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News & Views - Oct, 1995 Issue #36 

ADHD, What is It?
By Paul R. Crellin, M.D., 
Director Medical Services Yellowstone Treatment Centers 
Billings, Montana 

(Dr. Crellin oversees medical management of all treatment programs at Yellowstone Treatment Centers. As founder of the Children's Clinic, and The Child Study Center, Dr. Crellin has practiced medicine in Billings for more than 35 years. - Lon) 

ADHD refers to a symptom complex that includes hyperactivity, impulsivity, distractibility and short attention span. It is a "condition" that has been recognized since the 1850's and has received many names over the years, such as Hyperkinetic, Strauss Syndrome, Hyperkinetic Impulse Disorder, Minimal Brain Dysfunction, Attention Deficit Disorder with or without hyperactivity, and most recently Attention Deficit Hyperactivity Disorder. It is no wonder that one can be confused when this entity is discussed. 

The condition is felt to be genetically based, and probably is inherited on Chromosome 15. For years it has been suspected that it is much more common in boys than in girls, but most recent evidence suggests that sexes are involved equally, but that the picture in girls is different with respect to the degree of hyperactivity present, possibly explained by recent evidence that the brains of boys and girls are different. 

It has been believed for some years that the right frontal lobe of the brain is involved in this syndrome, and that the reticular activating system in the base of the brain is also an important involved area. Recent studies using computerized Electroencephalography (BEAM) has allowed for mapping of brain activity. In the males, the right frontal lobe is not as active as the right frontal lobe in females, and since this is thought to be the portion of the brain that monitors interpersonal relationships, it is postulated that this may explain why girls are less hyperactive and distractible than boys with this condition. 

Studies have shown that there is a relationship between metabolic abnormalities of certain neurotransmitters in children with ADHD, namely Dopamine, Serotonin and Norepinephrine. It appears that these neurotransmitters are deficient in children with ADHD, and the therapy for the condition at this time is directed toward management of this deficit. 

There is a significant relationship between ADHD and Learning Disabilities, thus it is believed to be important to have a very comprehensive evaluation to determine whether or not both entities are present. It has been shown that about 25% of children with Learning Disabilities have ADHD, but 75% of children with ADHD have Learning Disabilities. For best therapeutic results, it is important to treat both conditions if they co-exist. 

The important thing to remember is that there is treatment for these children/adolescents/adults, and appropriate therapy will help them to overcome many of the emotional complications that are frequently seen in persons with ADHD. With appropriate therapy their lives are made much more meaningful and they are able to find successes rather than failures, their self esteem will improve and life will be much more fulfilling. 

Copyright 1995, Woodbury Reports, Inc. (This article may be reproduced without prior approval if the copyright notice and proper publication and author attribution accompanies the copy.)

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