*These are not sufficient for diagnosis. If you think you are affected,
please see your physician or a specialist.

BRIEF NOTES ON AD/HD

• AD/HD through the life cycle: many difficult from birth, colicky; difficulty bonding, eye contact; sensitive to noise, touch, taste; excessively mischievous; early risk-taking; climbers; most not diagnosed until school starts; aggression
  
• Variable school performance; 40-50% with learning disabilities; 25-50% outgrow by puberty; outgrow hyperactivity but not inattention, impulsivity or disorganization; sometimes high levels of family conflict
  
• 52% abuse drugs/alcohol as adults; cocaine & marijuana also popular; Meds
  
• Often coincident with depression, bipolar disorder, Tourette’s, ODD/OCD, personality disorders
  
• Symptoms often reduced in novel-stimulating situations, better with structure and consistent rules, better with less emotionality (very sensitive to emotional tone)
  
• Symptoms worse if situation boring, high levels of emotion, physical or emotional stress, dislike
  
• Causes: genetics, brain trauma, prenatal toxic exposure, oxygen deprivation, brain infections, high fevers; much heterogeneity covered under label AD/HD
  
• Dopamine system most affected; prefrontal cortex deactivation leading to more difficulty with expressive language, short term memory deficits, impulsivity, restlessness, poor internal supervision, repeat mistakes
  
• If cingulate part of brain affected then worry, less flexible, stuck on thoughts or behaviors, oppositional
  
• Worldwide: found wherever clinicians have looked; rates differ depending on how diagnosed
  
• Not benign: more apt to drop out of school, to abuse substances, to have trouble holding jobs and maintaining relationships; hard prioritizing; overwhelmed by detail; hyperfocus
  
• Male-female difference; impact of aging; not lazy or stupid (no IQ connection); diet (more protein and less carbohydrates) and exercise important, music good
  
• Educational environment: seat near teacher at front of class, surround with good role models, avoid distracting stimuli, do not handle change well, stimuli-reduced study area that all students use, set times and routines, special study place, help with organization, need to work on follow through and positive thinking; ISOLATION not good
  
• Teachers should make eye contact during instruction, made directions clear and concise, be consistent, make sure instructions understood before starting task, repeat instructions if needed, make it easy for them to get help although try to reduce the help over time, notebook with assignments that parents check, one task at time, monitor frequently, test knowledge and not attention span, give extra time, easily frustrated and then act out