Attention Deficit Hyperactivity Disorder has had many names over the years. Whether it was the description of a boy in 1845 as "Fidgety Phillip" by Dr. Heinrich Hoffman, or as a "Defect in Moral Control" described by Sir George Still in 1902, ADHD has been with us for years, just under different labels. Newly discovered textbooks from 1795 describe the disorder as well, according to Dr. Russell Barkley.
The same symptoms and diagnostic markers used to identify ADHD were used for "Post Encephalitic Brain Disorder" in the 1920's, and "Minimal Brain Dysfunction" and "Hyperkinesis in Children" in the 1960's. It was only in the 1980's that the American Psychiatric Association defined this same group of symptoms as Attention Deficit Disorder, and later, Attention Deficit Hyperactivity Disorder, with different classification subtypes. The complete diagnostic criteria for ADHD can be found in the American Psychiatric Association's publication, the Diagnostic and Statistics Manual, abbreviated as the DSM. The DSM's most recent addition is the DSM -IV-TR, and it is considered the "bible" for diagnosing mental health issues. Source: National Institute of Mental Health Website
Data on the Prevalence of ADHD in the US
On September 5, 2005, the Centers for Disease Control issued a report entitled "Mental Health in the United States: Prevalence of Diagnosis and Medication Treatment for Attention Deficit Hyperactivity Disorder, United States, 2003." This report looked at the prevalence of ADHD diagnosis in all 50 states, based in part on telephone surveys of parents or guardians of 102,535 children, over an eighteen-month time frame. The CDC stated that ADHD, also known as Attention Deficit Disorder is a "neurobehavioral disorder characterized by pervasive inattention and hyperactivity/impulsivity that often results in substantial functional impairment." The CDC sought to clarify the number of children who had been diagnosed and trreated for ADHD, because previous estimates ranged from 2% to 18% of all children in community samples. The report states that approximately 4.4 million children ages 4 - 17 years of age were reported to have a history of an ADHD diagnosis, with 2.5 million, 56% of those diagnosed, were being treated with medication for the disorder in 2003. ADHD is 2.5 times more frequent amoung men than women, with the greatest prevalence being in males age 16 or older, and females age 11. ADHD diagnosis was more prevalent in boys in families below the poverty level, and in families where the most highly educated adult was a high school graduate. Prevalence varied substantially between states, with a low of 5% in Colorado to a high of 11% in Alabama.
What does this data tell us about ADHD?
About half of all kids diagnosed with ADHD are treated with medication.
Parental education and finances seem to affect the rate at which kids are diagnosed with ADHD, bringing up the question as to whether some cases of ADHD are misdiagnosed based on behavioral issues that are more closely related to family issues than to academic issues.
Secondly, there is a question as to whether kids are more likely to be medicated for their ADHD if they have health insurance, with the CDC data reporting that children who were taking medication for their ADHD were three times more likely to have health insurance than those who did not.
Kids are most likely to be diagnosed with ADHD between ages 9 and 11, roughly between third and fifth grades. This is before children enter Piaget's final developmental stage where they begin to be capable of more abstract reasoning, yet at the same time when the transition is made from learnng to read to reading to learn, and academic requirements for reading and writing increase substantially. This makes sense, since this is often when some kids "hit the wall" academically. Other common times for problems is at the beginning of middle school, where organization, writing down assignments, and meeting the expectations of many different teachers occurs, of in early high school, when the demands for interpretation, inference and abstract reasoning become stressed across the curriculum.
My Guys!
ADHD Month Show #1: Conversation with Dr. Kathleen Nadeau
Dr. Kathleen Nadeau is one of my heros. The opportunity to speak withe her for the LD Podcast was one of the highlights of 2006 for me. For those of you who are not familiar with Dr. Nadeau, she is a clinical psychologist in the Washington,
D.C., area. She earned her Ph.D. in clinical psychology from
the University of Florida, and has specialized in the issues
of attention and learning disorders for more than 20 years.
She currently serves as Director of the Chesapeake ADHD Center of Marylandin SIlver Spring. She lectures and gives workshops both nationally and internationally
on a variety of topics including: Giftedness and ADD (ADHD),
Workplace Issues for Adults with ADD (ADHD), Women and Girls
with ADD (ADHD), College Students with ADD (ADHD), and Life
Management Issues for Individuals with ADD (ADHD).
Dr. Nadeau is the author of more than ten books on ADHD. Her
best-selling children's book Learning to Slow Down and
Pay Attention, is now in its third edition. Her two books
for teens, School Strategies for ADD Teens and Help4ADD@HighSchool
are both top-selling books for adolescents with ADD (ADHD).
She is also the author of A College Survival Guide for
Students with ADD or LD.
Dr. Nadeau turned her attention to adult ADD (ADHD) in the
early 1990's and is the editor of the first book for professionals
on adult ADD, A Comprehensive Guide to ADD in Adults: Research,
Diagnosis and Treatment. She followed this book for professionals
with several books directed at helping adults with ADD better
manage their lives. These include the best-selling book ADD-Friendly
Ways to Organize Your Life, Adventures in Fast Forward - Life,
Love & Work for Adults with ADD, and ADD in the Workplace.
For the last decade, Dr. Nadeau has devoted her attention
professionally to the issues confronting girls and women with
ADD (ADHD). Her groundbreaking 1999 book, Understanding
Girls with ADHD, co-authored with Drs. Quinn and Littman
continues to be the only book that focuses on the diagnosis
and treatment of girls. She was co-editor of ADDvance:
A Magazine for Women with ADD and is co-founder of the
non-profit organization, The National Center for Gender
Issues and AD/HD. In 2002, Dr. Nadeau co-edited with her
partner, Dr. Quinn, two volumes on these important topics,
Understanding Women with ADHD and the only text on
ADHD in women for clinicians, Gender Issues and ADHD: Research,
Diagnosis, and Treatment.
In our conversation, we discuss how ADHD tends to look different in girls than in boys; when you should treat ADHD; why many parents are reluctant to consider medication as part of an ADHD treatment plan; and how some basic organization and problem-solving strategies can make your home less stressful.
On page 2 of our LD Podcast Resources Amazon page below, you will find a list and links to many of Dr. Nadeau's books, all of which I would highly recommend.
LD Online: One of the first and best sites about learning disabilities on the internet.
Schwab Learning-
a terrific site with great navigation that can help parents sort out
their questions abouth whether their children might have learning
disabilities.
Dr. Edward Hallowell- author of "Driven to Distraction", "Crazy Busy" and more. Principal of the Hallowell Institute in Massachusetts.
ADHD Resource Links
National Institute of Mental Health- this site has great information about the history of ADHD and its treatment. Very good links to other useful sites.
Centers for Disease Control website on ADHD- Great information on the general prevalnce of ADHD in the United States.
Pharmaceutical Companies: Drug companies clearly have an interest in providing information about ADHD and its possible medical treatment to physicians and consumers. This said, many of the websites hosted my drug companies contain alot of valuable information and links, ranging from general informaton about ADHD and its diagnosis, to strategies and study guides, to organization tips. These sites are worth a look, regardless of your opinion on the medical treatment of ADHD.
