I’m Jessica Kidwell, and this is Neuroversity. A space to expand our understanding of neurodiversity and elevate neurodivergent voices and experiences. October is ADHD Awareness month, and I absolutely could not let the month go by without dedicating an episode to the 2nd largest neurotype under the neurodivergent umbrella, ADHD. The largest? Dyslexia, which-shameless plug, you can learn more about in Episode 9 of this podcast, “A Beginners Lesson on Dyslexia with Certified Dyslexia Advocate and Consultant Lorraine Hightower”. But today is about ADHD, so are you ready to get ADHD aware? Alright, curious minds, let’s get started:
With 36 episodes under my belt, and the amount of time I spend in Neuroversity-I definitely have to check myself from falling prey to the Baader-Meinhoff phenomenon, also known as the recency bias. The more I learn about neurodivergent neurotypes, the more I see them all around me. And ADHD is my most common “arm chair diagnosis” these days. Especially in my adult female friends. I’m basically the “Oprah” of neurodivergent diagnoses, “you have ADHD, You have ADHD, YOU have ADHD”. I’m sure my unsuspecting friends, loved ones, acquaintances and a few total strangers love this unsolicited opinion. But, as I have said on numerous previous episodes, and will say again now, “I AM NOT A HEALTH PROFESSIONAL AND CANNOT DIAGNOSE ANYONE”, regardless of how certain I may feel or sound. So, let’s move back into an area where I can actually be helpful; providing information about a neurodivergent topic in order to help you or someone you know learn more and seek out professional advice should you deem that as something you’d like to pursue.
ADHD, Attention Deficit Hyperactivity Disorder, is a neurodevelopmental difference which affects 1 in 11 or about 9.8%** of children in the US. If you are 35 or older you may be familiar with the term ADD, or Attention Deficit Disorder. In 1994, ADD was replaced with ADHD, and some people use the two terms interchangeably, which can cause lots of confusion.
What also causes confusion is that many people think ADHD is a kid issue, and something you “grow out of”. That’s just not true. In fact, 75% or more of those children diagnosed with ADHD will continue to cope with that neurodevelopmental difference into their adulthood. *
And historically, more boys than girls are diagnosed with ADHD. More than 2x as many in fact. But, just as is being found in other neurodivergent neurotypes, that is looking more like a flaw in the screening tools rather than a true representation of less likelihood of any one neurodivergence actually occurring in girls. The behaviors of the neurodivergence are just different. And if all we studies were boys, then we have loads of professionals trained in recognizing biologically boy behaviors rather than the full scope of how a neurodivergence can show up. I can really go on a tear about the lack of biologically female representation in DECADES of neurodivergent research and how that has left generations of neurodivergent girls struggling with no support and no understanding of why they are different. But….back to ADHD.
So what IS ADHD? There are three presentations of ADHD: Predominantly Inattentive, Predominantly Hyperactive/Impulsive, and ADHD Combined. The Diagnostic and Statistical Manual, 5th Edition, or DSM-5 for short requires a medical professional to identify six or more behaviors of ADHD in children up to 16 order to receive a diagnosis. In adolescents 17 or older and in adults, five or more behaviors must be present to receive the diagnosis.
A summarized, but not exhaustive list of behaviors that fall under the “predominantly inattentive” presentation of ADHD include:
- Fails to give close attention to details or makes careless mistakes
- Has difficulty sustaining attention
- Does not appear to listen
- Struggles to follow through with instructions
- Has difficulty with organization
- Avoids or dislikes tasks requiring sustained mental effort
- Loses things
- Is easily distracted
- Is forgetful in daily activities
A summarized, but not exhaustive list of behaviors that fall under the “predominantly hyperactive/impulsive” presentation of ADHD include:
- Fidgets with hands or feet or squirms in chair
- Has difficulty remaining seated
- Runs about or climbs excessively in children; extreme restlessness in adults
- Difficulty engaging in activities quietly
- Acts as if driven by a motor; adults will often feel inside as if they are driven by a motor
- Talks excessively
- Blurts out answers before questions have been completed
- Difficulty waiting or taking turns
- Interrupts or intrudes upon others
And if a child exhibits six or more behaviors that fall into either type of presentation, then they are considered ADHD combined.
And because of the medical pathological need to categorize everything-each Type of ADHD is sorted into mild, moderate, and severe levels.
So, what can happen if you or your child has ADHD? If symptoms are ignored or missed, it can seriously impact school or work performance as well as relationship success. It can cause adverse mental health outcomes and increases the chances of substance abuse. It is extremely disruptive to all areas of life.
And as if having ADHD isn’t challenging enough, more than two thirds, or between 6 and 7 out of every 10 people with ADHD will also have one or more co-occuring neurodivergent or other behavioral difference. The most common being oppositional defiant disorder (or ODD) or conduct disorder (CD). Followed by generalized anxiety disorder, clinical depression, and autism spectrum disorder.
The point being, ADHD is serious. And those who have or suspect they have it, would really benefit from professional support. So, what does that look like?
First and foremost, if you suspect you, your child, or someone you know has ADHD, the best place to start is to talk to your doctor about it. Many healthcare professionals can diagnose ADHD: psychiatrists, pediatricians, neurologists, psychologists, clinical social workers, nurse practitioners, and licensed counselors or therapists. The key is making sure that the person you are using has experience in utilizing the DSM-5 criteria in assessing for ADHD. The Children and Adults with Attention Deficit and Hyperactive Disorder or (CHADD), which is a national organization providing resources, support, and membership to the ADHD community, has an excellent guide on what to ask a provider you are considering before they administer any evaluations. I have linked that guide, as well as links to other ADHD statistics and supports in the episode notes for this episode.
Once you have received an ADHD diagnosis, the treatment and supports provided can vary from person to person and from time to time throughout their life. ADHD is a neurodevelopmental difference, not a disease. You are not trying to cure this-your goal is to understand and then manage the way your, or your child’s, unique way of interacting with the world. Many people benefit from cognitive behavioral therapy practices, executive functioning skills training, parent based behavior training, and/or medicine. The American Academy of Pediatrics generally recommends that children under 6 receive behavioral therapy as a first line intervention, while for children 6 and over a combination of behavioral therapy and medication together. In a 2016 survey done by the Centers for Disease Control, of children aged 2-17 in the US with ADHD, 77% were receiving some form of treatment: of that 77%, 30% receive medication only, 15% receive behavior therapy only, and the rest (32%) receive both. Unfortunately, that means 23% of children with ADHD in 2016 were untreated. For adults with ADHD, the same treatment options exist as they do for children; behavioral treatments, medication, or a combination of both.
Alright fellow curious minds, now you can officially check observing ADHD Awareness Month off your to-do list for October. And if you are finding this episode outside of October, thanks for joining me for another episode of Neuroversity. As always, I would love to hear from you about what I’ve talked about today-or on any episode of Neuroversity. I hope the information you find here helps you feel less overwhelmed if you are navigating your own neurodivergent journey and helps all of us feel more informed about neurodivergent neurotypes. Because even though not everyone is neurodivergent, Neuroversity is for everyone.