Attention Deficit Disorder
Or ADD, is often spoken of in conjunction with attention deficit hyperactivity disorder, or ADHD, and the two conditions are indeed related. But there are also noticeable differences between them. ADD could be considered a subtype of ADHD and is in fact sometimes called “inattentive ADHD.” The clinical term was officially changed in 1994 to “ADHD predominantly inattentive,” or ADHD-PI. This is the term used by the Diagnostic and Statistical Manual of Mental Disorders (DSM), but most people still refer to the condition informally as ADD.
ADD is diagnosed when a person has a problem focusing and paying attention but generally does not have symptoms of being extremely active and/or impulsive. While someone with ADHD can have issues with inattentiveness, hyperactivity, and impulsivity, a person with ADD is usually much less disruptive; in fact, people with ADD can sometimes exhibit lethargy and fatigue. The problem for someone with ADD is more limited than with ADHD but can be just as frustrating in many ways. It can interfere with the person’s daily life and prevent him or her from functioning normally and interacting successfully with others.
ADD/ADHD Typically Develops in Childhood
Although, adults can also have it. According to the National Library of Medicine, ADHD is the most frequently diagnosed behavioral disorder in children. Boys are diagnosed with it much more often than girls are, by a ratio of 5 to 1. While most if not all kids display symptoms of ADD/ADHD at times, to be diagnosed with the disorder the symptoms must be out of the range of what would be considered normal for someone of the child’s age and developmental level. The condition can extend into adulthood. Perhaps not surprisingly, as many as 50% of the adults with ADHD had it as children.
It’s not known exactly what causes ADHD-PI, but it’s most likely a combination of both genetic and environmental factors. Studies involving brain imaging indicate that the brains of children with ADHD may be different than the brains of those without it.
So what does it mean when someone has an attention deficit disorder, and what are the signs of the condition? Here are some of the major symptoms:
- Does not pay close attention to details and/or tends to make careless errors in schoolwork or workplace duties
- Seems not to listen when being spoken to directly
- Has trouble staying on task, following through with instructions, and completing schoolwork, chores, or other tasks
- Forgetful in terms of daily activities
- Has disorganized work habits
- Often loses needed items like school assignments, books, pencils, and tools
- Easily gets distracted by irrelevant sounds or other stimuli that other people ignore
- Frequently shifts from one task or activity to another without completing them
- Avoids or doesn’t want to do things that require a lot of sustained mental effort, such as studying
- Makes frequent shifts in conversation, doesn’t pay attention to what other people are saying
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To be diagnosed with ADHD-PI, someone must exhibit at least six of these symptoms for a period of at least six months. The individual should show the symptoms in two or more different settings, such as at school and home or at work and home. There should be evidence that these symptoms are causing a significant level of impairment and disruption in the person’s daily activities, be they academic, professional, or social.
There is a Computerized Neuropsychological evaluation known as Qb Test, that can be used as an adjunct in Diagnosis and Treatment of ADHD.
QbTest (K040894) was cleared by the FDA in 2004 to aid in the clinical assessment of ADHD in children aged 6-12 years old. An updated version of QbTest (K122149) was cleared October 17, 2012 and expanded the indication for use to include the clinical assessment of ADHD In adolescents and adults (aged 12-60). In April 2014, QbTest was cleared to aid in the treatment interventions and follow up for ages 6-60. Cleared as a Class II device by the FDA, QbTest has demonstrated strong and sufficient evidence for positively identify an ADHD individual from the non ADHD cohort as well as identifying individuals as not having ADHD. In short, the testing with interpretation by a trained professional has a very high sensitivity and specificity and strong balance between the two.
QbTest is today the only ADHD test that is cleared and registered by regulatory authorities in both the US as well as in Europe. More than 170,000 patients in 10 countries have performed a QbTest as a part of their assessment and/or treatment evaluation.
Benefits of using QbTest
At the present, ADHD is primarily identified on the basis of self-reports, parent, teacher and clinician ratings of the presence or absence of a list of symptoms and judgments about functional impairment1. Behavioral ratings are problematic because they are subjective in nature with potential biases and individual inconsistency in perceived meaning of items. This results in poor inter-rater reliability, with parents generally less accurate than teachers when compared to objective test
QbTest has high clinical validity and has shown significant results in several publications and audit studies (see Clinical Documentation included). The test also has several other initial advantages:
- The test is time efficient for the patient and the data is available to the physician in real time allowing for diagnosis and treatment to begin on the same day. Getting the diagnosis right at the beginning leads to fewer visits for evaluation
- The test is non-invasive and non-language based. It is designed to reduce the impact of confounding factors, such as problems differentiating from left to right, dyslexia and underlying anxiety. Patients with dyslexia and anxiety are commonly misdiagnosed as having ADHD because there is significant symptom overlap. To confound the issue further, both dyslexia and anxiety are common ADHD comorbidities, existing side by side with the neurology of ADHD.
1 Taylor, E., DOpfner, M.,Sergent, J.,Asherson, P.,Banaschewski, T.,Buitelaar,J.,Coghill,D.,
Once someone is diagnosed, there are a variety of treatment options available. These can involve medications, behavioral therapy, or a combination of the two. The use of medications depends on the severity of the condition. Many people have heard of some of the common medications prescribed for ADD/ADHD, such as Ritalin and Adderall. These and other medications have proven effective in reducing symptoms in many cases, especially with children. But they can also be of limited effectiveness over the long term, and in the case of children there is some concern that treating ADD with medication is simply stopping undesirable behaviors as a way for parents and teachers to deal with a frustrating situation. It’s important to remember that medications don’t cure the condition but only treat the symptoms; if you stop the medication, the symptoms return.
For this reason, a combination of medication and therapy is usually the best course of action for treating ADHD-PI in a more complete and long-lasting way. We can bring problematic symptoms under control with one or more medications, which then allows the individual to focus on and make progress in behavioral therapy. When the patient is a child, such therapy often involves the cooperation of the parents as well. Behavioral therapy can help in many ways. In addition to helping both children and parents understand the stressful emotions that come with ADD and gain control over them, therapy can help an individual develop organizational skills, study techniques, and improved functioning in social situations.