October is ADHD Awareness Month
October is Attention-Deficit Hyperactivity Disorder (ADHD) Awareness Month, which provides the opportunity to raise awareness, promote understanding, and provide support to people living with ADHD. The theme for ADHD Awareness this year is “The Many Faces of ADHD” – so appropriate since the people who are supported in our START network may experience unique presentations of ADHD.
ADHD is more prevalent in IDD than in the broader population. The overall prevalence rate is about 6% in youth and 2.5% in adults. This is compared to 20% in people with IDD and up to 50% in people with ASD. While there is a paucity in screening tools for IDD and more research is needed in this area, there are some known factors that need to be considered when diagnosing ADHD in both people with intellectual disability and people with autism.
For those with intellectual disability, assessment needs to include determining if the attention difficulties are consistent or inconsistent with developmental level. Also, co-occurring mental health conditions, such as anxiety, may mask symptoms of ADHD. The concept of diagnostic overshadowing is a significant issue. There is concern that underdiagnosis of ADHD and misinterpretation of the symptoms can lead to inappropriate treatment. Studies have shown that people with ID who are accurately diagnosed and treated for ADHD are less likely to be prescribed antipsychotic medications than others with ID. This illustrates the importance of accurately identifying ADHD in ID and providing appropriate treatment.
ASD and ADHD share some similar symptoms, which can create confusion in determining the presence of ADHD. There is certainly an overlap related to executive functioning struggles, as well as many observable presentations. It is necessary to determine the underlying vulnerabilities related to the external signs. Consider the social difficulties experienced by both autistic people and people with ADHD. In autism, this is most likely related to differences in social communication and the ability to interpret social cues; while ADHD social difficulties are usually related to impulsivity and inattention. Another area of overlap is excessive motor movements which in autism are likely repetitive behaviors which provide comfort and regulation. In ADHD, excessive activity such as tapping, fidgeting, running are related to hyperactivity/impulsivity and serve to release excess energy. ASD and ADHD can certainly co-exist, but it is critical to carefully consider the underlying mechanisms to ensure that ADHD is identified accurately when it is present so the most effective treatments and strategies can be implemented.
Let’s take the opportunity during ADHD Awareness Month to increase understanding of ADHD and how it presents in people with IDD.
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