Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Attention deficit hyperactivity disorder (ADHD) refers to a chronic biobehavioral disorder that initially manifests in childhood and is characterized by problems of hyperactivity, impulsivity, and/or inattention. Not all affected individuals manifest all three behavioral categories. These symptoms have been associated with difficulty in academic, emotional, and social functioning. The diagnosis is established by satisfying specific criteria, and the condition may be associated with other neurological, significant behavioral, and/or developmental/learning disabilities. Therapeutic options included the use of medication, behavioral therapy, and adjustments in day-to-day lifestyle activities.
ADHD is one of the most common disorders of childhood. Studies in the United States indicate that approximately 8%-10% of children satisfy the diagnostic criteria for ADHD. ADHD occurs two to four times more commonly in boys than girls (male to female ratio 4:1 for the predominantly hyperactive type versus 2:1 for the predominantly inattentive type). While previously believed to be "outgrown" by adulthood, current opinion indicates that many children will continue throughout life with symptoms that may affect both occupational and social functioning. Some medical researchers note that approximately 40%-50% of ADHD-hyperactive children will have (typically non-hyperactive) symptoms that persist into adulthood.
The medical community recognizes three basic forms of the disorder:
Primarily inattentive: recurrent inattentiveness and inability to maintain focus on tasks or activities. In the classroom, this may be the child who is "spacing out" and "can't stay on track."
Primarily hyperactive-impulsive: Impulsive behaviors and inappropriate movement (fidgeting, inability to keep still) or restlessness are the primary problems. Unlike the inattentive ADHD-type child, this individual is more often the "class clown" or "class devil"
-- either manifestation leads to recurrent disruptive problems.
Combined: This is a combination of the inattentive and hyperactive-impulsive forms.
The combined type of ADHD is the most common. The predominantly inattentive
type is being recognized more and more, especially in girls and in adults. The predominantly hyperactive-impulsive type, without significant attention problems, is rare.
We are still learning about ADHD, and experts' ideas of the disorder are still being shaped. Some believe, for example, that the term "attention deficit" is misleading.
They maintain that people with ADHD are
actually able to pay attention too well, rather than too little, but have
difficulty regulating their attention, leaving them unable to properly
Others have trouble ignoring irrelevant details
and/or focus so intensely on specific details that they miss the bigger, more
Many ADHD sufferers cannot shift gears from one thing to another when they need to, leaving them unable to focus on what needs to be done. Extreme difficulty getting a child to stop playing a video game to come to dinner is a common example.
Trouble paying attention. People with ADHD are easily distracted and have a hard time focusing on any one task.
Trouble sitting still for even a short time. This is called hyperactivity. Children with ADHD may squirm, fidget, or run around at the wrong times. Teens and adults often feel restless and fidgety and are not able to enjoy reading or other quiet activities.
Acting before thinking. People with ADHD may talk too loud, laugh too loud, or become angrier than the situation calls for. Children may not be able to wait for their turn or to share. This makes it hard for them to play with other children. Teens and adults seem to "leap before they look." They may make quick decisions that have a long-term impact on their lives. They may spend too much money or change jobs often.