“I have not FAILED. I’ve just found 10,000 ways that won’t work”
ADD & ADHD
At various times in life, you may have wondered whether you or a loved one might have ADD or ADHD. There are certainly situations and times when it may be more difficult to focus attention and complete tasks. However, for people with Attention Deficit / Hyperactivity Disorder (ADHD), there is evidence of persistent difficulties with distractibility, disorganization and inability to complete tasks that cause significant impairments in their ability to function in different areas of their lives.
In addition, researchers now have a better understanding that many of the ADHD type symptoms may be more comprehensively understood as overarching challenges with “self-regulation”. Self-regulation refers generally to the ability to effectively direct an action towards an intended outcome to achieve a successful result. In order to accomplish such a task, it is necessary to manage many aspects of one’s behaviour. In addition, effective self-regulation requires the ability to inhibit off-task and/or inappropriate types of behaviour; maintain focus and attention on the goal at hand; successfully solve any problems that may appear in the course of trying to acquire the goal; and finally, effectively manage one’s emotional reactions that may arise in the course of trying to achieve the desired outcome. At times, one must also be able to delay gratification to a more appropriate time and it is also usually important to be able to learn from previous trials and mistakes. With this conceptualization, it is easier to understand some of the challenges that individuals may have in terms of social interactions and emotional outbursts, in addition to challenges with focus, concentration, and task completion.
Key symptoms that may be suggestive of ADHD and may warrant an ADHD assessment include the following types of challenges:
- Inconsistency in effort and the perception of laziness, especially in situations when sustained mental effort is required
- Teachers might report that children do not seem to be “working up to their potential”
- Evidence of widespread disorganization: messy backpacks, lockers, offices or bedrooms
- Problems following daily routine activities
- Procrastination with completing schoolwork & homework struggles
- High levels of distractibility and forgetfulness
- Losing things needed for school, work or home
- Seeming like the person is often “in their own little world”
- Starts many tasks but rarely completes them
- Problems with excessive activity, fidgeting or difficulty staying seated
- Feelings of restlessness and easy boredom
- Impulsivity or difficulty inhibiting inappropriate behaviour
- Excessive tendency to make noise (talking, humming, singing, tongue-clicking, etc.)
- Emotional outbursts and problems regulating emotions
A great deal of scientific research has been, and continues to be done in the area of ADHD. There is very compelling research that shows strong support for the notion that ADHD is a developmental, neurobiologically based condition that is most likely caused by differences in various connections in the brain, particularly involving the frontal lobes. There is also considerable research that suggests that there seems to be a strong genetic component to ADHD.
Despite the strong research results supporting the idea that ADHD is a neurobiologically-based condition, concerns are often raised by the public that ADHD may be over-diagnosed or misdiagnosed. These types of concerns may be related to a wide variety of ways that various professionals assess for, and subsequently make diagnostic decisions. At EVOLVE, the evaluation and assessment for ADHD involves a comprehensive approach that incorporates many factors. For instance, in-depth clinical interviews with family members are crucial in evaluating for symptoms across different settings. For school-age children and teens, interviews with teachers can also be helpful in assessing for symptoms in academic environments. A thorough review of academic records and any other available assessment reports is also done. For most individuals, some formalized testing of basic cognitive and academic skills is done in order to rule-out other possible explanations for inattentive types of behaviour. Finally, formal testing, specifically designed to assess focused attention, concentration and impulsive tendencies is typically done.
As a result of the thorough assessments done at EVOLVE, we are able to provide our clients with confident opinions about whether an individual meets the formal diagnostic criteria for ADHD and to identify the particular subtype of the condition. After clinical impressions are offered regarding the presence or absence of an ADHD diagnosis, our clients are provided with specific, concrete recommendations and strategies to help them to function more effectively in their everyday lives.
It is important to be aware that there are different subtypes of ADHD and individuals with different subtypes of the condition can have very different types of symptoms.
The specific Attention Deficit / Hyperactivity Disorder (ADHD) subtypes are:
This type of ADHD is characterized by a need to be constantly “on-the-go”, moving, talking, can’t sit still. There is a tendency to be impulsive and may engage in risky behaviour. The individual may have difficulty waiting their turn and frequently interrupt others. It is very difficult for people with this type of ADHD to complete tasks because of significant difficulties with concentration and sustained mental effort. Social difficulties can be evident due to unintentional tendencies to “annoy” others with some impulsive behaviours.
Previously, the term Attention Deficit Disorder (ADD) was used to refer to this type of attention problems. It is generally characterized by people who have difficulty concentrating and who may be easily distracted, but who do not seem to be particularly hyperactive or impulsive. Oftentimes, people with this type of ADHD go unnoticed for long periods because they are generally quiet and often don’t draw much attention to themselves. People with this type of ADHD tend to be disorganized, forgetful and often lose things that they may need. They are often described as “day-dreamers” or “absent-minded professors”. They tend to procrastinate starting tasks and have significant difficult completing tasks that they have started.
Individuals with this subtype of ADHD have clinically significant symptoms of both the Inattentive and the Hyperactive / Impulsive ADHD subtypes.