Attention Deficit Hyperactivity Disorder

Attention deficit hyperactivity disorder (ADHD) is a diverse behavioral syndrome affecting 3% to 7% of children in the United States, characterized by inattention, over activity, and impulse control problems. This disorder, as currently understood, can manifest in one of three ways: Individuals with this disorder may be primarily inattentive, may be primarily impulsive/ hyperactive, or may present with a combination of both inattention and impulsive/hyperactive behaviors. Research indicates that boys are 3 times more likely than girls to be diagnosed with this disorder and tend to demonstrate the more visible externalizing aspects of the condition, which include overactivity and behavioral dyscontrol. The disorder, which has gained increasing recognition and research over the past 3 decades, affects the educational, social, and behavioral functioning in lives of a substantial number of school-age children, a fact that has significant implications for educational programming in schools.

Research focused on the causes of ADHD has implicated genetic and neurochemical factors as playing a large part in the etiology of this disorder. It appears to be the case that, although environmental factors may play some role in how ADHD symptoms are expressed, maintained, or exacerbated, brain-based and heredity explanations appear to be more likely factors in the expression of ADHD. Although the disorder may be due to these genetic and neurobiological factors, the way in which ADHD is perceived by others is influenced by the context in which the individual is viewed. Children might tend to be viewed as less hyperactive, for example, in a physical education class in which they are required to run and be active as compared with a classroom in which sitting still and focusing on a lesson are required. Therefore, the severity of the disorder can be influenced by the lens of the observer in some cases. For those with a severe form of ADHD, this hyperactivity appears to manifest more clearly across multiple settings.

Some researchers have argued that ADHD is a misnomer for a set of behavioral symptoms resulting from problems with brain-based executive functioning. Executive functioning serves a regulatory purpose for behavior and is thought of as involving higher-order cognitive skills that allow individuals to plan, organize, direct, and control behavior. This capacity also allows individuals to select and persist in adaptive behaviors. The kinds of behaviors that individuals with ADHD have difficulty with are also the kinds of behaviors regulated by this executive system.

In addition to this overseeing function, the executive system assists individuals with time management, memory, and metacognition, or the capacity to think about one's own thought processes and strategies. It is well known that these executive skills develop over the course of our lives and assist in tasks of daily living as well as impacting upon the educational experience of the individual. In fact, research has found that individuals with ADHD may be susceptible to a kind of time blindness thought to be related to deficits in their executive functioning. Self-regulation and self-control, as assisted by skills involving response inhibition, self-regulation of affect, task initiation, and adaptability, are also often problematic for those with ADHD.

...