By: Regina M. Cashman, M.A., A.B.M.P.D.

Do you wonder if you or your child may have Attention Deficit Disorder (ADD)? Or have you, or someone you love, recently been diagnosed with ADD?

ADD is a physical, neurobiological condition that can impact an individual’s behavior, emotions and ability to learn. Research demonstrates, through PET (positron emission tomography) scans and MRI’s (magnetic resonance imaging), that there are both chemical and structural differences between the ADD and non-ADD brain. The research into the science of ADD is in its infancy but it is known that that there is also a genetic component. Traumatic assault on the brain due to an illness or injury can likewise result in ADD.

There is much controversy about the condition because there is no definitive scientific test to diagnose ADD. The occasional misdiagnosed child, coupled with uninformed jokes about ADD and/or psychiatric medications that have cropped up on popular T.V. shows and in the movies, has given the general public the impression that ADD is over-diagnosed and that there is an abundance of wrongfully medicated children in our society. This couldn’t be further from the truth. The reality is that ADD is significantly under-diagnosed. Research does not support the over diagnosis of ADD or the over prescription of psychotropic medications for the condition (Goldman et al., 1998; Jensen et al., 1999). The reality is that there are fewer children (2 to 3 percent of school-aged children) being treated for ADD than who are actually ADD. While diagnostic rates are much lower for s girls, minorities, and children receiving care though public service systems (Bussing et al., 1998a, 1998b) there has been a major increase in the number of stimulant prescriptions since 1989 (Hoagwood et al., 1998), and methylphenidate is being manufactured at 2.5 times the rate of a decade ago (Goldman et al., 1998). Most researchers believe that much of this increase is due to more awareness, better diagnosis and more effective treatment of a prevalent disorder. Girls, adolescents and adults, groups all under diagnosed in the past, are now being identified and treated more frequently. ADD is the most commonly diagnosed behavioral disorder of childhood and is thought to occur in 5 – 10% of the general population.

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) sets forth the criteria to be used by qualified clinicians when making a diagnosis of ADD. The DSM-IV classifies ADD into three sub-types: Inattentive, Hyperactive, and Combined. The guidelines for determining an ADD diagnosis are very specific. Everyone experiences ADD traits to some extent, at some point, over the course of a lifetime. A distinguishing factor between those who are, and those who are not, truly ADD is the frequency, intensity and duration of those traits. Research suggests that the symptoms of ADD can persist into adulthood, having a significant impact on familial, social and work relationships.

To be diagnosed with ADD individuals must have six of the nine characteristics in either or both DSM-IV categories listed below. The symptoms must have been present for a period of six months or more and cause impairment in more than one setting.

Criteria for the three primary subtypes are:

AD/HD - Inattentive Type

Individual meets both sets of inattention and hyperactive/impulsive criteria

Once diagnosed, a comprehensive multimodal treatment and intervention plan should be developed. Such a plan includes medical, educational, therapeutic and coaching intervention. Please visit www.addcoach.info. to take a prescreening assessment for ADD and to learn more about its management.

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