What is ADHD?

It seems very common, the feeling is that many suffer from it, and according to medical publications it is the most common neuro-developmental disturbance for students of school age (up to 10% of children). The full name is Attention Deficit Hyperactive Disorder, in short ADHD, and includes 2 groups of children, with different behaviors, under the same umbrella of ADHD.

Attention Deficit - children whose main problem is the inability to concentrate and can present the following symptoms:

  • Don’t pay attention to details

  • Inability to concentrate for long during games

  • It’s common for the child not to listen when their name is called

  • Inability to follow directions and finish a chore or mission, and not because they are unwilling to or don’t understand.

  • Hardship in organizing activities.

  • Avoid situations that require long mental work (like homework)

  • A tendency to lose objects

  • Easily distracted by outer and inner factors

  • Forgetfulness

 

Hyperactivity - hyperactive and impulsive children present the following behaviors:

  • Hyperactivity

  • Can’t stop moving or playing with fingers

  • Won’t sit still when they need to

  • A tendency to run, jump and climb in inappropriate situations

  • Can’t play in a calm and quiet way

  • Unstoppable, seems like they are connected to an engine

  • Over speak

  • Impulsive

  • A tendency to answer before the question is finished

  • Can’t wait in line

  • A tendency to break into other’s conversation or game

 

Children can suffer from a disorder that is mainly attention deficit or mainly hyperactive-impulsive, but it is also common to have a combination of both.

 

When reading the list you might feel that this perfectly describes you or one of your family members since every child (and adult) can sometimes behave this way or in a way that resembles it. What defines a child with ADHD is the frequency in which it takes place, as well as the fact this behavior appears in different environments (not just in school or just at home) and the fact that this behavior causes significant difficulty in the child’s function. It is only considered ADHD if all of these occur.

 

It’s important to know that ADHD can be the result of a variety of “mimicking disorders”, which the doctor must know of. In addition, there are many “accompanying disorders” that can appear in addition to ADHD, so it’s important for the doctor to collect as much information as possible on the child, assess and examine them carefully before making the diagnosis of ADHD.

 

How is the diagnosis of ADHD made?

ADHD is a behavioral disorder. Although the amount of information is growing about the biological basis of ADHD, there is no objective test, blood test or MRI that can diagnose a child with ADHD. The same way anxiety or depression is diagnosed by what the patient and those surrounding them describe, ADHD is also diagnosed this way - without a blood test or MRI but by what the parents and teachers tell about the child’s behavior.

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The diagnosis process is long. Recommendations for the diagnosis process of ADHD have been released by professionals in Israel and around the world (for example, the Israeli ministry of health, APA etc.).

Common criteria agreed upon by all: 

  • Collect information from the parents, teacher, school advisor and psychologist (when relevant) about behavior that could suggest ADHD, and understand how these behaviors affect the child. This information has the highest importance in diagnosing ADHD.

  • When collecting the information use criteria established by the DSM

  • When collecting information go over and rule out mimicking and accompanying disorders of ADHD.

 

To make the process easier, there are international questionnaires that give a wide view of the child’s situation. Vanderbilt questionnaires have been checked by the American association of pediatricians and have been widely used in the USA and around the world. The advantage of using these questionnaires is that they have been verified on large populations and usually help not only in diagnosing the disorder but also in diagnosing mimicking and accompanying disorders.

 

There are different techniques in Israel and the rest of the world for filling out a computerized diagnostic test for ADHD. It’s important to know that these questionnaires don’t under any circumstances replace the diagnosis process described above. These computerized tests aren’t necessary in diagnosing ADHD anywhere in the world and they can’t truly make the diagnosis. The computerized tests aren’t mandatory requirements anywhere in the world, but they can sometimes help the process and the follow-up. Examples of these are TOVA, MOXO, and BRC. As mentioned earlier, blood tests or brain imaging (such as MRI) aren’t part of the diagnostic tools. If the information that comes up during the conversation with the doctor or the physical exam raises certain suspicions, there might be a need for complementary tests.

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