ADHD Update and Call-to-Action
Julia Grover-Barrey OTR/L
Founder of In-Tuned®
Fact: ADHD is one of the more prevalent neurodevelopmental disorders, effecting 5 to 7% of children, mostly boys, and between 3 to 5% of adults.
Myth(s):
ADHD is a disorder contrived by big pharma to sell prescription drugs.
“We used to call it being a boy, now we call it ADHD”.
ADHD is the result of ineffective or bad parenting.
ADHD is a continuum disorder with some being at the extreme end of typical functioning, while others are quantitatively different from their peers. ADHD causes significant functional impairment in daily life activities, reduces school success and strains personal relationships (Faraone & Larsson, 2019). Many have difficulties into adulthood negatively affecting aspects of function, including employability.
ADHD is heterogeneous meaning it can present in different ways, co-exist with other neurodevelopmental and mental health disorders, yet the core symptoms are unique to the disorder and can be weeded out with proper assessment (Temelturk et al, 2023).
Core symptoms:
Inattention
Hyperactivity
Behavioral inhibition/impulsivity
As far as risk factors go, genetics are the largest with several candidate high risk genes all having small effect. In other words, there is no one gene responsible, but a mixed bag. A first degree relative with the disorder is the largest risk factor.
As for underlying neurobiology the predominant theory since the late 1990’s has been poor executive function with the prefrontal cortex poorly orchestrating top-down processing negatively affecting working memory, inhibitory control, and cognitive flexibility (Barkley, 1997). Yet not all with ADHD have executive dysfunction.
More recently researchers have found multiple brain regions and multiple neural networks involved in ADHD beyond the cortex, especially the emotional centers of the brain, such as the amygdala. The amygdala is more active when processing negative emotions and those with ADHD have more activity in this brain region than typical controls (Sonuga-Barke, E., Bitsakou, P., & Thompson, M., 2010). Negative emotion is experienced when waiting for perceived rewards and those with ADHD are more likely to make short term impulsive choices in their attempts to reduce waiting time. Poor reward delay has an objective neural signature for those with ADHD.
Possibility: Is it what the individual is doing in between perceived rewards that make them unique and create challenges with behaviors at home and school?
Call-to-Action: Join me for a discussion and group problem-solving session on how we can effectively intervene, remediate, and support those with ADHD. This is a think-outside-the box event: Wednesday, November 15th, 2023, 4-5:30 pm MST.
All the best,
Julia
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Barkley, R. (1997). Behavioral inhibition, sustained attention, and executive functions: constructing a unifying theory of ADHD. Psychological Bulletin, 121(1), 65-94.
Faraone, S. & Larsson, H. (2019). Genetics of attention deficit hyperactivity disorder. Molecular Psychiatry, 24(4), 562-575. doi.10.1038/s42380=018-0070-0
Sonuga-Barke, E., Bitsakou, P., & Thompson, M. (2010). Beyond the dual pathway model: evidence for the dissociation of timing, inhibitory, and delay-related impairments in attention-deficit/hyperactivity disorder. Journal of the American Academy of Child-Adolescent Psychiatry, 49(4), 345-355. doi.10.1016/j.jaac.2009.12.018
Temelturk, R.D., Aydin, O., Gullu, B.U., & Kilic, B.G. (2023). Dynamic eye-tracking evaluation of responding joint attention abilities and face scanning patterns in children with attention deficit hyperactivity disorder. Development and Psychopathology, 1-12. doi.10.1017/S095457942300041X