Many people are unable to sit still, plan ahead, finish tasks or be fully aware of what is going on around them. To their family, classmates or coworkers they seem to exist in a whirlwind of disorganized or frenzied activity. On some days and in certain situations they seem fine, often leading others to believe they can control this behavior. The disorder can adversely affect relationships with others in addition to disrupting their daily life, consuming energy and diminishing self-esteem. ADHD, once called hyperkinesis or minimal brain dysfunction, is a common disorder among children. It affects some 3-5% of all children - perhaps as many as 2 million American children. Two to three times more boys than girls are affected. On average, at least one child in every classroom in the United States needs help for the disorder. ADHD often continues into adolescence and adulthood, and can cause a lifetime of frustrated dreams and emotional pain.

ADHD is a developmental disorder in which certain traits such as impulse control lag in development when compared to the general population. Using magnetic resonance imaging of the prefrontal cortex, this developmental lag has been estimated to range from 3 to 5 years. These delays are considered to cause impairment. ADHD has also been classified as a behavior disorder. A diagnosis of ADHD does not, however, imply a neurological disease.

At present, ADHD is a diagnosis applied to children and adults who consistently display certain characteristic behaviors over a period of time. The most common behaviors fall into three categories: inattention, hyperactivity and impulsivity. ADD (Attention Deficit/Deficiency Disorder) occurs when hyperactivity is not present. While it was previousely thought that Attention Deficit was primarily a childhood problem, it is now believed that only one-third of this population grows out of it.

Not everyone who is overly hyperactive, inattentive or impulsive has an attention disorder. Are these behaviors excessive, long-term and pervasive, occurring more often than in most others the same age? Are they a continuous problem, not just a response to a temporary situation? Do the behaviors occur in several settings or only in one specific place such as the playground or the office?

According to the Diagnostic and Statistical Manual of Mental Disorders, there are three patterns of behavior that indicate ADHD, and someone may have one or more.

Signs of inattention include:

• becoming easily distracted by irrelevant sights and sounds
• failing to pay attention to details and making careless mistakes
• rarely following instructions carefully and completely
• losing or forgetting things such as toys, or pencils, books and tools needed for a task.

Some signs of hyperactivity and impulsivity are:

• feeling restless, often fidgeting with hands or feet, or squirming
• running, climbing or leaving a seat in situations where sitting or quiet behavior is expected
• blurting out answers before hearing the whole question
• having difficulty waiting in line or for a turn.

To be considered ADHD, the behaviors must have appeared before age 7 and continued for at least 6 months. In children they must be more frequent or severe than in most others of the same age. Above all, the behaviors must create a real handicap in at least two areas of a person's life, such as school, home, work or social settings. Someone whose work or friendships are not impaired by these behaviors would not be diagnosed with ADHD, nor would a child who seems overly active at school but functions well elsewhere.

Other conditions may produce similar symptoms resulting in an incorrect diagnosis. Anything from chronic fear to mild seizures can make a child seem overactive, quarrelsome, impulsive or inattentive. For example, a formerly cooperative child who becomes overactive and easily distracted after a parent's death is dealing with an emotional problem, not ADHD. A chronic middle ear infection can also make a child seem distracted and uncooperative. Living with family members who are physically abusive or addicted to drugs or alcohol can produce effects that may resemble ADHD, but are not.

In other children, ADHD-like behaviors may be their response to a defeating classroom situation. Perhaps the child has a learning disability and is not developmentally ready to learn to read and write at the time these are taught. Perhaps the work is too hard or too easy, leaving the child frustrated or bored.

It's also important to realize that during certain stages of development, the majority of young children tend to be inattentive, hyperactive or impulsive, and yet do not have ADHD. Preschoolers have lots of energy and run everywhere they go, but this doesn't mean they are hyperactive. Many teenagers go through a phase when they are messy, disorganized and reject authority but it doesn't mean they will have a lifelong problem controlling their impulses.

ADHD is a serious diagnosis that may require long-term treatment with counseling and medication. Medication-free methods should receive a trial before immediately beginning drug use. Identifying the problem can help people understand why they behave in these ways. This understanding can be an important part of coping with the disorder.

(2009) A University of Central Florida study may explain why children with attention deficit hyperactivity disorder move around a lot - it helps them stay alert enough to complete challenging tasks.

In studies of 8- to 12-year-old boys, Psychology Professor Mark D. Rapport found that children with and without ADHD sat relatively still while watching Star Wars and painting on a computer program.

All of the children became more active when they were required to remember and manipulate computer-generated letters, numbers and shapes for a short time. Children with ADHD became significantly more active - moving their hands and feet and swiveling in their chairs more - than their typically developing peers during those tasks.

Rapport's research indicates that children with ADHD need to move more to maintain the required level of alertness while performing tasks that challenge their working memory.

Performing math problems mentally and remembering multi-step directions are examples of tasks that require working memory, which involves remembering and manipulating information for a short time.

"We've known for years that children with ADHD are more active than their peers," said Rapport, whose findings are published in the Journal of Abnormal Child Psychology. "What we haven't known is why."

"They use movement to keep themselves alert," Rapport added. "They have a hard time sitting still unless they're in a highly stimulating environment where they don't need to use much working memory."

Rapport compared the children's movements during the tests to adults' tendency to fidget and move around in their chairs to stay alert during long meetings.

The findings have immediate implications for treating children with ADHD. Parents and educators can use a variety of available methods and strategies to minimize working memory failures. Providing written instructions, simplifying multi-step directions, and using poster checklists can help children with ADHD learn without overwhelming their working memories.

"When they are doing homework, let them fidget, stand up or chew gum," he said. "Unless their behavior is destructive, severely limiting their activity could be counterproductive."

ADD for Adults?

The causes of Adult ADD/ADHD, as with children, are still unknown. ADD/ADHD is thought to occur at least in part due to abnormal functioning of neurotransmitters, the chemical messengers of the brain. Risk factors for Adult ADD/ADHD include a childhood diagnosis of ADD/ADHD or suspicious behaviors, a family history of ADD/ADHD behaviors, or issues in pregnancy such as smoking or drinking; low birth weight and premature birth also are risk factors.

ADD/ADHD looks very much like a willpower problem, but it isn’t. It’s essentially a chemical problem in the management systems of the brain.

ADD/ADHD affects persons of all levels of intelligence. And although everyone sometimes has symptoms of ADD/ADHD, only those with chronic impairments from these symptoms warrant an ADD/ADHD diagnosis.

A person with ADD/ADHD is many times more likely to have another psychiatric or learning disorder than most other people. ADD/ADHD usually overlaps with other disorders.

Many adults struggle all their lives with unrecognized ADD/ADHD impairments. They haven’t received help because they assumed that their chronic difficulties, like depression or anxiety, were caused by other impairments that did not respond to usual treatment. [Dr. Thomas E. Brown, Attention Deficit Disorder: The Unfocused Mind in Children and Adults]

ADDH or ADHD? Here are some points of contrast in another format to assist in their distinction.

Conventional causes:
ADD - The cause seems to reside primarily in the parietal lobe. The frontal lobe processes are intact.
ADHD - The size and structure of many brain areas differs; especially, a lack of activity in the frontal area (“Hypofrontality”). This is linked to a deficiency of the neurotransmitters dopamine and norepinephrine which are involved with arousal and alertness. Low serotonin is linked to impulsivity and problematic behavior.

Main Indicators:
ADD - Fear; anxiety; low brain energy leading to a capacity problem; slow cognitive thinking; daydreaming; avoidance and procrastination; mental confusion; poor memory retrieval. But the frontal processes are intact so these people rely on logic.
ADHD - Problems with attention, impulsivity and hyperactivity.

Impulsiveness:
ADD - Rarely impulsive but can appear so when frustrated.
ADHD - Self-regulation is weak because the control mechanisms of the frontal lobe are not functioning well, e.g. self talk is not used; they are unaware of the consequences to their actions, fast cognitive speed contributes to impulsiveness.

Distractibility:
ADD - This is the primary problem. They cannot sustain attention and concentration because:
a) low energy which causes loss of focus and follow through
b) environmental factors
c) their own racing or wandering thoughts
ADHD - Cannot maintain focus so have poor sustained effort; race from task to task; are easily bored; forget and lose things because they missed information due to being distracted; need external motivation.

Hyperactivity/ Restlessness:
ADD - Due to anxiety, not the ADHD motor issue. These people are driven and cannot relax. Daring activities are rare; activities are not for excitement but for relief from constant, wandering, racing thought patterns and anxiety.
ADHD - Due to motor activity, not anxiety. These people crave excitement and stimulation.

Social Problems:
ADD - Shy; withdrawn, immature; often seen and not heard; information processing difficulties lead to not knowing how to talk, dress, act, etc.; conversation is difficult because of slow thinking or missed information; they can manipulate because of fear of others’ anger or guilt about asking directly; interrupt because their wandering thoughts will cause them to forget what they want to say. May appear to not be listening but this is really due to the person’s information processing deficit.
ADHD - Egocentric; do not connect with others because they don’t care; are rejected socially because of inappropriate behavior; are intolerant and can become abusive; cannot negotiate so manipulate others; interrupt because of impulsivity and lack of control; do not listen because of attention difficulties and lack of concern for others.

Communication:
ADD - When not talking excessively because of anxiety, these people say little but think a lot; therefore they do not display their thoughts or feelings. They are afraid to express anger or arouse it in others.
ADHD - Meaningful relationships. However, personal relationships may be difficult and uncertain. Because of egocentricity, poor focus, distractibility, intolerance, etc.

Time Sense:
ADD - Time is poorly planned; being late is common but can be improved with teaching and practice
ADHD - Time is poorly planned (miscalculation of time needed to complete a task); being late is common but can be improved with teaching and practice.

Impatience:
ADD - Do not need instant gratification. These people become impatient only after trying unsuccessfully for a long time at which point they are tired, disheartened and upset.
ADHD - Constantly frustrated and crave instant gratification.

Sensitivity:
ADD - Shy and fearful of others’ displeasure.
ADHD - Vulnerable to criticism to which they react, sometimes angrily.

Frustration Tolerance:
ADD - Desperate to succeed so will keep trying too long resulting in them being overwhelmed and despairing. This tendency may show as anger.
ADHD - Frustration tolerance is low, leading to irritability, anger and aggression.

Rigidity of thinking:
ADD - Tend to be concrete thinkers. May lead to rigid thinking patterns.
ADHD - Black and white thinkers due to the frontal processes not functioning properly. They are rigid in relationships and are NOT team players.

Planning and Organization:
ADD - May appear to have difficulty planning but these difficulties are really the result of distractibility, confusion and slow thinking processes.
ADHD - There may be sequencing problems due to poor frontal lobe functioning.

Perseveration:
ADD - A big problem. These people will keep trying too long, burn out, and quit.
ADHD - Not a problem for this population.

Learning Difficulties:
ADD - Information processing is poor because information is missed. Difficulties in slow cognition are common but once they understand the material they can use it. Reading and spelling be difficult because of weak phonemic skills. Mental arithmetic can and geometry can also present problems.
ADHD - May have learning disabilities (e.g. dyslexia) because of differences in brain functionality. Learning difficulties caused by the ADHD include missing information, and failing to learn from ones mistakes. They can often comprehend information but cannot make use of it.

Lying:
ADD - Aim to please. If they do lie it is usually only to avoid others anger or disapproval.
ADHD - May lie for no valid reason. Lying is impulsive and fear is not involved.

Criminal Activity:
ADD - Are not as at risk for criminal behavior as people with ADHD because they have a better understanding of the consequences to their action. Stealing is usually only committed to cover up something. People with ADD make poor criminals because they have slow cognitive speed and do not tend to get away in time.
ADHD - A lack of internal rules to govern behavior may lead to criminal activity. Maintaining a job may be a significant difficulty leading to low income and crime. People with ADHD are highly represented in the prison system.

Excessive Behavior:
ADD - 1) talking, 2) spending, 3) gambling, 4) anger, 5) movement, 6) eating, 7) alcohol/drug abuse especially cocaine. Caused by no internal STOP sign, no guilt, and no anxiety.
ADHD - 1) talking due to anxiety, not hyperactivity 2) alcohol/ drugs to self-medicate for anxiety (marijuana popular as it gives a sense of relaxation) 3) movement due to anxiety, not hyperactivity.

Positive Attributes:
ADD - movers and shakers, exciting, energetic, aggressive (all assets in pursuits others are afraid to try). Can do well if self-employed.
ADHD - These people do really well what they know they can do.