What is ADD / ADHD?
ADD or ADHD is an acronym for Attention Deficit Disorder / Attention Deficit Hyperactivity Disorder.
According to the Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5), it is a mental health disorder characterized by a persistent pattern of inattention and/or hyperactivity-impulsivity that develops in childhood and interferes with a person’s daily functioning and can include the following symptoms:
- Short attention span; difficulty sustaining attention and concentration for extended periods of time
- Being easily and frequently distracted by external stimuli and/or internal thoughts
- Difficulty following through on instructions or complete assignments, projects, and other tasks in a timely manner
- Often appears not to listen when spoken to directly (e.g., mind seems to be elsewhere, even in the absence of any obvious distraction)
- Poor organization skills as demonstrated by frequent forgetfulness, inattention to details and/or losing things required for tasks
- Hyperactivity as evidenced by high energy level, restlessness, difficulty sitting / remaining still or loud excessive talking
- Impulsivity as evidenced by difficulty awaiting turn, frequently interrupts or intrudes on others or does not consider consequences before acting on first impulses
Isn’t ADD / ADHD a condition found only in young children?
No. According to the DSM-V, the prevalence of ADHD occurs in most cultures in about 5% of children and about 2.5% of adults.
Research suggests that symptoms of ADD / ADHD can continue into adulthood and may have a significant impact on adult patients [e.g., impact on relationships, education, work / career, and even personal safety].
Because ADD / ADHD is frequently misunderstood, many patients who suffer from it do not receive proper treatment and can be difficult to diagnose in adults.
I’m pretty sure I have ADD / ADHD. What is the process to diagnose and treat ADD / ADHD?
Because the symptoms ADD / ADHD can be difficult to recognize and diagnose, the evaluation process is thorough and will comprise of three parts:
- Presenting complaint, history of presenting illness
- Psychological and/or psychiatric treatment history
- Risk Assessment
- Medical history, allergies, and medications
- Biological functioning
- Cognitive functioning
- Family history
- Social history
- Developmental history
- Presence of Trauma: History of physical abuse, sexual abuse, emotional abuse, neglect, domestic violence or other traumatic events
- Substance use history
- Legal history
- Mental Status Exam / Cognitive Functional Assessment
- Severity of presenting problem(s)
- Patient’s preferences and goals for treatment
- DSM V Diagnosis
- Treatment recommendations or interventions [Initiate referrals to other treatment providers or identify resources for support]
- Preliminary discharge plan
Part II: Administration of Brown Attention-Deficit Disorder Scales [note: This assessment will be scheduled as a separate, follow up office visit and is not covered by insurance].
The Brown Attention-Deficit Disorder scale is a well-known and consistent measure of ADD / ADHD across the lifespan. Based on Thomas Brown’s cutting-edge model of cognitive impairment in ADD/ADHD, the Brown ADD scales reliably screen and explore cognitive functioning associated with ADD / ADHD.
Part III: Treatment recommendations and interventions
Review assessment results with patient and/or patient’s family/legal guardian and discuss treatment options; which may include the following:
- Individual therapy and counseling to teach patient / patient’s family positive, adaptive coping strategies, ADHD coaching and other non-medical interventions to help cope with symptoms associated with ADD / ADHD.
- If necessary, coordination of care with patient’s Primary Care Physician, Pediatrician, Psychiatrist, or other specialist for medication management.
- Help identify other resources and supports for treatment [e.g., explore potential resources and accommodations in school system [IEP, 504 plan], university and other academic settings [e.g., Student Disability Resources]. This may include clinician writing letters of recommendation and support to help assist patient with their current academic needs.
