Delve deeper into ADHD with answers to some of the biggest questions.
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Great question — and one we hear a lot! ADD is the old name for the Predominantly Inattentive ADHD subtype. ADD is a term that was removed from the diagnostic manual in 1994, but it is still commonly used. The correct name for the condition is now Attention Deficit Hyperactivity Disorder (ADHD).
“Neurodevelopmental Disorder” is an umbrella-term for conditions that affect the growth or development of the brain or central nervous system. A condition like this usually manifests early in a child’s development, before the child enters primary school. The disorder is characterised by developmental deficits that produce impairments of personal, social, academic, or occupational functioning.
ADHD may be considered mild, moderate, or severe depending on the number of symptoms and the extent of functional, social, or occupational impairment. Diagnosis will fall into one of three subtypes — Primarily Inattentive (PI), Primarily Hyperactive Impulsive (HI) and Combined Type (CT).
Inattention manifests behaviourally as wandering off task, lacking persistence, having difficulty sustaining focus, or being disorganised. Other symptoms include:
- Poor attention to detail, making careless mistakes, and difficulty in sustaining attention in tasks.
- Not following through on instructions, or failing to complete tasks.
- Losing things necessary for tasks or activities.
- Avoiding, disliking, or being reluctant to engage in tasks that require sustained mental effort.
- Being easily distracted by extraneous stimuli.
- Not listening — or gives the appearance of not listening — even when spoken to directly.
- Poor organisation skills.
- Forgetting everyday routines, practices, or items in daily activities.
In recognising this subtype, these characteristics are not due to defiance or lack of comprehension.
Hyperactivity refers to excessive motor activity at an inappropriate time, such as excessive fidgeting, tapping, or talkativeness. Impulsivity refers to hasty actions that occur in the moment without forethought and have high potential for harm to the individual. Other symptoms include:
- Fidgeting with hands, tapping hands or feet, or squirming in seat.
- Leaving a seated position in situations where remaining in seat is expected.
- In children, running or climbing in situations where it is inappropriate. For adolescents and adults, this presents as restlessness.
- Being unable to play or engage in leisure activities quietly.
- Excessive talking, such as blurting out answers before a question has been completed, or interrupting others in conversation.
- Difficulty waiting a turn.
In recognising this subtype, these characteristics are not due to a desire to be intentionally rude, defiant, or disruptive.
The short answer is, “no”. However, ADHD includes impairment in one or more processes related to perceiving, thinking, remembering, or learning, so it may be more useful to view ADHD as a learning disorder. In doing so, it is important to acknowledge that it differs from currently recognised reading or non-verbal learning disorders.
No, there is more than one subtype of ADHD. Those diagnosed with Predominantly Inattentive Subtype have no symptoms of hyperactivity.
Research shows that ADHD tends to run in families, so there are likely to be genetic influences. Children who have ADHD usually have at least one close relative who has ADHD, and at least a third of fathers who had ADHD in their youth have children with ADHD. Even more convincing of a possible genetic link is that when one twin of an identical twin pair has the disorder, the other is likely to have it too.
ADHD symptoms evolve over time (for example, hyperactivity and fidgeting commonly decrease with age), but the condition is rarely outgrown. In fact, many people are not diagnosed until adulthood. However, in many cases, with support, treatment, and management strategies, ADHD can be effectively navigated to the point where the condition appears to be outgrown.
There is no simple “test” for ADHD. The diagnosis of ADHD is a clinical diagnosis made using well-tested diagnostic interview methods. Diagnosis is based on history, the description of symptoms, observable behaviours in at least two separate settings (school, work, and home), and the exclusion of other conditions that may mimic ADHD.
Diagnosis should include input from parents, teachers, and others who may be interacting with the child or adult. The process will also consider conditions which may accompany ADHD, and the additional impacts this will have on the person. For example, depression, anxiety, learning difficulties, developmental status, oppositional defiant disorder and conduct disorder.
While it is common for children to display hyperactive tendencies following the consumption of high volumes of sugar, this is often fleeting, and different to ADHD. The current weight of evidence indicates that ADHD is not caused by too much sugar or food colourings in the diet.
Although a small body of research suggests some children may benefit from nutritional interventions, delaying the implementation of well-established, effective interventions to engage in unproven methods is likely to be harmful for children.
There are no well-established nutritional interventions proven to be effective for assisting the majority of children with ADHD, especially in the long-term. In other words, it is thought that diet does not play a role in the cause or management of ADHD.
There is no doubt that some foods affect behaviour, but food allergens or intolerances are not ADHD. ADHD and food chemical intolerance may co-exist as two separate conditions, just as ADHD and Asthma may co-exist, and ADHD symptoms may be worsened by the other condition and vice versa.