ADHD: Attention Deficit?

David L. Rickman, Ph.D.

• The term “Attention Deficit Hyperactivity Disorder” is misleading.

– ADHD is NOT the result of any deficits in attention (Barkley, 2005).

– ADHD is the result of self-control and self-regulation deficits (Barkley, 2006).

• Difficulties with inhibiting behavior appear symptomatically as attentional problems.

– Self-Control and attention are separate functions and involve clearly different anatomical regions of the brain.

It was once believed that the Reticular Formation, which regulates arousal and attention, was dysfunctional in persons with ADHD.Functional Magnetic Resonance Imaging research has revealed that the Preorbital Frontal Cortex functions differently in individuals with ADHD.

• Preorbital Frontal Cortex• Reticular Formation

The Preorbital Frontal Cortex:• Planning (Time Management)• Sequencing• Organizing• Self-Control• Other Executive Functions

Individuals with ADHD, with or without impulsivity or hyperactivity, have difficulties with executive functions.

• Accurate Diagnosis of ADHD (Anastopoulos & Shelton, 2001) – Physical Examination– Teacher Anecdotal Records– Behavior Rating Scales– Formal Observations in Multiple Settings– Developmental/Educational/Family History– Continuous Performance Testing

• Gordon Diagnostic System• Test of Variables of Attention• Conners Continuous Performance Test

• Effective Treatments of ADHD– Medication (CNS Stimulants)

• Dextroamphetamine (Dexedrine)• Methylphenidate (Ritalin, Concerta)• Amphetamine/Dextroamphetamine (Adderall)• Pemoline (Cylert)

– Behavior Management • Time-Out• Response-Cost• Behavior Contracts• School-To-Home Daily Reports

– Assistive Technology• “Attention Training System”• Voice Recorders• “Invisible Clock”• Computer Software• “Wiggle Cushion”• Relaxation Training• Biofeedback (Experimental)

Helpful Websites

• www.russellbarkley.org – Ongoing ADHD research, publications, conference schedules of Dr. Barkley.

• www.nimh.nih.gov – Authoritative site of the National Institute of Mental Health.

• www.vdps.net/special/psyhome.html - (In development) An informational website which contains classroom accommodations for various student difficulties.

References

Anastopoulos, A. & Shelton, T. (2001). Assessing attention-deficit/hyperactivity disorder. New York: Kluwer Academic/Plenum Publishing Co.

Barkley, R.A. (2006). Attention deficit hyperactivity disorder: A handbook for diagnosis and treatment (3rd edition). New York: Guilford Press.

Barkley, R.A. (2005). ADHD and the nature of self-control. New York: Guilford Press.