![]() So what kind of disorder is ADHD? The current concept is that it is a disorder primarily of executive function. So even though labels are imperfect and are not strictly necessary to address a problem, the system often demands them. However, in reality, school systems and other institutions need labels and allocate resources accordingly. That’s my practical clinician’s approach to many situation. ADHD ORGANIZATIONAL SOFTWARE CATEGORIES HOW TOThe concept of ADHD is useful in understanding why certain kids may be having problems and how to address them. In fact, for practical purposes it is not necessary to obsess about whether an individual meets criteria for the diagnosis (are they fidgity enough) but rather to focus on whether they are having identifiable problems, and then address those problems. But the definition of a disorder only requires that there are identifiable features that deviate significantly from the mean and which cause demonstrable problems. It may be just one end of the Bell curve of typical human variation. To clarify, no one says that ADHD is a disease, or that there is some pathological process going on. Here we get into the difficulty of definition. This subjective aspect to the diagnosis does make it reasonable to ask the question – how do we know this is a real disorder and not just normal variation. The challenge in making a diagnosis is that all kids exhibit some of these symptoms to some degree – so some judgment and experience is required in determining if a feature is present to an excessive degree for that child’s age. But in addition, these symptoms must cause demonstrable impairment in school or social function. The criteria for hyperactivity include things like being very fidgity, blurting out answers before questions are finished, and difficulty awaiting one’s turn. The diagnostic criteria for inattention includes things like the inability to sustain attention to a task and an unwillingness to engage in a task that requires sustained mental effort. Migraine, which is not a controversial disorder, is diagnosed the same way. This kind of “squishy” diagnosis often fuels the fire of ADHD denial – but in reality many medical diagnoses are made this way. The clinical definition of ADHD, like all behavioral diagnoses, is based upon having a minimum number of a list of characteristic symptoms. Of course it is modified by the environment – but at its core, it’s a problem of brain function.Ī new study supports this conclusion, but before I get to that let me go over some background. My reading of the literature is that the evidence strongly supports the conclusion that ADHD is a brain disorder. My only interest is to understand what the science says about ADHD. I believe all three kinds of entities exist. ADHD ORGANIZATIONAL SOFTWARE CATEGORIES SOFTWAREI have no particular bias toward any kind of explanation – whether ADHD is a hardware or software problem, or an observational artifact. As is often sadly the case, I find the public debate largely disconnected from the scientific research. The key controversy (and it is mainly a public, not a scientific, controversy) is whether ADHD is an actual brain disorder, a product of environmental factors (bad parenting, too much TV), or a cultural fiction. ADHD (attention deficit and hyperactivity disorder) is somewhat of a beleaguered and misunderstood disorder. ![]()
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