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ADHD: Attention Deficit?

David L. Rickman, Ph.D.

The term Attention Deficit Hyperactivity Disorder is misleading.


ADHD is NOT the result of any deficits in attention (Barkley, 2005). ADHD is the result of self-control and selfregulation deficits (Barkley, 2006).
Difficulties with inhibiting behavior appear symptomatically as attentional problems.

Self-Control and attention are separate functions and involve clearly different anatomical regions of the brain.

It was once believed that the Reticular Formation, which regulates arousal and attention, was dysfunctional in persons with ADHD. Functional Magnetic Resonance Imaging research has revealed that the Preorbital Frontal Cortex functions differently in individuals with ADHD.

Preorbital Frontal Cortex Reticular Formation

The Preorbital Frontal Cortex:


Planning (Time Management) Sequencing Organizing Self-Control Other Executive Functions Individuals with ADHD, with or without impulsivity or hyperactivity, have difficulties with executive functions.

Accurate Diagnosis of ADHD


(Anastopoulos & Shelton, 2001)

Physical Examination Teacher Anecdotal Records Behavior Rating Scales Formal Observations in Multiple Settings Developmental/Educational/Family History Continuous Performance Testing
Gordon Diagnostic System Test of Variables of Attention Conners Continuous Performance Test

Effective Treatments of ADHD


Medication (CNS Stimulants)
Dextroamphetamine (Dexedrine) Methylphenidate (Ritalin, Concerta) Amphetamine/Dextroamphetamine (Adderall) Pemoline (Cylert)

Behavior Management
Time-Out Response-Cost Behavior Contracts School-To-Home Daily Reports

Assistive Technology
Attention Training System Voice Recorders Invisible Clock Computer Software Wiggle Cushion Relaxation Training Biofeedback (Experimental)

Helpful Websites
www.russellbarkley.org Ongoing ADHD research, publications, conference schedules of Dr. Barkley. www.nimh.nih.gov Authoritative site of the National Institute of Mental Health. www.vdps.net/special/psyhome.html - (In development) An informational website which contains classroom accommodations for various student difficulties.

References
Anastopoulos, A. & Shelton, T. (2001). Assessing attention-deficit/hyperactivity disorder. New York: Kluwer Academic/Plenum Publishing Co. Barkley, R.A. (2006). Attention deficit hyperactivity disorder: A handbook for diagnosis and treatment (3rd edition). New York: Guilford Press. Barkley, R.A. (2005). ADHD and the nature of self-control. New York: Guilford Press.

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