For people who have not been exposed to Attention Deficit Hyperactivity Disorder, the initials ADHD are not much more than a mysterious acronym somehow connected to kids and Ritalin. But for those who have a closer view, ADHD presents myriad challenges and behavioural problems. What is ADHD? Who is affected? How is it diagnosed? Treated?

ADHD is the most common behaviour disorder diagnosed in children an adolescents in North America. Conservative estimates suggest that 3-5% of school-aged children have significant symptoms of ADHD, though some community-based prevalence data points to rates of 4-12%.

While the cause for ADHD is not known, there is a link to genetics. The disorder tends to run in families and those with ADHD usually have at least one close relative also diagnosed. But most convincing is that when one twin of an identical pair has the disorder, the other is also likely to have it.

Diagnosing ADHD is based on criteria listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). It calls for the presence of at least six symptoms from either two main categories: inattention, and hyperactivity and impulsivity. The most common symptom relates to inattention as someone with ADHD will have difficulty paying attention, and is usually unable to consistently focus, remember and organize.

The second category of symptoms relates to impulsiveness: someone with ADHD will frequently act before thinking, or may have poor judgement or not solve problems well. Hyperactivity is related to this and includes squirming, fidgeting and not being able to sit still for even a short time.

The difficulty of diagnosing ADHD arises from its subjectivity; there is no simple swab or blood test that can identify the problem. Rather, diagnosis is based on observed behaviour. Worse, many ADHD symptoms also present for other disorders and conditions. And a person with ADHD may have a combination of disorders to confuse the issue. As for severity, this depends on the individual and varies from mild to severe.

Diagnosing ADHD usually occurs when a child is aged 6-12 years because the behaviour problems arising out of the disorder are most evident in the classroom setting. Younger children can exhibit some of the symptoms as a normal part of their development, making diagnosis more difficult.

To properly diagnose ADHD demands careful observation and examination of the evidence. Rather than only looking at symptoms, we should examine the true functional impairment of the person. Gathering evidence solely from the parents is not enough, a variety of sources must be used. These will include teachers and the physician’s own observations, along with a complete and detailed patient history.

Treatment for ADHD is most often drug-based using either methylphenidate (Ritalin) or dextroamphetamine, both psychostimulants. Although behaviour management and socialization training benefit some people, medication remains the single most effective intervention.

We most often hear about ADHD in connection with children, but 70-80% of children will carry the disorder into adolescence; and 70% of those will continue to have significant symptoms into adulthood. One well-known individual who discovered he had ADHD is Dr Gabor Mate, a Vancouver-based physician and national columnist. He wrote about the disorder in his book, “Scattered Minds.” Recently, Dr Mate was the guest speaker at a workshop on the Sunshine Coast that was attended by more than 200 people. He shared some of his experiences and knowledge, and brought new understanding about a disorder that can be so easily misunderstood. As a result of this workshop, a local support group is being formed. Please contact Ellen Smith at 604-885-9340 for more information.