Attention Deficit Hyperactivity Disorders

ADHD can be defined as the inattentive type, the hyperactive type, or the inattentive and hyperactive type combined. The inattentive type of ADHD will display symptoms such as poor listening, loosing or misplacing items, becoming sidetracked, forgetting daily activities, diminished attention span, lack of ability to complete schoolwork or tasks, avoidance of initiating homework or other activities that require attention, and fails to focus on details.

People with hyperactive type of Attention Deficit Hyperactivity Disorder displays symptoms such as squirming when seated with their hands or feet, they suffer from restlessness that is difficult to control, they appear to be “driven by a motor” or are often “on the go”, lacks ability to play or engage in leisure activity in a quiet manner, is incapable of remaining seated, and is overly talkative.



Often, people with ADHD will compensate until the schoolwork or work tasks reach a certain difficulty level that they can no longer compensate for and then the symptoms will become apparent. There is a strong genetic link for Attention Deficit Hyperactivity Disorder, but it can also be related to environmental factors.

Healthcare providers will often require ADHD testing as a requirement for treatment. ADHD testing will include an interview about the symptoms, health history and behaviors, as well as questionnaires. The patient or child may be asked to fill out the questionnaires or checklist, and the provider may also ask others to complete the questionnaires. These other sources of information may include the teachers, parents, or friends. A general physical exam can help rule out other conditions that may be causing the symptoms. Observation may be a valuable source of information if the patient is a child. Review of records obtained from prior medical care and/or school records will be considered. Anytime there is a change in providers, the patient should have their old records sent to the new provider.

Finally, psychological testing may be used. Behavior rating scales and projective testing such as Rorschach Inkblot testing may be beneficial. ADHD is treated first with non-stimulant options before stimulants are considered. Stimulant medications are only written for by Medical Doctors as they are a schedule 3 medication. Nurse Practitioners do not write for these schedule 3 medications. The oversight physician will be consulted on a case by case basis and the nurse practitioner will lean on their oversight physician to assist in sound decision making.

Treatment for ADHD with stimulants will require narcotic contract signatures and random urine drug screens to ensure the medications are being utilized appropriately. There will also be a monthly follow up on stimulant medications initially. There are also nonpharmacological interventions that can reduce the symptoms associated with Attention Deficit Hyperactivity Disorder such as dietary restrictions. There are also accommodations that may be an option for students to aid in their success at school. Longer testing times and testing alone in a quieter environment with decreased distractions can benefit students with Attention Deficit Hyperactivity Disorder. Your healthcare provider can write prescriptions for these accommodations that will be recognized by the school.

Medscape, DSM-5