Attention Deficit Hyperactivity Disorder (ADHD): An Overview

Everything we do on a daily basis requires some degree of focus, concentration, organization or attention. To  get ready for the day we have to follow logical steps – have a shower, get dressed, eat breakfast, pack your lunch and belongings and leave on time to reach your destination. It seems simple right?

But what happens when these seemingly simple skills are compromised. We may find ourselves procrastinating and putting off getting dressed to watch the news or check Facebook. You become distracted by cleaning up the kitchen before breakfast; then you find a “note to self” to remember to defrost meat for dinner that night. But first you have to check the recipe for portions. Then a notification from Facebook pups up and next thing you know 20 minutes has passed and you’ve got 5 minutes to get ready and leave.

For people with ADHD (Attention Deficit Hyperactivity Disorder), nearly every task has a thousand distractions or alternate routes. While we all have difficulties with attention, organization, planning and focus, for some it warrants a diagnosis and therapeutic intervention to overcome some of these challenges and to improve their daily lives.

To know whether this is the case for you, it is important to identify the signs, symptoms and know how to accurately assess and intervene.

Symptoms; what is ADHD and what does it look like.

Put simply, ADHD is a neurodevelopmental disorder that typically affects our ability to maintain attention and focus and inhibit impulsive or hyperactive behaviours. ADHD typically develops in childhood and without intervention to manage symptoms, issues can persist into adolescence and adulthood.  This can have a significant impact on academic, social, emotional and professional functioning.

ADHD is usually classified into three different presentations as follows:

-       Inattentive: people meeting this presentation will typically have a lot of difficulties initiating and maintaining focus, organizing tasks, reduced attention to detail, easily distracted, deficits in task follow through and avoidance of difficult tasks.

-        Hyperactive: characterized by difficulties inhibiting physical or behavioural impulses. This might look like having trouble sitting still, fidgeting, moving from activity to activity quickly or  excessively interrupting or talking out of turn.

-         Combined: This occurs when both inattentive and hyperactive symptoms are present to an equal degree.

Another significant issue regarding ADHD is it’s high rate of co-occurrence with other mental health conditions, with as many as 80% of people with ADHD experiencing another disorder (https://www.mentalhelp.net/adhd/and-comorbidity.) . Commonly disorders that are comorbid with ADHD include:

-       Oppositional Defiance Disorder

-       Autism Spectrum Disorder

-       Anxiety, Depression, Bipolar

-       Conduct Disorder

-       Learning Disorder

-       Sensory Integration Disorder

Because of this, it is important to understand and clearly identify what symptoms are most concerning and how they might be affecting your emotions, thoughts, behaviours. relationships, education or work. To do this, it is essential to have comprehensive assessment strategies.

How Brain Care Assesses ADHD

Brain Care offers comprehensive and specialized assessments of ADHD to help gain a better understanding of you, your child or a loved one. To do this, we implement a multi-facetted approach to cover how you or your loved ones presentation affects you. The following methods help us to achieve a comprehensive understanding:

• Clinical interview : A comprehensive discussion about you or your loved ones experience with ADHD to understand  your initial presenting symptoms. Here we gather a history of your symptoms, how they developed and progressed and how they affect you in your daily life.

• ​Screening Evaluation  - Based on the clinical interview, you may be asked to complete a range of screening questionnaires to gather a full picture of your symptom profile. This may include screening of your attention, cognitive functioning, emotional state, and anything else specific to you.

• ​Connors-3 Questionnaire's (self, parent & teacher): This assessment tool is a more formal investigation into a persons observations of ADHD symptoms and common co-morbid patterns. The Connors-3 compares symptoms severity in relation to others the same age and can be used as part of an assessment battery for diagnoses.

• Assessment of Executive Functioning (such as the Dellis Rating of Executive Functioning): These will provide rich information into the specific areas of executive functioning (planning, organising, working memory, problem solving etc) that a person experiences.

• The Vineland-3 is an assessment of adaptive behaviour; the things that people do to function in their everyday life. It compares results to others the same age in a standardised way to identify how severely symptoms of ADHD affect your ability for communication, daily living skills, socialisation and even motor skills (in younger populations).

• ​ The Sensory Profile is a standardised assessment tool to identify how sensory events affect daily functioning. It investigates areas of registration, sensory seeking, sensory avoidance and sensitivity for auditory, visual, touch, movement, oral, and body positioning sensations. How these sensations are perceived can have a significant impact on our ability to pay attention and focus in daily life.

• QEEG & ERPs is an assessment that measures brain waves to examine how the brain is functioning. For ADHD, it can identify areas of the brain that are over or under active and how this affects attention, executive function, emotions, sensory processing and more.

• ​A Report with summary of results, diagnosis, therapy plan, and behavioral strategies can also be provided for your reference or to share with teachers, allied health professionals, or significant people in yours or your loved ones life.

How Brain Care Treats and Manages ADHD

Based on your comprehensive assessment, ADHD symptom profile and personal situation, a comprehensive and personalised therapy program can be developed to treat and manage symptoms.

Psychology and Counselling for ADHD

The therapy approach will vary based on your individual circumstances. Two common approaches to help manage and treat symptoms of ADHD are:

-       Behavioural therapy. This is a common approach that focusses on learning and promoting positive behavioural patterns and discouraging those that are not desired or functional. Commonly the clinician will work closely with the person and parents to achieve the best outcome. Strategies may include implementing reward systems, identifying effective responses to undesirable behaviours, or identifying ways to prevent or respond to common triggers for behavioural issues.

-       Cognitive Behavioural Therapy (CBT). It  is also used to identify underlying thought patterns affecting feelings and behaviours before offering and practicing alternatives to improve behavioural responses. CBT is also commonly used to address underlying or co-existing emotional issues that may be contributing to symptoms of ADHD.

Biofeedback and Neuromodulation for ADHD

As ADHD is a neurodevelopmental disorder, addressing the underlying physiology of yours or your loved ones symptoms can be an important aspect to assist in behavioural change. Biofeedback and Neuromodulatory therapies for ADHD include:

-       Heart Rate Variability (HRV) can help address symptoms of ADHD by learning to regulate arousal levels. HRV measures the natural moment to moment changes in heart rate and reflects the balance between fight and flight (stress and high arousal) or rest and digest (recovery and low arousal). High arousal in ADHD may look like impulsive behaviour, emotional reactivity, hyper focus on topics of interest and sensory over stimulation  while low arousal may look like inattention, sensory seeking behaviours, and disengagement from tasks that are not of interest. HRV training teaches you to regulate your nervous system and arousal so that you can be in a calmer and more attentive state to deal with the demands of daily tasks.

-       EEG Biofeedback or Neurofeedback is the process of learning to train your brain waves to make them more adaptive. Neurofeedback for ADHD typically targets areas of the brain related to executive and cognitive functioning, cognitive and emotional flexibility, sensory processing, sleep regulation and emotional issues. This will depend on the results of a QEEG assessment and what deviations in brain function are identified.

-       Transcranial Direct Current Stimulation (tDCS) uses a very week electrical current to help gently activate or suppress areas of the brain that may be under or over active to improve symptoms of ADHD.

The demand of our daily lives requires ongoing attention, concentration, organization and planning which ADHD can significantly impact. Feeling like you have no control over these skills can also affect our emotions and sense of self-belief to function optimally in a continually changing world. If you believe you or someone you love is experiencing symptoms of ADHD and are looking for support, Brain Care is here to help evaluate your current experience and provide solutions for effective management and treatment of ADHD.