Academic research about Attention Deficit Hyperactivity Disorder, commonly referred to as ADHD, has grown exponentially over the last decade. However, unfortunately public perceptions about ADHD are still shrouded with misunderstanding. Since ADHD is a medical condition affecting roughly 10% of children and 5% of the adult population, it is crucial that we gain a more accurate understanding of it.
Let’s begin with one of the most disturbing and erroneous misperceptions, the view that ADHD is not real. ADHD, Attention Deficit Hyperactivity Disorder is an inherited neurobiological condition. That means that ADHD is a medical condition that is caused by a difference in brain chemistry from the general population. Numerous brain imaging studies have shown visible differences in brain chemistry and structure among individuals affected by ADHD.
In fact, a large scale study using brain imaging compared 3200 individuals with ADHD showed visible differences in brain activity in the prefrontal cortex, the area largely responsible for executive functions (Medicalnewstoday.com, 2017).
ADHD is also highly genetic. Researchers have isolated two specific genes responsible for the condition. In other words, if one parent has ADHD there is greater than 50% chance that one or more of their children will also have the condition. In addition, among identical twins 80% share the ADHD trait. Further, ADHD is an officially recognized medical diagnosis by major medical, psychiatric, and educational organizations.
In fact, the National Institute for Health, the American Psychiatric Association, and the Department of Education all recognize ADHD as a legitimate medical diagnosis.
Since, we just clarified the biological basis for ADHD, we can address the other false perceptions surrounding the causes of ADHD . Among those are ineffective parenting. Twin studies of children with ADHD raised in separate families illustrate that the family environments of the children contribute very little to their individual differences in ADHD symptoms (Barkley, 2015). Further, although parenting practices do not cause ADHD, they can impact development of coexisting disorders such as oppositional defiant disorder (ODD) or conduct disorder (CD), and inconsistent discipline and a parenting style found to be associated with ADHD symptoms (Ellis et al. 2009). Another false belief is that too much sugar or screen team causes ADHD. Although, both of these issues can exacerbate ADHD symptoms, neither are causes.
Other common misperceptions about ADHD arise from the name itself. Experts in the field consider the term ADHD a misnomer for a several reasons. First, individuals with ADHD do not have a deficit of attention. Rather, they can have an attention surplus, a term coined by Harvard University psychiatrist and world renown author and ADHD expert Dr. Ned Hallowell. In other words, since they have difficulty regulating their attention, their focus can be pulled in a multitude of directions simultaneously. For example, while listening to a lecture attention can wander to a vibrating cell phone, the sounds of construction in the adjacent building, the uncomfortable chair, a growling stomach, and thoughts of what to have for supper tonight.
On the other hand, in situations of high interest, the ADHD mind possesses the ability to hyperfocus, a state of intense concentration or colloquially called being “in the zone.”
People with ADHD in hyperfocus can accomplish incredible tasks. For example, Peter Shankman a successful entrepreneur with ADHD wrote an entire novel on a NY to Tokyo flight. Hyperfocus, as explained by ADHD expert, Dr. William Dodson occurs because ADHD is driven by an interest driven nervous system (IDNS). According to Dr. Dodson whereas the majority of people can engage in a task that is interesting, important or there that has reward or consequence. Those with an IDNS can only get engaged if there interest is aroused or if there is novelty, urgency, or competition (Addidtude.com, Dodson).
Another reason the term Attention Deficit Hyperactivity Disorder remains an inaccurate description of the condition is that not all people with ADHD exhibit hyperactivity. While the stereotypical image of ADHD, a boy in constant motion unable to contain his endless supply of energy, depicts the hyperactive-impulsive type of ADHD, the American Psychiatric Association has identified three types of ADHD. The three types are: 1) ADHD, predominantly Impulsive/hyperactive 2) ADHD predominantly inattentive and 3) ADHD combined hyperactive/impulsive and inattentive. The main symptom for the inattentive type is difficulty focusing but without hyperactivity. Nonetheless, the combined presentation is by far the most common, where individuals are challenged by symptoms of hyperactivity, impulsivity, as well as inattention.
Other experts suggest a more appropriate name would be Executive function disorder, since inattention and hyperactivity alone, do not encompass the breadth of symptoms affected individuals with ADHD. Whereas, executive function skills include the gamut of ADHD challenges. According to leading ADHD researchers Tom Brown PhD and Russell Barkley, PhD ADHD impairments are executive function impairments including difficulty with organization, prioritization, planning, self-regulation, task initiation and follow through.
There’s also a common misconception that ADHD is overdiagnosed. It is a fact that the number of children and adults diagnosed with ADHD has nearly doubled over the last 20 years. However, overdiagnosis is not necessarily the correct explanation for these statistics. While isolated instances exist of students under increased pressure to perform seeking ADHD medication, overworked teachers trying to maintain decorum in large classes, and marketing efforts by the pharmaceuticals producing stimulant medications, according to experts these reasons do not account for the dramatic increase in ADHD diagnoses.
Many factors contribute to the increase in ADHD diagnoses. Perhaps the most significant is the growing awareness among parents, teachers, and school systems of the defining characteristics of ADHD.
Abundant research about ADHD in recent years has fueled a proliferation of media coverage on the topic and increased ADHD awareness. In addition, the rise of ADHD advocacy groups in the United States and Globally provide support, information, and resources. Further, the Affordable Care Act has granted many access to health care treatment previously lacking. Not surprisingly, the greatest increase in ADHD diagnoses were among the poor and minority groups. According to Dr. Miriam Eisenberg of the National Institute of Child Health and Human Development, “Based on the review of prevalence studies and research on the diagnostic process, there does not appear to be sufficient justification for the conclusion that ADHD is systematically overdiagnosed. Yet, this conclusion is generally not reflected in public perceptions or media coverage of ADHD.” (researchgate.net, 2018)
Another ADHD myth that needs to be dispelled is that only young boys are affected by ADHD. This false belief arises from the reality that boys are overwhelmingly affected by the hyperactive presentation of ADHD. Therefore, in the classroom and at home, there symptoms are more noticeable by parents and teachers alike and consequently, these boys are diagnosed at a young age. However, since girls are predominantly affected by the inattentive presentation, their symptoms are generally more subtle and less disruptive. Hence, they often go unnoticed by all but the most astute observers. Girls with ADHD are the students politely daydreaming and although they may be underachieving are far less visible than their typically rambunctious male counterparts.
“We were initially taught that ADHD is a boys’ phenomenon,” says Dr. Stephen Hinshaw, chair of the psychology department at UC Berkley. “Three decades later we know this is an equal opportunity condition.”
In addition, for the majority of children ADHD follows them into adulthood. In fact, only the most recent changes to the ADHD diagnostic criteria for health care providers recognize the phenomena of the condition in adults.
For those who live with ADHD or love those that do, ADHD is a real challenge. By knowing the facts about ADHD you can be a vital part of advocating for those with ADHD and creating greater awareness and understanding.