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Attention Deficit Hyperactivity Disorder
(ADHD) is a neurological condition that results in a person displaying
a number of behavioural symptoms. The pattern of behaviour differs
between individuals because each person has a different combination of
symptoms and each symptom varies in severity. Some of the more common
symptoms include:
| Distractibility |
difficulty in sustaining attention,
often getting distracted by other stimuli such as sights and sounds and
losing concentration easily. |
| Impulsivity |
doing things without thinking, saying things out
of turn and appearing impatient. |
| Hyperactivity |
not being able to sit still, constantly moving
and fidgeting. |
| Insatiability |
continuing with a line of conversation, never
appearing to be satisfied with an answer. |
| Social Clumsiness |
not picking up on subtle social clues, and so
appearing tactless and overpowering. |
| Poor Co-ordination |
difficulty in performing multiple tasks, looking
uncomfortable in their movements, and being clumsy. |
| Disorganisation |
not having structure to their tasks, often
flitting between jobs, whilst also being messy. |
| Variability |
switching moods very quickly, having good and bad
days. |
How is ADHD diagnosed in children?
Making a formal diagnosis of ADHD is a
complex process and involves a number of health professionals. However,
the greatest difficulty is ensuring that symptoms are not just a
reflection of other disorders, such as dyslexia, and that the symptoms
are not masked by a co-morbid condition, such as asperger’s syndrome.
The official list of symptoms which
healthcare professionals use to diagnose ADHD in children (diagnostic
criteria DSM-IV1 or ICD-10) state that: -
The child must display 6 symptoms of
either inattention or hyperactivity-impulsivity (or both) and symptoms
must have been present for at least 6 months.
Inattention
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Fails to pay close attention to
details or makes careless errors in schoolwork, work or other
activities |
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Has trouble keeping attention on tasks or play |
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Doesn't appear to listen when being told something |
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Neither follows through on instructions nor
completes chores, schoolwork, or jobs (not due to failure to understand
or a deliberate attempt to disobey) |
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Has trouble organising activities and tasks |
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Dislikes or avoids tasks that involve sustained
mental effort (homework, schoolwork) |
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Loses materials needed for activities
(assignments, books, pencils, tools, toys) |
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Easily distracted by irrelevant information |
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Forgetful |
Hyperactivity-Impulsivity
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Squirms in seat or fidgets |
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Inappropriately leaves seat |
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Inappropriately runs or climbs (in adolescents or
adults, there may be only a subjective feeling of restlessness) |
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Has trouble quietly playing or engaging in
leisure activity |
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Appears driven or "on the go" |
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Talks excessively |
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Answers questions before they have been
completely asked |
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Has trouble waiting his/her turn |
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Interrupts others |
The symptoms must begin before 7 years
of age, and be present in at least two places, such as school and home.
The disorder must negatively affect functioning in these places, and
the symptoms must not occur solely because of a psychotic disorder
(e.g. schizophrenia), or be better explained by an alternative disorder
(e.g. mood, anxiety or personality disorder).
The above criteria enables three types
of ADHD to be diagnosed as follows:
| 1. |
Combined Type: if both inattention
and hyperactivity-impulsivity symptoms exist. |
| 2. |
Inattentive Type: if only inattention symptoms
exist (sometimes referred to as Attention Deficit Disorder) |
| 3. |
Hyperactive-Impulsive Type: if only
hyperactivity-impulsivity symptoms exist. |
How is ADHD diagnosed in adults?
Diagnosing ADHD in adults involves the
assessment of the following symptoms:
| 1. |
A sense of underachievement, of not
meeting one’s goals (regardless of how much one has actually
accomplished). |
| 2. |
Difficulty getting organised. |
| 3. |
Chronic procrastination or trouble getting
started. |
| 4. |
Many projects going simultaneously; trouble with
follow through. |
| 5. |
A tendency to say what comes to mind without
necessarily considering the timing or appropriateness of the remark. |
| 6. |
A frequent search for high stimulation. |
| 7. |
An intolerance of boredom. |
| 8. |
Easy distractibility, trouble focusing attention,
tendency to tune out or drift away in the middle of a page or a
conversation, often coupled with an ability to hyperfocus at times. |
| 9. |
Often creative, intuitive, highly intelligent. |
| 10. |
Trouble in going through established channels,
following “proper” procedure. |
| 11. |
Impatient; low tolerance of frustration. |
| 12. |
Impulsive, either verbally or in action, as in
impulsive spending of money, changing plans, enacting new schemes or
career plans, and the like; hot-tempered. |
| 13. |
A tendency to worry needlessly, endlessly; a
tendency to scan the horizon looking for something to worry about,
alternating with inattentiveness to or disregard for actual dangers. |
| 14. |
A sense of insecurity. |
| 15. |
Mood swings, mood lability, especially when
disengaged from a person or a project. |
| 16. |
Physical or cognitive restlessness. |
| 17. |
A tendency toward addictive behaviour. |
| 18. |
Chronic problems with self-esteem. |
| 19. |
Inaccurate self-observation. |
| 20. |
Family history of ADD or manic-depressive illness
or depression or substance abuse or other disorders of impulse control
or mood. |
Twelve of the symptoms must be present.
Other indicators include a history of childhood ADHD (although not
necessarily formally diagnosed), and the symptoms not being explained
by another medical or psychiatric condition.
What are the effects of ADHD?
ADHD is predominantly diagnosed in children, and has a profound impact
on a child’s developmental learning. It is now recognized that children
do not grow out of ADHD, indeed it has been estimated that 60% of the
child ADHD population retain their symptoms into adulthood. Often
people who carry ADHD symptoms into adulthood experience low
self-esteem due to constant academic and social failures. This
exacerbates the problem of having to cope with ADHD symptoms in adult
life and can compromise an individual’s ability to achieve their
potential. Studies that have evaluated outcome of adults with ADHD have
reported a high incidence of anti-social disorders and substance
dependent disorders.
Furthermore, the prevalence of ADHD
sufferers in a prison population has been found to be 45%. These
reports imply that the early treatment of ADHD is essential to provide
the best chance for a child or adult to lead as normal a life as
possible.
How does neurofeedback treat ADHD?
In the case of children with attentional
difficulties, e.g. ADHD, brain research has documented an excess amount
of slow-wave activity, called theta waves, in the pre-frontal cortex.
Theta waves are especially predominant when children with ADHD try to
engage in an active concentration task, which makes it very difficult
for them to focus and sustain their attention on the task over a
prolonged period of time. This is illustrated in the brainmaps below.
Through neurofeedback training, children are taught to decrease their
amount of theta activity and increase faster beta frequencies which
enable them to sustain attention and focus on the task at hand.

Successful neurofeedback training has
been shown to:
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Reduce hyperactivity, attentional
problems and externalizing behaviours in children with ADHD. |
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Reduce or completely stop the need for stimulant
medication. |
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Increase general intelligence and school
performance. |
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Improve social functioning and emotional skills. |
If you or your child has been diagnosed
with ADHD, PeakMind can offer neurofeedback training as a form of
treatment. After the initial assessment, the neurofeedback training
would usually consist of between 20-40 one-hour sessions.
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