ADD (Attention-Deficit Disorder) and ADHD (Attention-Deficit Hyperactivity Disorder) are closely related psychiatric disorders regarding neurodevelopment. ADD/ADHD affects both children and adults, and is characterized by difficulties with attention, hyperactivity, and impulsiveness which are inappropriate to a person’s age.
According to the organization CHADD (Children and Adults with Attention-Deficit Hyperactivity Disorder), there are three subsets of ADD/ADHD, each with a different set of symptoms:
ADHD—Primarily Inattentive Type:
- Fails to give close attention to details or makes careless mistakes
- Has difficulty sustaining attention
- Does not appear to listen
- Struggles to follow through on instructions
- Has difficulty with organization
- Avoids or dislikes tasks requiring sustained mental effort
- Is easily distracted
- Is forgetful in daily activities
ADHD—Primarily Hyperactive/Impulsive Type:
- Fidgets with hands or feet or squirms in chair
- Has difficulty remaining seated
- Runs around or climbs excessively
- Has difficulty engaging in activities quietly
- Acts as if driven by a motor
- Talks excessively
- Blurts out answers before questions have been completed
- Has difficulty waiting or taking turns
- Interrupts or intrudes upon others
- Meets both inattentive and hyperactive/impulsive criteria
These symptoms are more or less the same in both children and adults. However, adults usually develop coping skills that can mask or minimize the obvious negative effects of their symptoms. (Generally speaking, you won’t find adults running, jumping, climbing trees.) Impulsivity in adults may manifest in talking excessively, starting or ending relationships abruptly, problems with gambling, or other risky behaviors.
Since the symptoms for ADD/ADHD happen to everyone at some point in their lives, the diagnostic criteria is very strict. In children, symptoms must be more severe and more frequent than with peers; have lasted longer than six months; and have begun before age seven. For adults, the symptoms must have been present since childhood and affect a person’s ability to function in everyday life.
The ability to function in everyday life is also affected by ADD/ADHD impacting executive function skills, which are required for managing daily life tasks. A person diagnosed with ADD/ADHD might have trouble with executive function skills such as time keeping, organization, concentration, regulating emotions, processing speed, overcoming procrastination, etc. Executive functioning problems can manifest in different ways such as difficulty turning in homework, chronic lateness, or failure to seek help if not on the right track. These difficulties tend to appear in adolescence or adulthood, when changing life expectations require greater use of executive function skills. More frequent demands make the breakdown points more evident, especially in school, work, or independent living.
The different ways in which ADD/ADHD manifests in individuals has led to many debates about possible inaccuracies in diagnosis. For example, not all symptoms will be present at all times; many people with ADD/ADHD can remained focused for extended periods on activities or tasks that interest them. This appears to directly contradict one of the key symptoms, difficulty sustaining attention.
Differences in how the symptoms are displayed by the sexes have also historically affected who is diagnosed. Boys tend to act out in ways that are more obviously disruptive, leading to earlier and possibly more frequent diagnosis than in girls. (Boys remain roughly three times more likely to be diagnosed with ADD/ADHD than girls. The question remains whether this is because of a greater susceptibility in boys, or because girls with ADD/ADHD are more likely to pass unnoticed.)
ADD/ADHD remains a somewhat controversial diagnosis, with some people believing that it is over-diagnosed, especially in children. Those with ADD/ADHD who are undiagnosed often end up with damaging labels or opinions of themselves, believing the reasons behind their struggles are simply because they are lazy, stupid, or crazy. Those with ADD/ADHD also appear to be more likely to develop depression, anxiety, or other mood disorders, especially in those whose ADD/ADHD struggles make it difficult to navigate social situations.
Those with ADD/ADHD have several different options for managing their symptoms, such as developing coping skills, taking medication, or making lifestyle adjustments. A combination of these is often recommended; young children are not recommended to take medication except in severe cases.
Within the gifted community, ADD/ADHD symptoms can parallel traits commonly associated with giftedness. James T. Webb and Diane Latimer, from their 1993 publication “ADHD and Children Who Are Gifted”, note the similarities between giftedness and ADHD:
|Behaviors Associated with ADHD (Barkley, 1990)||Behaviors Associated with Giftedness (Webb, 1993)|
|1. Poorly sustained attention in almost all situations||1. Poor attention, boredom, daydreaming in specific situations|
|2. Diminished persistence on tasks not having immediate consequences||2. Low tolerance for persistence on tasks that seem irrelevant|
|3. Impulsivity, poor delay of gratification||3. Judgment lags behind development of intellect|
|4. Impaired adherence to commands to regulate or inhibit behaviour in social contexts||4. Intensity may lead to power struggles with authorities|
|5. More active, restless than normal children||5. High activity level; may need less sleep|
|6. Difficulty adhering to rules and regulations||6. Questions rules, customs, and traditions|
These similarities mean that gifted children are at risk of being misdiagnosed with ADHD. This can be particularly damaging if their giftedness remains unaddressed. For the gifted individual who does have ADHD, the challenge becomes the correct identification and treatment of negative symptoms.
Developing coping skills, particularly for executive function struggles, is important for both the gifted individual, the individual with ADD/ADHD, and the gifted individual with ADD/ADHD.