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Thursday, June 28, 2007

Attention Deficit Hyperactivity Disorder

Attention Deficit Hyperactivity Disorder (ADHD) is a neurobiological condition seen primarily in the school-aged population that affects one' s ability to maintain attention. Historically, other terms have been used for this disorder ( minimal brain damage, minimal brain dysfunction, hyperactive, hyperkinetic ), but these terms have changed as knowledge of the problem has increased.
Symptoms
The disorder and its symptoms are chronic , meaning they affect an individual throughout life. The symptoms are also pervasive , meaning they are a continuous problem and not just a response to a temporary situation. The behaviors occur in multiple settings, rather than just one.
Current research supports the idea of two distinct characteristics of ADHD, inattention and/or hyperactivity-impulsivity .
Inattention
Inattention is characterized by difficulty concentrating. Irrelevant thoughts, sights, and sounds seem to get in the way of focusing and sustaining attention. As a result, the student often appears as if he or she is not listening.
Performance varies depending on the nature of the activity the student is asked to complete. Students may give automatic and effortless attention to things and activities they enjoy, but attending to the details of planning, organizing, and completing a task on time is difficult. Learning new things is difficult as well. The student shows poor self-regulation of behavior, i.e., he or she has difficulty monitoring and modifying behavior to fit different situations and settings.
Hyperactivity
Individuals who are hyperactive seem unable to sit still. They squirm in their seats, roam around the room, tap their pencil, wiggle their feet, and touch everything. They are restless and fidgety. They may bounce from one activity to the next, trying to do more than one thing at once.
Impulsivity
Impulsive individuals have difficulty thinking before they act, e.g., hitting a classmate when they are upset or frustrated. They may have difficulty waiting their turn, e.g., when playing a game.
Who Has ADHD?
Prevalence estimates of ADHD are sensitive to who is asked what, and how information is combined. Consequently, systematic reviews report ADHD prevalence estimates as wide as 2%-8% (1, 2). According to the National Center for Health Statistics, approximately 6.7% of children aged 5 to 17 were reported to have ADHD in 1997-2000 (3); the National Dissemination Center for Children with Disabilities reports a figure of 5% in school-aged children. Boys are three times more likely than girls to have ADHD (4).
Speech and Language
Inattention, hyperactivity, and impulsivity have their effects on speech and language. Following instructions carefully and completely is difficult. Answers to questions may be blurted out before the teacher or others have finished asking a question. Time may not be taken to use well-formed and grammatical sentences. Stories or discussions about the day at school may be so disorganized that listeners cannot follow what is being said. Or, the child assumes knowledge of the listener that he or she does not have. For example, I left that place. I talked to her. I ate cereal this morning.
Speakers may be interrupted, or language may not be changed for different communication partners. For example, the more casual, informal language used with friends on the playground may be inappropriately used with teachers or other authority figures in the school.
Specific speech and language patterns vary from child to child with ADHD. For example, some children with ADHD also have learning disabilities that affect their speech and language. Evaluation of each child's individual speech and language pattern is critical to developing an appropriate treatment plan.

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