ADD/ADHD--Often it is misunderstood by parents and teachers why people with attention difficulties struggle in their academic work. It is very possible for these individuals to try their best and still not achieve academically. Their problems may lead to others such as anxiety and/or depression because of their awareness of their struggles as well as how they are treated and perceived by others. One of the challenges for the individuals with this diagnosis is that their behaviors may be perceived as attitudinally based and as being defiant or lazy. While this can be a fine line, there are also very real challenges for these individuals who become angry and frustrated and are then at risk to stop trying.
There are multiple reasons why an individual may be having attentional difficulties in the academic or work arena. At the conclusion of the initial intake appointment, the recommendations for testing will be discussed and the individual will be asked to complete an individualized battery of tests to ascertain if the ADHD diagnosis is warranted.
Among the difficulties of individuals who qualify for the ADHD diagnoses are problems with executive functions. Some of the processes of executive functions are as follows:
• Working memory or the ability to hold information in short term memory or accessing facts in long term memory, manipulate it in some way and derive an answer;
• Arousal, Activation & Effort which includes activities such as getting started and finishing work, and paying attention;
• Emotional Regulation/Control which include the abilities to think before speaking or acting, tolerating frustration, and the ability to control behavior and direct future actions including the recognition of consequences; and
• Complex problem solving which including breaking components apart, analyzing the pieces and the reconstruction and organization into new ideas.
ADD or ADHD?
In the DSM-IV TR which is the diagnostic manual there is no diagnosis listed for ADD. What are in the manual are the diagnoses of ADHD, Predominately Hyperactive; ADHD, Predominately Inattentive; and ADHD, Combined Type. What people call ADD is listed in the manual as ADHD Predominately Inattentive.
Often parents and individuals do not think that they qualify for the diagnosis of ADHD because they are not hyperactive yet they are still struggling. The diagnosis of ADHD-Inattentive Type has a different set of symptoms that are related to inattention that have persisted and that are problematic for the individual. The diagnostic criteria in the DSV-IV TR for inattention are as follows:
Often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities
Often have difficulty sustaining attention in tasks or play activities
Often does not seem to listen when spoken to directly
Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions)
Often has difficulty organizing tasks and activities
Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework)
Often loses things necessary for tasks or activities (e.g. toys, school assignments, pencils, books, or tools)
Is often easily distracted by extraneous stimuli
If often forgetful in daily activities