The truth about ADHD

By Dr. Poonam Khanna, D.O./Child and Adolescent Psychiatrist

Despite what the word “deficit” suggests, children with Attention Deficit Hyperactivity Disorder (ADHD) don’t lack attention—they have too much of it! Most experts today suggest that children with ADHD simply struggle to manage their attention. Their minds dart from place to place, or they might have trouble closing their minds to things that aren’t immediately relevant in order to focus on things that are. Because they’re paying attention to so many things, they cannot focus.

ADHD can affect your child’s attention, or it can make him or her hyperactive or impulsive, or in many cases, both.

ADHD affects a category of brain operations called “executive function,” which are the processes related to managing yourself and the things around you to reach a goal. The six functions most disturbed by ADHD are:

  1. Flexibility, or the ability to change your mindset or think of alternate ways to solve problems.
  2. Organization, or the ability to think ahead and prepare for the future.
  3. Planning, or the ability to set a goal and take steps toward achieving it.
  4. Working memory, or the ability to store information in your mind and access it with short-term memory.
  5. Separating emotions from reason.
  6. The ability to manage the things you say and do, such as waiting in line.

ADHD in the brain

The executive functions above are mostly controlled by the front lobes in the brain. In MRIs, people with ADHD show low activity in the frontal lobes associated with controlling impulse and managing timing motor responses. Interestingly, in one study, children played a “red light, green light”-type game. When children without ADHD made errors in controlling their responses, it was due to a lapse of attention. But when children with ADHD made errors, their brains showed activity.

Risk factors

In the United States, only about 3 to 7 percent of children have ADHD. Of the children who do have it, more than 50 percent also experience a co-condition. Common co-conditions to ADHD include learning disorders, restless legs syndrome, depression, anxiety disorders and substance abuse. If you or another family member has ADHD or one of its co-conditions, the likelihood of your child having it increases significantly.

Although historically, ADHD has been diagnosed in more boys than girls, the ratio is gradually evening out.

Experts say that more than 50 percent of children with ADHD will retain the disorder into adulthood, though the hyperactivity will likely wane a bit due to the changes in the brain after adolescence.