It's important to realize that while ADHD is usually associated with hyperactivity, there is a form that is not associated with hyperactivity. This form is especially common in girls. Girls with predominately inattentive type ADHD will usually be seen as dreamy or detached. Unfortunately, some will be called "airheads" or "space cadets." Such a young lady can look at a book for 30 minutes without reading a word.
One parent told me that their daughter would lose every article of clothing that wasn't hooked to her body. Nearly every day, this child's teacher would have to send her back to the playground to retrieve her sweater or coat, only to have her return 15 minutes later without it, having forgotten what she went after.
A girl with that kind of distractibility would find it extremely difficult, if not impossible, to get home night after night with books and assignments written down, and then to complete the work and turn it in the next morning.
Dr. James Dobson has written, "The 'far away' child worries me more than the one who is excessively active. She may be seen as a good little girl, who just isn't very bright, while the troublemaker is more likely to get the help he needs. He's too irritating to ignore."
There is increasing evidence from medical studies that genetic factors play a role in ADHD. Jacquelyn Gillis and her team, then at the University of Colorado, reported in 1992 that the risk of ADHD in a child whose identical twin has the disorder is between 11 and 18 times greater than that of a non-twin sibling of a child with ADHD. She showed that between 55 and 92 percent of the identical twins of children with ADHD eventually develop the condition.
A large study of twins in Norway, involving 526 identical twins (who inherit exactly the same genes) and 389 fraternal twins (who are no more alike genetically than siblings born years apart) found that ADHD had nearly an 80 percent chance of being inherited. They concluded that up to 80 percent of the differences in attention, hyperactivity and impulsivity between people with ADHD and those without the disorder can be explained by genetic factors.
In addition, scientists are telling us that there are genetic mechanisms that regulate hyperactivity, especially as they relate to dopamine. For example, a significant percentage of people with ADHD have been found to have an abnormality of the dopamine D4 receptor gene, which is associated with abnormal risk-taking behavior and hyperactivity.
What does this mean for your family? Simply that one or both of the parents of your ADHD child are likely to have ADHD. If so, dealing with your child may remind you of some painful memories from your childhood or teenage years. This can make it even more difficult and emotional to deal with your child.
Furthermore, the unaffected siblings may be more likely to have children of their own with ADHD. These are just a few of the reasons that many ADHD therapists will recommend that parents and siblings also be tested for ADHD and consider education and counseling for the entire family.
There are studies indicating that there is an association between ADHD and the abuse of alcohol and drugs, as well as criminal activity. When it comes to tobacco abuse, a study from the University of California, Berkley, reported "a significant difference in rates of daily smoking and tobacco dependence for those with ADHD who had used stimulant medication in childhood in contrast to controls." These researchers felt there was a possible link between ADHD treatment histories and levels of tobacco dependence in adulthood.
However, most experts believe these anti-social behaviors are much more likely in those who have ADHD and another disorder, such as conduct disorders and mental health disorders. They believe those with ADHD alone do not appear to be at increased risk for these problems. For example, they point to a study that showed that medication for children with ADHD reduced the probability of substance use disorder (SUD) by 85 percent when compared with the risk among unmedicated kids with ADHD.
The general danger of the typical characteristics of ADHD — particularly in adolescence and adulthood — is a desire for high-risk activity. Dr. Dobson points out, "Even as children they can be accident-prone. But, as they get older, rock climbing, bungee jumping, car racing, motorcycle riding, white-water rafting and other high-risk activities are among their favorite activities."
"Adults with ADHD are sometimes called 'adrenaline junkies,' because they are hooked on the 'high' produced by the adrenaline rush associated with dangerous behavior. Others are more susceptible to drug use, alcoholism and other addictive behaviors." Because of this, about 40 percent of adolescents living with ADHD have been arrested by their eighteenth birthday.
Dr. Dobson warns those with ADHD: "Some adults who have ADHD are at higher risk for marital conflict, too. It can be very irritating to a compulsive, highly ordered husband or wife to be married to a 'messie' — someone whose life is chaotic and one who forgets to pay the bills, fix the car or keep records for income-tax reports. Such a couple usually needs professional counseling to help them learn to work together and capitalize on each other's strengths."
Nevertheless, for many that live with ADHD, the symptoms will diminish with neurological social maturing. Nevertheless, it is helpful for all of us to realize that many of those living with ADHD can, with instruction, skill and mentoring, demonstrate in remarkable ways their outstanding giftedness — which can include creativity, energy, enterprising thinking and leadership skills.
Adapted from Why ADHD Doesn't Mean Disaster by Dennis Swanberg, Diane Passno and Walter L. Larimore, M.D. A Focus on the Family book published by Tyndale House Publishers.