Attention deficit disorder (A complete guide)

Attention deficit disorder

Attention deficit disorder (ADD) is a neurological disorder characterized by behaviour problems including but not limited to difficulty focusing, listening to instructions, and completing tasks and assignments. 

In this blog post, we will discuss the symptoms, potential causes, and treatments for attention deficit disorder (ADD).  

Attention deficit disorder (A complete guide)

What is attention deficit disorder (ADD)?

 Since 2013, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) has characterized ADD as a subset of attention deficit hyperactive disorder (ADHD).

There are three subtypes of ADHD outlined below:

·     Inattentive: this is what people commonly think of when they hear “ADD”. The person is easily distracted but does not show symptoms of impulsivity of hyperactivity 

·     Hyperactive/impulsive: The person has clear symptoms of hyperactivity and impulsivity but is not easily distracted

·     Combined: The person diagnosed experiences both inattentiveness and hyperactivity/impulsivity 

How is ADD Diagnosed?

There are approximately 6.4 million children diagnosed with ADD in the United States.

If six or more of the following symptoms for children up until age 16 or five or more for adolescents 17 and older and adults persist for at least six months and are age and developmentally inappropriate, a person can be diagnosed with inattentive ADD:   

·     Trouble keeping attention on tasks or activities

·     Does not listen even when spoken to directly

·     Fails to pay close attention to detail and often makes careless mistakes in schoolwork or at work

·     Fails to finish schoolwork, chores, or other duties 

·     Struggles with an organization in daily tasks and activities

·     Very easily distracted and forgetful 

·     Often loses things necessary to complete tasks such as pens and pencils, keys, wallet, paperwork, or cell phone 

·     Reluctance in doing tasks that require significant mental effort such as schoolwork 

To be diagnosed with hyperactive/impulsive ADD, six or more of the following symptoms for children up to age 16 or five or more for adolescents 17 and older and adults must be persistent for at least six months and are age and developmentally inappropriate:

·     Fidgetiness (i.e., tapping hands and feet, squirming in seat)

·     Gets up from seat even when expected to remain seated

·     Consistently Interrupts conversations 

·     Often appears “on the go” 

·     Blurts out answers before a question has been completed 

·     Unable to play quietly or appropriately take part in activities 

In addition, the following criteria must be met: 

·     Has symptoms in many settings such as school, work, home, or other activities 

·     The symptoms interfere with daily functioning at school, work, or in social situations 

·     The symptoms cannot be explained by another mental health condition such as an anxiety or mood disorder 

Boys and men are more likely to be referred for ADD testing, receive accommodations, and participate in research studies, so it is difficult to identify the exact ratio of men to women with ADD.

It has been suggested that ADD is more prevalent in boys and men, but this is likely skewed due to underreported cases of girls and women with ADD. 

ADD or ADHD can also occur in people who suffer from depression.

A study from the University of Chicago concluded that adolescents with ADHD are 10 times more likely to suffer from depression than adolescents without a diagnosis of ADHD.

Attention deficit disorder (A complete guide)

What causes ADD?

ADD affects the areas of the brain that control executive functioning skills such as attention, concentration, memory, motivation and effort, and organization. 

It is important to understand that ADD is not caused by poor parenting, head injuries, childhood trauma, video games or other electronic devices, lack of exercise, or excess sugar.

Although these used to be widely held beliefs, there have been no scientific correlations between these examples and development of ADD. 

Researchers have shown that people with ADD have abnormalities in certain neurotransmitters, or chemicals in the brain that relay signals to control behavior.

Dopamine and norepinephrine are two such neurotransmitters.  

In addition, patients with ADD have deficits in the brain circuits that are involved in the engagement and maintenance of attention.

Studies have shown reduced activity in the premotor cortex and prefrontal cortex, areas in the brain responsible for motor activity and attention, respectively.

Researchers have also shown differences in the volume and activity levels in the prefrontal cortex, caudate nucleus, ventral tegmental area, substantia nigra, cerebellum, and corpus callosum, areas that are known to regulate mood, emotion, and coordinated movements.  

In addition to differences in brain function and activity, certain genes have been implicated in the development of ADD.

All three of these genes involve dopamine function, including genes for dopamine receptors. 

What are some problems associated with ADD?

People diagnosed with ADD may also have issues with hyperactivity and other behaviour problems.

Children with ADD may have other learning disabilities and repeated problems in school, such as consistently disrupting the class.

Sadly, adults and other children may conclude that these students are “lazy” due to their lack of follow-through with assignments, however, this is a clear misconception.

If you want to learn more about myths associated with ADD click here

What are the symptoms of ADD in adults?

Adults with ADD have usually had the disorder since childhood but may not have been diagnosed until later.

Typically, a family member, colleague, or peer prompts an evaluation due to a specific ongoing problem at work or in relationships. 

Adults can have any of the three subtypes of ADD, but the symptoms usually differ from children because of the higher maturity level.

Symptoms such as fidgeting in children can be seen as restlessness in adults. 

What are the symptoms of ADD in children? 

Children with inattentive ADD may have the following symptoms: 

·     Easily distracted, consistently loses focus 

·     Trouble maintaining attention on daily tasks and activities

·     Forgetful and loses materials needed to complete tasks and activities 

·     Does not give close attention to detail in schoolwork or other activities 

·     Makes careless mistakes 

·     Doesn’t follow instructions

·     Ignores person speaking, even when spoken to directly

·     Leaves tasks unfinished such as schoolwork and chores 

·     Struggles with organization 

·     Dislikes and avoid tasks that require sustained mental effort

Some school-specific symptoms of inattentive ADD include: 

·     Daydreaming or forgetfulness

·     Losing school materials, misplacing assignments

·     Failure to turn in school assignments

·     Showing a demeanor of boredom or disinterest in class

·     School assignments, desk, or locker appearing disorganized

Children diagnosed with hyperactive and impulsive ADD may have the following symptoms:

·     Talks excessively even when told not to

·     Constantly fidgets by squirming or tapping hands or feet

·     Gets up from seat even when told to remain seated

·     Unable to play quietly 

·     Constantly interrupts and has trouble waiting for their turn 

·     Runs around or climbs when expected to remain seated 

If you or your child meet these criteria and don’t know where to start with getting the right help, you can contact the Cognitive Assessment Group

Attention deficit disorder (A complete guide)

What are the current treatments for ADD? 

A combination of the right medication and therapy are usually the most effective treatments for ADD. 

Drugs such as Clonidine may be used when treating ADHD.

Cognitive-behavioural therapy, or CBT, has been a very effective strategy in helping patients with ADD develop new adaptive coping mechanisms.

The focus of therapy is on identifying workable actions and skills in the present moment that can be applied to daily situations. 

Group therapy and peer support groups are also extremely successful in helping patients process the interpersonal and emotional effects that having ADD has imposed on them.

People with ADD often feel overwhelmed as well as shame, guilt, and failure. 

Many ADD patients seek out coaches specifically to help improve organizational skills, goal completion, time management, and general productivity.

These coaches strive to maintain a positive approach to achieving goals while also holding the patient accountable for his or her actions. 

In addition to all the forms of therapy discussed above, ADD is usually treated with medications prescribed by a psychiatrist.

Stimulants such as Ritalin or Adderall are commonly used. 

What are the important points that I should remember about ADD? 

In this blog post, we discussed how ADD is characterized in the DSM-5, what criteria need to be met for diagnosis, and treatment plans.

ADD is a complex neuro-behavioural disorder that is caused by a combination of genetic factors and brain circuitry differences. 

Attention deficit disorder (A complete guide)

FAQs about ADD

Here are some frequently asked questions (FAQs) about ADD: 

1. What causes ADD?

There are many risk factors that contribute to the development of ADD.

These include genetics (i.e., if your parent or sibling has ADD or another mental health disorder), exposure to harmful chemicals in the environment such as lead, maternal drug use during pregnancy, or premature birth. 

2.    How do you know if your child has ADD? 

Look out for the following signs if you suspect your child has ADD.

If so, take them to a psychiatrist or other appropriate healthcare provider for an evaluation. 

-Self-focused behaviour: inability to recognize the needs of others

-Constant interrupting

-Struggles with waiting their turn 

-Fidgeting

-Issues playing quietly 

-Difficulty finishing tasks

-Trouble focusing

3.    What is the difference between ADD and ADHD?

ADD is a subtype of ADHD, and can include symptoms of hyperactivity, inattentiveness, or a combination of both. 

4.    What are the seven types of ADD?

-Classic ADD symptoms: inattentive, easily distracted, hyperactive, impulsive, disorganized  
 
-Inattentive ADD

-Over-focused ADD

-Temporal lobe ADD

-Limbic ADD

-Ring of fire ADD (“ADD plus”)

-Anxious ADD

5.    Can you grow out of ADD?

Add can evolve over time, but it is unlikely that it will be outgrown. 

Want to learn more about ADD? Try these books!

Thriving with ADHD Workbook for Kids: 60 Fun Activities to Help Children Self-Regulate, Focus, and Succeed

This best-selling workbook helps children diagnosed with ADD manage their feelings of loneliness, frustration, and helplessness.

Therapist Kelli Miller uses her professional and personal expertise to advise kids in reframing the way they think about their disorder from something negative to a more positive and unique perspective.

The workbook includes exercises that deal with staying focused, controlling impulses, and making more thoughtful decisions.

There are techniques for self-regulation and organization, as well as specific action plans.

These include preparing for daily activities such as homework charts, expressing emotions, and creating an effective morning routine.

You Mean I’m Not Lazy, Stupid, or Crazy?!: The Classic Self-Help Book for Adults with Attention Deficit Disorder

This book is the first of its kind for written for adults with ADD and includes helpful tips for improving memory and organization.

It explains how a diagnosis of ADD differs from lapses in memory, lack of concentration, or impulsivity.

Importantly, it goes into detail on the differences between ADD in men and women and how declining levels of estrogen impact cognitive function.

Learning to balance work, family, and relationships as well as how to seek professional help are also included in this fantastic self-help guide. 

Focused: ADHD & ADD Parenting Strategies for Children with Attention Deficit Disorder

Blythe Grossberg is an expert with over 15 years of experience in treating adults and children with ADD and gives essential information on the best ways to parent a child or children with ADD.

The book includes over 40 parenting strategies on managing hyperactivity and inattentiveness, worksheets to supplement your child’s treatment plan, and guiding principles to become an advocate for your child.

She encourages parents to promote positive behavior and work with their child’s unique needs. 

Questions or comments? Post below!

References

Attention Deficit Disorder Without Hyperactivity.Very Well Mind. Written by Ann Logsdon, October 29th, 2019 

What’s the Difference Between ADHD and ADD?Healthline. April 12th, 2017. 

ADHD: The Facts.Attention Deficit Disorder Association. 1998. 

Juanita Agboola

Juanita Agboola is the editor in chief of HFNE and an expert in mental health online. She has been writing about online behavior, mental health and psychology issues since 2012. All Guides are reviewed by our editorial team which constitutes various clinical psychologists, PhD and PsyD colleagues.