Attention-deficit/hyperactivity disorder (ADHD) is one of childhood’s most common underdevelopment conditions. It affects 5-9% of people. ADHD is often diagnosed in childhood, but it can continue throughout life. Inattention, hyperactivity, and impulsivity are all symptoms of ADHD. These can change with age. Treatments can include stimulant medication and behavioral therapy.The Centers for Disease Control and Prevention report that as of 2016, over 6.1 million children had been diagnosed at one time with ADHD. About twice as many boys as girls are diagnosed.Julie Schweitzer of the UC Davis MIND Institute, a professor at the Department of Psychiatry and Behavioral Sciences and a ADHD expert, discusses common symptoms and shares the latest research done by the MIND Institute.
What symptoms are most common in ADHD?
Both the age of the person and the environment must be considered. The symptoms must be severe and present in all settings: both at home and school for children, and at the workplace and at home for adults. ADHD can often affect relationships with others.
Problems paying attention
Losing or forgetting things
A lack of motivation to complete tasks or projects.
Avoiding careless mistakes
Trouble sitting down
Squirming or fidgeting, tapping the hands
Talking too much
As if being driven by a motor, it is always in motion.
Difficulty in taking turns Interrupting or blurting out answers-problems with waiting-the symptoms of ADHD can be inattentive or hyperactive, or impulsive and hyperactive and its symptoms are often misunderstood. We focus on evidence-based care and research at the MIND Institute. Recently, I was a coauthor of the World Federation of ADHD Consensus Statement which reviewed critical research worldwide. Over 80 authors from over 27 countries compiled more than 200 key findings on ADHD supported by research.
What are the differences between ADHD symptoms in children and adults?
As the brain develops so do symptoms. Some people have no symptoms. Others continue to struggle with them into adulthood. Adults face many challenges, including procrastination and poor time management. They also have low stress tolerance and a tendency to be restless. Adults might also choose jobs that require high levels of activity or multitasking, such as sales. Some people with ADHD have trouble controlling their emotions, and they may become irritable.
Why does ADHD fade in some people but not others?
We are studying this at the MIND Institute. The MINT study (Mapping Impulsivity’s Underdevelopment Pathway) has been going on for eight years, and it includes over 200 participants aged 12-30. Around age 26, the prefrontal cortex, and cerebellum are fully mature. ADHD symptoms may be lessened as these brain areas mature.
Julie Schweitzer, a professor at the Department of Psychiatry and Behavioral Sciences of The MIND Institute is a member of the MIND Institute.
We collect brain scans, track measures such as students’ grades, and ask them, their parents and their teachers to rate the behaviors. Do they use drugs, eat junk foods, wear a helmet when riding a bicycle, or eat fast food? This is to track self-control, and how people make decisions. They are also asked to complete working memory and reward responses. These tasks tap into the processes that influence decision-making. We may then ask them to decide whether they want $10 in a month or a dollar today.
For many years, we have followed these adolescents and young adults to see if some of their symptoms disappear, and, if so, what happens within the brain.
What have you found so far?
Our research found that the structural connectivity between brain areas related to dopamine (a neurotransmitter associated with reward and affected stimulant medications) differs between people who have ADHD and those who are typically developing. We found stronger connections between reward and emotion areas and weaker ones in reward and attention regions. This may result in greater impulsivity.Working memory is also being studied. This allows you to remember information for a short period of time to complete a particular task. Working memory problems are present in some people with ADHD, but not in all. To understand why this is, we asked participants with ADHD (and those without) to perform brain scans while they were asked to recall three or more objects in either a forward or a backward order. We compared how the amount of information and complexity of the task affected the brain scans of participants (both with ADHD and without). In tasks that required more information or were more complex, we found that certain brain areas in ADHD individuals were less active. This could have implications for interventions such as training in working memory.ADHD, irritability and hyperactivity:In addition, we have found significant results related to ADHD and irritation. In a recent study, we looked at the role of irritability in ADHD symptoms during adolescence. We looked at gender and sex differences in ADHD to see if they moderated the relationship between irritability, and future ADHD symptoms. We found that higher baseline irritability predicted higher hyperactive/impulsive symptoms 18 months later. Only females were affected.A second study of irritability and functional brain connectivity showed a stronger connection between reward and threat processing brain regions, and a weaker connection between attention and emotion processing brain regions. Clinicians should now consider treating people with ADHD who are irritable when they don’t achieve their goals.An example of tasks that participants in the VRAM study are asked to perform.
What are the treatment options for ADHD symptoms?
The best treatment often involves a combination of medication, often a stimulant, and behavioral therapy. This could include academic support in school, coaching for better goal setting, establishing methods to achieve goals, as well as help with time management. Exercise and other methods that help regulate emotions can also be beneficial. Clinicians should assess whether they are affected by irritability and need to address it based on our research as well as other studies.The MIND Institute provides parent education workshops that help improve family interactions between parents and children, create a more predictable and structured home environment, as well as better home-school co-ordination. The topics include homework strategies, positive attention and the rights of children with ADHD.
What is your research into behavioral therapy?
A VRAM participant learns to use the virtual classroom software.
Our VRAM (Virtual et al.) The study examines a non pharmaceutical way to address ADHD and distractibility. In a virtual reality classroom, we test whether “exposure” therapy with habituation of joint distractions can help children overcome distractibility. Participants are given a VR headset to wear and tested on their ability to perform tasks that require attention in a virtual environment with many distractions such as teachers or students walking by. The goal is to train your brain to remain focused in spite of distractions. Sessions last 25 minutes. Participants aged 8-12 are required to attend one session per day. The aim is to transfer lessons and training from the virtual classroom into the actual classroom.
Do you plan to conduct any other ADHD research?
In the coming weeks, we hope to begin a project that involves a specially-designed “smart fidget” ball. This study is a collaborative effort between researchers from the UC Santa Cruz and MIND Institute. Participants will be asked to perform memory and attention tasks, and they will also watch film clips that elicit an emotional response. The team will examine natural movements like fidgeting and then give participants the “smart fidget” ball to tap, click or squeeze. Machine learning will be used to analyze the results and predict which fidget ball behaviors work best and recommend them for possible therapy.
Can a diagnosis of ADHD be positive?
Yes! People with ADHD tend to be energetic, creative, risk-taking, spontaneous, and adaptable. They are often hyper focused on something they find interesting or engaging.
What can a parent expect to do if they believe their child may have ADHD?
Begin by contacting a primary care provider or pediatrician who can refer your child to a psychologist for an evaluation. Clinical psychologists are able to provide behavioral therapy and perform detailed evaluations. Psychiatrists are able to provide ADHD treatment, especially if the condition is combined with another psychiatric challenge. Many options exist for treating symptoms, which can improve the quality of life. I encourage parents with questions to seek medical guidance.