Attention deficit/hyperactivity disorder (ADHD) is a chronic, debilitating disorder which may impact upon many aspects of an individual’s life, including academic difficulties, social skills problems, and strained parent-child relationships.
People with ADHD look exactly the same as other people, but what sets them apart from others is their behaviour, how they negotiate life and their ability or inability to control their own emotions, behaviour and mind-chatter.
It is therefore not surprising that the epicentre of this disability is found in the brain. ADHD is a brain-based biological disorder. The ADHD nervous system is a unique and special creation that regulates attention and emotions in different ways than the nervous system in those without the condition.
Brain imaging studies using PET scans in children with ADHD show consistantly lower brain metabolism patterns in areas of the brain that control attention, social judgement and movement than those of children without the disorder.
In children with ADHD several brain regions and structures (pre-frontal cortex, striatum, basal ganglia and cerebellum) are 5-8% smaller than in typical children. The frontal lobe, controls among other things, planning, organisation, emotional regulation and attention – all aspects of executive functioning that are negatively affected by ADHD.
Two other brain areas, the temporal and inferior parietal cortices, are up to 24% larger in gray matter, and this accounts for inattention and hyperactivity commonly associated with ADHD.
But, that is not all – there is also a chemical component. Low levels of the neurotransmitter, Dopamine (a type of brain chemical), are found in children with an ADHD brain.
In children the ADHD brain shows markedly delayed development – and even when the ADHD brain ‘catches up’ somewhere in the late teens even twenties, – deficits still exist, as do chemical connection problems.
Whereas it was previously thought that children eventually outgrow ADHD, recent studies suggest that 30–60% of affected individuals continue to show significant symptoms of the disorder into adulthood. Children with the disorder are at greater risk for longer term negative outcomes, such as lower educational and employment attainment.
A vital consideration in the effective treatment of ADHD is how the disorder affects the daily lives of children, young people, and their families. Indeed, it is not sufficient to merely consider ADHD symptoms during school hours—a thorough examination of the disorder should take into account the functioning and wellbeing of the entire family.
As children with ADHD get older, the way the disorder impacts upon them and their families changes. The core difficulties in executive function seen in ADHD result in a different picture in later life, depending upon the demands made on the individual by their environment. This varies with family and school resources, as well as with age, cognitive ability, and insight of the child or young person. An environment that is sensitive to the needs of an individual with ADHD and aware of the implications of the disorder is vital. Optimal medical and behavioural management is aimed at supporting the individual with ADHD and allowing them to achieve their full potential while minimising adverse effects on themselves and society as a whole.
ADHD associated characteristics