Frequently Asked
Questions

What’s the difference between impulsivity and hyperactivity? 

In some ways, they are the same thing, but they can look different. At its heart, ADHD is often referred to as an impulse control issue. (Check out questions about video games for more info on impulsivity.)

With adults, the impulse is not so much get-out-of-your-chair-and-pull-Suzy’s-pigtails, but more check-out-social-media-and-get-to-your-work-later. The impulse takes you away from what you’re supposed to be doing. With hyperactivity, a person has to always be moving. They might be able to get some things done, but the things they get done often involve a higher level of mobility.

Does exercise/physical activity help people with ADHD? If so, can it be more effective than medication?

Exercise, especially exercise that involves balance, helps with symptoms of ADHD. We cannot say enough about exercise and its positive effects on the brain. Exercise can help with learning, improve self-esteem, and, yes, even improve focus. Throughout the day, stimulant medication will probably be more effective for the major boxes that need to be checked, such as sustained attention, especially when someone with ADHD is engaged in a somewhat boring task. For the long term, creating structure, chunking time frames, taking timed breaks, establishing a baseline of attention, and seeking to grow attention span time are the best ways to manage. For more information on this, google BDNF (brain-derived neurotrophic factor). Exercise helps to stimulate BDNF, a protein, which in turn better enables memory which allows learning to take place.

Does having ADHD lead to watching more porn or other process addictions such as gambling or even video game addiction?

This goes back to the question of impulse control. People with ADHD are a bit more starved for dopamine than “neurotypical” people. (We used to use the term normal, but normal is just a setting on the dryer. And who wants to be normal anyway?) Dopamine is the neurochemical associated with internal reward. So, a good neurotypical knows that when they finish their 20 minutes of assigned reading, they will feel a level of reward. Someone with less dopamine or someone who has symptoms of ADHD may seek a shorter form of reward, or more instant gratification. This can range from cookies to pornography. Both instantly stimulate the reward section of the brain, both are available to most people in first-world cultures thanks to modern technology (the internet and cheap sugar-laden calories). ADHD doesn’t necessarily lead to these addictions, but those with ADHD could be more prone to addictions.

Who can determine/diagnose ADHD?

This is mostly determined by the licensure requirements of the state, country, or municipality you’re in. For example, David Kaktin practices out of the State of Ohio, USA, where, anyone who has a license to diagnose a medical or mental health disorder can diagnose ADHD, officially.

This doesn’t mean that everyone with a license to diagnose should diagnose. Fun fact: A medical doctor is allowed to do surgery in most states. This does not mean that the doctor who prescribes you an anti-depressant should be doing a facelift. It’s not necessarily their area of expertise. As it’s been said, “Just because you can, doesn’t mean you should.”

We take the diagnosing of ADHD very seriously. This is why we use both objective and subjective measures to determine ADHD. This is a process that doesn’t happen in a 10-15 minute office visit, which is about the time primary care physicians have to spend with their patients. Often, that’s the amount of time they need to treat most of the maladies they see on a regular basis like acne, asthma, or allergies.

Can you be easily distractible and NOT have ADHD?

Think about what that last ‘D’ in ADHD stands for: Disorder. This is where it gets a little philosophical. If a person has many of the symptoms of ADHD, but it’s not causing a problem, then it’s not a “disorder” and not really ADHD. At least not in our book—we don’t believe in treating things that aren’t problems like they are problems. If someone’s natural body temperature is 98.8 degrees and not 98.6, should they be prescribed ice baths until they get back to the “normal” temperature? Of course not. We believe it’s time to intervene only when symptoms become problematic in a person’s academics, work, and/or personal life.

Do you grow out of ADHD once you reach adulthood?  

This used to be assumed back in the day. But in this day and age—when adult jobs involve more multitasking, lengthier projects requiring heftier attention span time, and projects involving a variety of moving parts, while the expectation of returned emails, texts, and voicemails remains—ADHD is becoming just as much of an adult phenomenon.

How do I know if I have ADHD?

Check back to the question above about who can diagnose ADHD. Having a competent diagnosis is the best way to know for sure. A lot of people think they “have it,” but lately diagnoses have become commonplace in the lexicon and that doesn’t mean they’re correct.

Often when we ask about OCD symptoms, people think they have OCD because they like their room to be clean. Having a clean room does not equate with the diagnosis of OCD. Just like several of the symptoms of ADHD on their own does not equate to the diagnosis of ADHD.

Take, for instance, procrastination. Lots of people put things off for a variety of reasons. As it’s said, “Why do today, what can be done tomorrow?” People with anxiety put off things that give them anxiety. People put off doing things they don’t like—homework, doing their taxes, going to the dentist…the list is endless.

So if you get tested for ADHD, make sure it’s a thorough process—it shouldn’t happen in a 10-minute meeting. The diagnosis should include objective measurement (testing that is not done by checking boxes, but an actual performance test where the test taker’s performance is compared to a normative and non-normative population). This should also include a lengthy information-gathering process (Interview). This is where information such as school, work, and conversational performance, among other aspects of a person’s overall functioning, could be ascertained.

What can parents do at home to help their children with ADHD?

Structure, structure, structure!

Parents serve as the prefrontal cortex to the child's brain. The prefrontal cortex is where the administration of the higher functioning part of the brain lives. It can answer questions like “What day is two days from now and what am I supposed to be doing on that day?” Adults and children have deficits in that part of the brain. Children with ADHD thinking about time can think of it as “now and not now.” More specifically, “I’m having fun playing this video game now. My homework is to be done at a time that is not now, and it’s due at a time that is also not now.” This is where parents need to step in to provide that time structure.

A child with ADHD is prone towards distraction and everything internally (their own brain) and externally (everything that can be seen or heard) is a distraction. So the parents’ job is to limit the distractions, or basically bring the kid back to the goal-oriented behavior that is desired. Also, realize that everyone's attention span is finite. No normal human being can read Moby Dick in one sitting, or even hear it read to them. People with ADHD have a shorter attention span than average, thus have less time to engage in a behavior, like reading or homework, before they lose focus and cannot absorb information.

Also, advocate for your ADHD kid! Children with ADHD may have interventions such as a 504 plan or an IEP, but not all schools and teachers follow these plans. This is where the parent has to step in to advocate for their child.

Here’s an example of how one parent created structure and advocated for her child with ADHD: 

I sat with her every day for homework. Most of the time I would read her science material out loud, and she was able to comprehend and answer the questions at the end of the chapter. Otherwise it would have taken her forever, and she would have read so slowly that she’d have trouble remembering what she read. We kept a routine, and had a basket for schoolwork on the counter all through elementary school. I respected her teachers (most of them were awesome) and advocated for her as well.

Her pediatrician suggested lists, like on her counter to help her remember what she needed. We did that, and ultimately that totally pissed her off and was a motivator for her. I let her have a say, like when she felt “dumb” for going to skills class one particular year, I took her out of that class. We basically worked our asses off and she did too. I know we are very fortunate for how everything turned out, but it was work.

 What does inattentive ADHD look like?

In a word: overlooked, especially in a school setting. Primarily inattentive ADHD is the losing focus part of ADHD. Since it’s not hyperactivity or impulsivity, it may go unnoticed by teachers and even parents, but parents/teachers and spouses may have asked: “Why does it take you forever to get things done?” and “Were you even listening?” or “I thought we talked about this?”

It looks like forgotten homework, missing the point of a conversation, zoning out, looking out the window, or just not being focused.

Exhibiting these behaviors is not being bad or passive-aggressive; it’s more about focus gone astray.

Do video games exacerbate ADHD?

Video games are an impulsive/short attention span's dream come true. Loads of highly paid psychologists work hand in hand with highly paid developers to create a high-stimulating simulation that keeps the player engaged. So, it could cause some problems similar to addiction, which, to the parent or spouse of the game player, may look like exacerbated ADHD, because it could exacerbate their symptoms: Forgotten homework, forgetting chores, not hearing parents, constantly thinking about game content, seemingly obsessed…

If this sounds similar to addiction, you’re not wrong. Video game addiction is considered a process addiction. People with ADHD often have impulse control issues, and process addictions like video games, gambling, and pornography are risk factors.

Of course, this doesn’t mean everyone with ADHD will have problems with these or any other type of addictions.

Why doesn’t ADHD exist in France?

This is really more of a European and not a French question, but when we’ve asked people on social media to hit us with questions about ADHD, this one came up and it’s worth talking about. European methods first treat with psychotherapy prior to a medication treatment. Also in Europe, when you leave the TV on, you don’t constantly hear “ask your doctor if ______ is right for you.” 

Here in the U.S., pharma is often the easy answer. It’s not necessarily the wrong answer but it’s an easy and often effective answer. There’s a medication that goes with most diagnoses so they can be treated quickly. This allows more people to be seen by health care professional, since they can diagnose and prescribe within a 10-minute office visit. But complex questions may require complex answers—which may be more than just the conversation ending with a prescription. 

It’s estimated that almost 10 percent of school-aged males, from kindergarten through graduate school, have been or are being prescribed medication for ADHD. Several of the speakers who tour the U.S. to talk about ADHD are sponsored by companies that make (surprise!) ADHD medications.

To learn methods that aren’t medication based to treat ADHD is more of an investment in time and effort.

Why Don’t You Accept Insurance for the Evaluation Process?

We used to accept insurance for ADHD evaluations, but getting authorization was a time-consuming and often arduous process. We decided that our time is better spent with our clients rather than insurance bureaucrats—and we devote quite a bit of time to the clinical work and our clientele.

Also note that insurance companies do not reimburse us for the time it takes to craft reports, which can be made available to (and written specifically for) doctors, schools/universities, counselors, and even to clients. Reports that accompany testing are up to 9 pages in length. 

Insurance companies also do not reimburse us for the time it takes to consult with testing facilities for further analysis during our neuropsychological testing process. Insurance companies (at best) pay for diagnosis and treatment. But often claims are rejected, and that requires further billing and further hassle. We’re a small practice and we pride ourselves on being able to offer individualized attention to our clients.