ADHD In Adults Can Hurt Job Performance

Attention-deficit/hyperactivity disorder (ADHD) is a condition not limited only to childhood.

According to the April issue of Mayo Clinic Health Letter, more than half of children with ADHD can expect to contend with the condition as adults. ADHD in adults often is more subtle than in children, but still can be troublesome. It usually presents itself in one of two ways or a combination:

Inattention: Prioritizing and focusing on tasks can be enormous challenges. Organizing work or following instructions may be more difficult than it is for others.

Excessive levels of activity or difficult-to-control impulses: Adults with ADHD aren’t likely to be as physically active as hyperactive children with ADHD. Instead, adults may experience ongoing feelings of restlessness or have trouble relaxing. An adult may always feel the need to be on the go. Impulsivity may show up as impatience, mood swings, intense anger outbursts or trouble with relationships.

Tip-offs that a medical evaluation is needed include:

– A history of academic or career under achievement.

– Inconsistent work performance, such as frequently quitting or losing jobs.

– Difficulty managing daily responsibilities such as paying bills on time or completing household chores.

– Difficulty with relationships, perhaps related to such behaviors as forgetfulness, being easily angered or not completing tasks.

Interviews and detailed medical and behavioral histories are usually keys to diagnosis. Tests to measure attentiveness and concentration could be part of the evaluation.

Adult ADHD is generally managed with some combination of medication, psychotherapy or life coaching. Many adults with ADHD find counseling helpful. Counseling alone may be sufficient treatment for many adults with this illness.

Children With Both Autism And ADHD Often Bully

Children with both autism and attention deficit or attention deficit hyperactivity disorders are four times more likely to bully than children in the general population, according to a study released today in the journal, Ambulatory Pediatrics. However, the researchers caution against labeling these children simply as bullies.

“This is the first nationally representative study of bullying behaviors among children with autism. The majority of parents of children with autism and ADD or ADHD were concerned about their children’s bullying behaviors, but there is much we do not yet understand. It is too early to label these children as bullies.” said Guillermo Montes, Ph.D., senior researcher at Rochester, N.Y.-based Children’s Institute. “These children may have pent up energy that needs to be properly channeled, or they may have other underlying behavioral or medical issues that have not been addressed.”

The study pulled data from the 2003 National Survey of Children’s Health conducted by the National Center for Health Statistics. The sample included 53,219 children ages 6 to 17. The researchers were interested in finding out whether children with autism were more likely to bully other children. They hypothesized that that children with autism may bully more often because they are more often male (who are more likely to bully); they are more likely to be bullied (and victims are more likely to bully); and many children with autism require treatment for aggression (which potentially includes bullying).

But the researchers did not find that children with autism had a higher rate of bullying – unless they also had ADD or ADHD. Those with both disorders showed a rate four times higher than children with just autism and with children overall. They also had a higher rate of bullying than children with ADD or ADHD but no autism. This poses an important opportunity for health care providers who see children with autism and ADD or ADHD, which occurs in about half of children with autism spectrum disorders.

“It would be helpful for clinicians to be aware that so many parents of children with both autism and ADHD are describing bullying behaviors,” said Jill Halterman, M.D., M.P.H., associate professor of Pediatrics at the University of Rochester Medical Center and second author of the paper. “These children may benefit from additional support services, such as from a behavioral or mental health specialist, depending on the severity of symptoms. These services may be available through community based organizations or from the broader health care system.”