality
Attention difficulties commonly occur in children and adults for various reasons. Sometimes they can be related to mood issues, motivational issues, environmental challenges or physical health issues. But, when there are significant and persistent difficulties, with a combination of inattention, overactivity, impulsivity, and distractibility that impairs functioning or development in multiple settings, this can be attributed to Attention Deficit Hyperactivity Disorder in children and/or adults.
Of children aged 4-17 years of age in the United States, 5.1 million or 8.8%, have a current diagnosis of ADHD, with boys (12.1%) more than twice as likely as girls (5.5%) to have ADHD. Approximately half of children with ADHD continue to have symptoms into adulthood, or 4.4% of adults overall.
The exact cause of the disorder is unknown but research shows that areas of the brain are affected and there is a family/genetic connection. The impact of the disorder includes lower academic performance, increased risk of injury, increased risk of traffic accidents, increased likelihood of smoking, poorer social function and lower self esteem. Treatment can reduce the symptoms of ADHD, but it does not completely eliminate the impact of these complications.
When it comes to ADHD, it’s important to separate the myths vs. the facts. Here are some important considerations to keep in mind when thinking about an evaluation, diagnosis and treatment.
“ADHD isn’t a real disorder”
- It is a recognized medical condition
- ADD = ADHD
- Exact cause unknown
- Multiple factors have been implicated in the development of ADHD – family history/genetics, certain environmental factors, problems with the central nervous system /an imbalance of chemical messengers, or neurotransmitters, within the brain.
- Research has shown that certain brain regions don’t synchronize properly and overall brain architecture is different.
“ADHD is overdiagnosed”
- Studies show that ADHD is underdiagnosed in minority populations
- Awareness of the disorder has been growing since the 1990s when it became recognized under special education law as a condition that affects learning.
“ADHD only occurs in childhood”
- The symptoms of ADHD can occur as early as the preschool years. The intensity of the behaviors and how they are affecting a preschooler’s life, development, self-esteem, and general functioning is considered.
- Some children with ADHD continue to have symptoms during their teen years and about 50 out of 100 have symptoms into adulthood.
- Symptoms in adults look different.
- Hyperactivity tends to diminish
- Inattentive symptoms become more troublesome
- Sense of “inner restlessness”
“Children outgrow ADHD”
- ADHD is a lifelong condition
- Some children do outgrow their symptoms
- Most children carry the disorder into adolescence and adulthood
- Symptoms change as a child gets older and learns ways to manage them
“My child is just lazy or dumb or unmotivated”
- ADHD has nothing to do with a person’s intellectual ability.
- A child who finds it nearly impossible to stay focused in class, or to complete a lengthy task may try to “save face” by acting as though he/she does not want to do it or is too lazy to finish.
- This behavior stems from real difficulty in functioning and possible frustration.
- They simply work differently.
“My child is a handful or is a daydreamer – but that’s normal”
- There are variations of “normal”
- How much behaviors consistently impede a child and their ability to succeed at school, fit into family routines, follow household rules, maintain friendships, interact positively with family members, avoid injury or otherwise manage in his/her environment should be considered
“My child focuses on video games for hours. He/she cannot have ADHD”
- ADHD poses problems with tasks that require focused attention over long periods of time, not so much for activities that are highly engaging or stimulating
- Less or unstructured time can be difficult to manage
- Social situations can also be problematic due to the constant, subtle exchange of social and emotional information
“ADHD is caused by poor parental discipline”
- ADHD is not caused by bad parenting.
- Parenting techniques can affect symptoms.
- Try to stay positive
- Establish structure and stick to it
- Set clear expectations and rules
- Encourage healthy lifestyles – eating, exercise, sleep
- Teach how to make friends
- Learn to anticipate potentially explosive situations
- Be a good role model
“If after an evaluation, a child does not receive the ADHD diagnosis, he/she doesn’t need help”
- ADHD is diagnosed on a continuum
- A child may not always show symptoms of ADHD, especially in an unfamiliar setting
- Monitoring symptoms and behaviors in multiple settings is critical
- Counseling, home management tools, school behavior management recommendations, social skills interventions, and help with managing homework flow, organization and planning can be helpful
“All you need are medications to treat ADHD”
- Medications often curb symptoms
- They help children focus and be less hyperactive
- Typically a combination of treatments are the most effective way to treat ADHD
- Behavioral therapy
- Notes/reminders to prevent self from forgetting tasks
- Academic help
“Medicine for ADHD will make a person seem drugged”
- Properly adjusted medicine for ADHD sharpens a person’s focus and increases his or her ability to control behavior
- Sedation or personality changes are not side effects of the medication
“ADHD stimulant medication leads to addiction”
- No evidence
- Research has shown that people with ADHD who take medication tend to have lower rates of substance abuse than people with ADHD who don’t take the medication
- A long-term study looked at childhood & early teen use of stimulants and early adulthood use of drugs/alcohol/nicotine in males with ADHD and showed no increase or decrease in substance use.
“Treatment for ADHD will cure it. The goal is to get off medication as soon as possible”
- ADHD is a chronic condition that changes over time
- Depending on the circumstances and demands as a person matures, the need for continuing medication or other treatments varies
- TRUE GOAL = function well at stage of development in all environments