Attention Deficit Hyperactivity Disorder (ADHD) is generally treated by medication in the United States. Medication treats the acute symptoms of the disease, but does little to affect the long-term prognosis if the medication in stopped. Non-pharmacological methods of treating ADHD take longer to work, but effect long-term changes in behavior. Thus, a multimodal treatment of ADHD is the best choice, especially in light of the fact the many children who take medication stop their medications within 1 year.

Prevalence

Attention Deficit Hyperactivity Disorder is a disorder that affects approximately 3-5% of the children in the United States (American Psychiatric Association, 1994). Contrary to popular thought, however, the disorder is not limited to childhood. It is a lifetime illness, with the disease progressing into the teen years and adulthood.

Of the children diagnosed with ADHD, 70-80% will continue to meet the criteria when they reach their teenage years, and 50-70% will meet the criteria when they reach adulthood (Guervemont & Dumas, 1994; Barkley & Murphy, 1998; Shaughnesy & Martin, 1998). This lifetime span of the illness is indicative of the need for lifetime solutions to the problems that it brings.

Definition

ADHD has been defined by Barkley (1991) as a disorder of response inhibition and executive dysfunction leading to deficits in self-regulation, impairment in the ability to organize behavior toward present and future goals, and difficulty adapting socially and behaviorally to environmental demands. Additionally, it is classified in the Diagnostic and Statistical Manual of Psychiatric Disorders, Fourth Edition (DSM-IV) as a disruptive disorder due to its impact on those around the person with the disorder. However, unlike the other two disruptive disorders, oppositional defiant disorder and conduct disorder, ADHD is the only "non-voluntary" disruptive disorder. Instead, it is the result of limited behavior due to incompetent and developmental impairments (Schaughency & Rothlind, 1991).

Symptoms

Not all ADHD is created equal. There are three different types of ADHD according to the DSM-IV (1994, p 85). The first is ADHD predominately inattentive type; the second is ADHD predominately hyperactive-impulsive type; the third is ADHD combined type; and the fourth is ADHD not otherwise specified.

The appropriate subtype is important in the treatment of the person with ADHD. While medication may treat the symptoms for either subtype, the dichotomous symptoms, as described by Hutchins (1994), are important in the psychotherapeutic treatment:

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