What is ADHD?

There’s a common phrase going around these days. I hate it when a child usually displays NORMAL active behaviour, and another parent asks, “What’s going on with your kid? Is he hyper or what?” Does she even know what hyper means? So what’s the difference between a regular active child and a hyperactive child? And what is this term ADHD everyone keeps bringing up? Does it really exist?

The terms `attention deficit’, `attention-deficit hyperactivity disorder’, `hyperkinetic disorder’ and `hyperactivity’ are used by professionals to describe the problems of children who are overactive and have difficulty concentrating.
The terms attention deficit disorder (ADD) or attention-deficit hyperactivity disorder (ADHD) are used in the USA. The official term in the UK is hyperkinetic disorder. In SA we use the term ADHD as in the USA. These differences in terminology can sometimes cause confusion. In both instances, these children usually have problems with attention control and overactivity.

Attention Deficit Hyperactivity Disorder is a common behavioral disorder that affects an estimated 8% to 10% of school-age children. Boys are about three times more likely than girls to be diagnosed with it, though it’s not yet understood why.
Children with ADHD act without thinking, are hyperactive, and have trouble focusing. They may understand what’s expected of them but have trouble following through because they can’t sit still, pay attention, or attend to details.

What is ADHD in neurological terms? The most recent models describing what is happening neurologically in the brains of people with Attention Deficit Disorder suggest that several areas of the brain may be affected by the disorder.

They include:
Frontal Lobes
Inhibitory Mechanisms of the Cortex
Limbic System
Reticular Activating System
Each of these areas of the brain is associated with various functions of the brain.

The frontal lobes help us to pay attention to tasks, focus concentration, make good decisions, plan ahead, learn and remember what we have learned. The frontal lobes also help us to behave appropriately for a given situation. Emotional issues such as anger, frustration, and irritability that come on impulsively in some types of ADHD probably come from the pre-frontal cortex.

The inhibitory mechanisms of the cortex keep us from being hyperactive, from saying things out of turn, and from getting mad at inappropriate times, for examples. These inhibitory mechanisms of the cortex help us to “inhibit” our behaviors.

The limbic system is the base of our emotions and our highly vigilant look-out tower. If the limbic system is over-activated, a person might have wide mood swings, or quick temper outbursts. He might also be “over-aroused,” quick to startle, touching everything around him, hyper-vigilant.

A normally functioning limbic system would provide for normal emotional changes, normal levels of energy, normal sleep routines, and normal levels of coping with stress. A dysfunctional limbic system results in problems with those areas.

The Reticular Activating System is the attention center in the brain. It is the key to “turning on your brain,” and also seems to be the center of motivation.
The Reticular Activating System is connected at its base to the spinal cord where it receives information projected directly from the ascending sensory tracts. The brain stem reticular formation runs all the way up to the mid-brain.
The Reticular Activating System plays a significant role in determining whether a person can learn and remember things well or not, on whether or not a person is impulsive or self-controlled, on whether or not a person has high or low motor activity levels, and on whether or not a person is highly motivated or bored easily.

Above is a sample Q-EEGs of two Attention Deficit Disorder children compared to two non- ADD ADHD children.
The Attention Deficit Disorder children show excessive slow brainwave activity (theta and alpha ranges) compared to non- ADD ADHD activity. The slow brainwave activity indicates a lack of control in the cortex of the brain.

According to Harvard Medical School, current research strongly suggests that Attention Deficit Disorder – ADHD is caused in part by a deficiency of norepinephrine in the ascending reticular activating system. It is thought that the stimulant medications, such as Ritalin, increase the levels of norepinephrine in that part of the brain, as well as increasing the levels and effects of norepinephrine and dopamine in the frontal lobes. (We will discuss treatments soon Insha’allah).

People, I tried my best to keep the scientific stuff simple. I am just trying to show that it is a neurological problem. I know that parents will be interested in signs and symptoms and treatment, what our stance on ADHD is, etc. We will Insha’allah keep adding posts on ADHD related topics. Now back to the definition of ADHD…

Attention Deficit Disorder might affect one, two, or all three of these areas, resulting in several different “styles” or “profiles” of children (and adults) with Attention Deficit Disorder.

Of course, all children (especially younger ones) act this way at times, particularly when they’re anxious or excited. But the difference with ADHD is that symptoms are present over a longer period of time and occur in different settings. They impair a child’s ability to function socially, academically, and at home.

Children can have ADHD even if they don’t have all of the symptoms of ADHD. That is because there are several types of ADHD, including:

ADHD, Inattentive Type – which includes those children who mostly have symptoms of inattention, such as not being able to pay attention to details, getting easily distracted, being forgetful, etc.
ADHD, Hyperactive – Impulsive Type – which includes those children who mostly have symptoms of hyperactivity and/or impulsivity, such as fidgeting a lot, having trouble staying in his seat, talking excessively, being on the go, interrupting others, having trouble waiting for his turn, etc.
ADHD, Combined Type – if the child has all of the major symptoms of ADHD
A lot of people talk about ADD and ADHD as if they were two different things, reserving ADHD or attention deficit hyperactivity disorder for those children who are hyperactive and ADD for those aren’t. Keep in mind that both ADD and ADHD are simply generic terms for Attention Deficit Hyperactivity Disorder though and don’t really describe the type of ADHD a person has.

I do not want to make these posts too lengthy. Like I said, we will keep adding posts on ADHD related topics Insha’allah. Please feel free to comment and give us your experiences if you are a parent or teacher.