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| ADD & ADHD |
| & Social Security Disability |
| Attorney Stephanie Joy (c.2011) "Combining the practice of SS law with Compassion and Communication" |
TM
Attention deficit/hyperactivity disorder (ADHD) is poor or short
attention span and impulsiveness inappropriate for the child's age; some
children also manifest hyperactivity. Although there is considerable
controversy about incidence, it is estimated that ADHD affects 5 to 10%
of school-aged children and is diagnosed 10 times more often in boys
than in girls. Many features of ADHD are often and invariably before age
7, but they may not and invariably before age 7, but they may not
interfere significantly with academic performance and social functioning
academic performance and social functioning until the middle school
years. ADHD was previously just called "attention years. ADHD was
previously just called "attention deficit disorder"; however, the common
occurrence of hyperactivity in however, the common occurrence of
hyperactivity in affected children—which is really a physical extension of
attention which is really a physical extension of attention deficit—led to a
change in the current terminology. ADHD can be in the current
terminology. ADHD can be inherited. Recent research indicates that the
disorder is caused by abnormalities in neurotransmitters (substances
that transmit nerve impulses within the brain). The symptoms of ADHD
range from mild to severe and can become exaggerated or become a
problem in certain environments, such as in the child's home or at
school. The constraints of school and organized lifestyles make ADHD a
problem, whereas in prior generations, the symptoms may not have
interfered significantly with children's functioning because such restraints
were often much fewer. Although some of the symptoms of ADHD also
occur in children without ADHD, they are more frequent and severe in
children with ADHD.
Symptoms
ADHD is primarily a problem with sustained attention, concentration, and
task persistence (ability to finish a task). The child may also be
overactive and impulsive. Many preschool children are anxious, have
problems communicating and interacting, and behave poorly. They seem
inattentive. They may fidget and squirm. They may be impatient and
answer out of turn. During later childhood, such children may move their
legs restlessly, move and fidget their hands, talk impulsively, forget
easily, and they may be disorganized. They are generally not
aggressive. About 20% of children with ADHD have learning disabilities
and about 80% have academic problems. Work may be messy, with
careless mistakes and an absence of considered thought. Affected
children often behave as if their mind is elsewhere and they are not
listening. They often do not follow through on requests or complete
schoolwork, chores, or other duties. There may be frequent shifts from
one incomplete task to another. About 40% of affected children may
have issues with self-esteem, depression, anxiety, or opposition to
authority by the time they reach adolescence. About 60% of young
children have such problems as temper tantrums, and most older
children have a low tolerance for frustration.
Signs of ADHD
All signs do not have to be present for a diagnosis of attention
deficit/hyperactivity disorder (ADHD). However, signs of inattention must
always be present for a diagnosis. Signs must be present in two or more
situations (for example, home and school) and must interfere with social
or academic functioning.
Signs of inattention:
Often fails to pay close attention to details
Has difficulty sustaining attention in work and play
Does not seem to listen when spoken to directly
Often does not follow through on instructions and fails to finish tasks
Often has difficulty organizing tasks and activities
Often avoids, dislikes, or is reluctant to engage in tasks that require
sustained mental effort
Often loses things
Is easily distracted by extraneous stimuli
Is often forgetful
Signs of hyperactivity:
Often fidgets with hands or feet or squirms
Often leaves seat in classroom and elsewhere
Often runs about or climbs excessively
Has difficulty playing or engaging in leisure activities quietly
Is often on the go or acts as if “driven by a motor”
Often talks excessively
Signs of impulsivity:
Often blurts out answers before questions have been completed
Often has difficulty awaiting his turn
Often interrupts or intrudes on others
Diagnosis
The diagnosis is based on the number, frequency, and severity of
symptoms. Symptoms must be present in at least two separate
environments (typically, home and school)—occurrence of symptoms just
at home or just at school and nowhere else does not qualify as ADHD.
Often, diagnosis is difficult because it depends on the judgment of the
observer. There is no laboratory test for ADHD. Questionnaires about
various aspects of behavior can help the doctor make the diagnosis.
Because learning disabilities are common, many children receive
psychologic testing both to help determine if ADHD exists and to detect
the presence of specific learning disabilities.
ADHD: Epidemic or Over-Diagnosis?
An increasing number of children are diagnosed with attention
deficit/hyperactivity disorder (ADHD). However, there is a growing
concern among doctors and parents that many children are
misdiagnosed. A high activity level may be completely normal and be
simply an exaggeration of normal childhood temperament. Alternatively,
it may have a variety of causes, including emotional disorders or
abnormalities of brain function, such as ADHD. Generally, 2-year-olds
are active and seldom stay still. A high activity and noise level is common
up until age 4. In these age groups, such behavior is normal. Active
behavior can cause conflicts between parents and child and may worry
parents. It also can create problems for others who supervise such
children, including teachers. Determining whether a child’s activity level
is abnormally high should not simply depend on how tolerant the
annoyed person is. However, some children are clearly more active than
average. If the high activity level is combined with short attention span
and impulsivity, it may be defined as hyperactivity and considered part of
ADHD. Scolding and punishing children whose high activity level is within
normal limits usually backfires, increasing the child’s activity level.
Avoiding situations in which the child has to sit still for a long time or
finding a teacher skilled in coping with such children may help. If simple
measures do not help, a medical or psychologic evaluation may be
useful to rule out an underlying disorder such as ADHD.
Treatment and Prognosis
To minimize the effects of ADHD, structures, routines, a school
intervention plan, and modified parenting techniques are often needed.
Some children who are not aggressive and who come from a stable and
supportive home environment may benefit from drug treatment alone.
Behavior therapy conducted by a child psychologist is sometimes
combined with drug treatment. Psychostimulant drugs are the most
effective drug treatment. Methylphenidate is the psychostimulant drug
most often prescribed. It is as effective as other psychostimulants (such
as dextroamphetamine) and is probably safer. A number of slow-release
(longer-acting) forms of methylphenidate are available in addition to the
regular form and allow for one time per day dosing. Side effects of
methylphenidate include sleep disturbances, such as insomnia, appetite
suppression, depression or sadness, headaches, stomachaches, and
high blood pressure. All of these side effects disappear if the drug is
discontinued; however, most children have no side effects except
perhaps a decreased appetite. However, if taken in large doses for a
long time, methylphenidate can occasionally slow the child's growth;
therefore, doctors monitor weight gain. A number of other drugs can be
used to treat inattentiveness and behavioral symptoms. These include
clonidine, amphetamine-based drugs, antidepressants, and antianxiety
drugs. Sometimes, combinations of drugs are used. Children with ADHD
generally do not outgrow their inattentiveness, although those with
hyperactivity tend to become somewhat less impulsive and hyperactive
with age. However, most adolescents and adults learn to adapt to their
inattentiveness. Other problems that emerge or persist in adolescence
and adulthood include poor academic achievement, low self-esteem,
anxiety, depression, and difficulty in learning appropriate social
behaviors. Importantly, the vast majority of children with ADHD become
productive adults, and people who have ADHD seem to adjust better to
work than to school situations. However, if the disorder is untreated in
childhood, the risk of alcohol or substance abuse or suicide may
increase.
Excerpted from Merck Manual Online.
attention span and impulsiveness inappropriate for the child's age; some
children also manifest hyperactivity. Although there is considerable
controversy about incidence, it is estimated that ADHD affects 5 to 10%
of school-aged children and is diagnosed 10 times more often in boys
than in girls. Many features of ADHD are often and invariably before age
7, but they may not and invariably before age 7, but they may not
interfere significantly with academic performance and social functioning
academic performance and social functioning until the middle school
years. ADHD was previously just called "attention years. ADHD was
previously just called "attention deficit disorder"; however, the common
occurrence of hyperactivity in however, the common occurrence of
hyperactivity in affected children—which is really a physical extension of
attention which is really a physical extension of attention deficit—led to a
change in the current terminology. ADHD can be in the current
terminology. ADHD can be inherited. Recent research indicates that the
disorder is caused by abnormalities in neurotransmitters (substances
that transmit nerve impulses within the brain). The symptoms of ADHD
range from mild to severe and can become exaggerated or become a
problem in certain environments, such as in the child's home or at
school. The constraints of school and organized lifestyles make ADHD a
problem, whereas in prior generations, the symptoms may not have
interfered significantly with children's functioning because such restraints
were often much fewer. Although some of the symptoms of ADHD also
occur in children without ADHD, they are more frequent and severe in
children with ADHD.
Symptoms
ADHD is primarily a problem with sustained attention, concentration, and
task persistence (ability to finish a task). The child may also be
overactive and impulsive. Many preschool children are anxious, have
problems communicating and interacting, and behave poorly. They seem
inattentive. They may fidget and squirm. They may be impatient and
answer out of turn. During later childhood, such children may move their
legs restlessly, move and fidget their hands, talk impulsively, forget
easily, and they may be disorganized. They are generally not
aggressive. About 20% of children with ADHD have learning disabilities
and about 80% have academic problems. Work may be messy, with
careless mistakes and an absence of considered thought. Affected
children often behave as if their mind is elsewhere and they are not
listening. They often do not follow through on requests or complete
schoolwork, chores, or other duties. There may be frequent shifts from
one incomplete task to another. About 40% of affected children may
have issues with self-esteem, depression, anxiety, or opposition to
authority by the time they reach adolescence. About 60% of young
children have such problems as temper tantrums, and most older
children have a low tolerance for frustration.
Signs of ADHD
All signs do not have to be present for a diagnosis of attention
deficit/hyperactivity disorder (ADHD). However, signs of inattention must
always be present for a diagnosis. Signs must be present in two or more
situations (for example, home and school) and must interfere with social
or academic functioning.
Signs of inattention:
Often fails to pay close attention to details
Has difficulty sustaining attention in work and play
Does not seem to listen when spoken to directly
Often does not follow through on instructions and fails to finish tasks
Often has difficulty organizing tasks and activities
Often avoids, dislikes, or is reluctant to engage in tasks that require
sustained mental effort
Often loses things
Is easily distracted by extraneous stimuli
Is often forgetful
Signs of hyperactivity:
Often fidgets with hands or feet or squirms
Often leaves seat in classroom and elsewhere
Often runs about or climbs excessively
Has difficulty playing or engaging in leisure activities quietly
Is often on the go or acts as if “driven by a motor”
Often talks excessively
Signs of impulsivity:
Often blurts out answers before questions have been completed
Often has difficulty awaiting his turn
Often interrupts or intrudes on others
Diagnosis
The diagnosis is based on the number, frequency, and severity of
symptoms. Symptoms must be present in at least two separate
environments (typically, home and school)—occurrence of symptoms just
at home or just at school and nowhere else does not qualify as ADHD.
Often, diagnosis is difficult because it depends on the judgment of the
observer. There is no laboratory test for ADHD. Questionnaires about
various aspects of behavior can help the doctor make the diagnosis.
Because learning disabilities are common, many children receive
psychologic testing both to help determine if ADHD exists and to detect
the presence of specific learning disabilities.
ADHD: Epidemic or Over-Diagnosis?
An increasing number of children are diagnosed with attention
deficit/hyperactivity disorder (ADHD). However, there is a growing
concern among doctors and parents that many children are
misdiagnosed. A high activity level may be completely normal and be
simply an exaggeration of normal childhood temperament. Alternatively,
it may have a variety of causes, including emotional disorders or
abnormalities of brain function, such as ADHD. Generally, 2-year-olds
are active and seldom stay still. A high activity and noise level is common
up until age 4. In these age groups, such behavior is normal. Active
behavior can cause conflicts between parents and child and may worry
parents. It also can create problems for others who supervise such
children, including teachers. Determining whether a child’s activity level
is abnormally high should not simply depend on how tolerant the
annoyed person is. However, some children are clearly more active than
average. If the high activity level is combined with short attention span
and impulsivity, it may be defined as hyperactivity and considered part of
ADHD. Scolding and punishing children whose high activity level is within
normal limits usually backfires, increasing the child’s activity level.
Avoiding situations in which the child has to sit still for a long time or
finding a teacher skilled in coping with such children may help. If simple
measures do not help, a medical or psychologic evaluation may be
useful to rule out an underlying disorder such as ADHD.
Treatment and Prognosis
To minimize the effects of ADHD, structures, routines, a school
intervention plan, and modified parenting techniques are often needed.
Some children who are not aggressive and who come from a stable and
supportive home environment may benefit from drug treatment alone.
Behavior therapy conducted by a child psychologist is sometimes
combined with drug treatment. Psychostimulant drugs are the most
effective drug treatment. Methylphenidate is the psychostimulant drug
most often prescribed. It is as effective as other psychostimulants (such
as dextroamphetamine) and is probably safer. A number of slow-release
(longer-acting) forms of methylphenidate are available in addition to the
regular form and allow for one time per day dosing. Side effects of
methylphenidate include sleep disturbances, such as insomnia, appetite
suppression, depression or sadness, headaches, stomachaches, and
high blood pressure. All of these side effects disappear if the drug is
discontinued; however, most children have no side effects except
perhaps a decreased appetite. However, if taken in large doses for a
long time, methylphenidate can occasionally slow the child's growth;
therefore, doctors monitor weight gain. A number of other drugs can be
used to treat inattentiveness and behavioral symptoms. These include
clonidine, amphetamine-based drugs, antidepressants, and antianxiety
drugs. Sometimes, combinations of drugs are used. Children with ADHD
generally do not outgrow their inattentiveness, although those with
hyperactivity tend to become somewhat less impulsive and hyperactive
with age. However, most adolescents and adults learn to adapt to their
inattentiveness. Other problems that emerge or persist in adolescence
and adulthood include poor academic achievement, low self-esteem,
anxiety, depression, and difficulty in learning appropriate social
behaviors. Importantly, the vast majority of children with ADHD become
productive adults, and people who have ADHD seem to adjust better to
work than to school situations. However, if the disorder is untreated in
childhood, the risk of alcohol or substance abuse or suicide may
increase.
Excerpted from Merck Manual Online.
If you suffer from disabling Attention Deficit Disorder (ADD or ADHD) or other Mental Illness or condition and can no longer work a full time work week, I would be happy to help you obtain your rightful Disability Benefits. You may be eligible for Social Security Disability benefits, even if you will eventually, and hopefully, recover. I would be honored to assist you. Start by filling out the FREE online Social Security Disability Claim Evaluation Form, calling me at 201-317-0610 or emailing me at stephaniejoy@myssicase.com. |