Chapter 14 infographic image description

The title of the infographic is Thinking Critically About ADHD—Normal High Energy or Disordered Behavior?

The Learning Objective Question reads, Why is there controversy over attention-deficit/hyperactivity disorder?

There are six panels in the infographic. The first panel has the heading, Diagnosis in the U.S. Under the heading there are two pie charts. The one on the left is labeled, 4- to 17-year-olds. It shows that 11 percent of 4-to-17-year olds have been diagnosed with ADHD. (Footnote 1: Schwarz & Cohen, 2013.) The second pie chart is labeled, adults. It shows that 2.5 percent of adults have been diagnosed with ADHD. (Footnote 2: Simon et al., 2009.) To the right of the pie charts is a large symbol for males and a small symbol for females. The heading says, Twice as often in BOYS as in girls.

The second panel has the heading, Symptoms. A bulleted list begins.

• inattention and distractibility (Footnote 3: Martel et al., 2016)
• hyperactivity, (Footnote 4: Kofler et al., 2016)
• impulsivity.

Beside the bulleted list is an illustration of three children (two girls and a boy) sitting at their desks with one boy jumping all over the room, tipping the children’s desks. One other boy is sitting on the floor under his desk, having been knocked out of his chair by the rambunctious boy.

The next panel is divided into two sections. On the left, the heading reads, Skeptics note: Energetic child plus boring school equals ADHD over diagnosis. A bulleted list begins.

• Children are not designed to sit for hours in chairs inside.
• The youngest children in a class tend to be more fidgety and more often diagnosed. (Footnote 5: Chen et al., 2016.)
• Older students may seek out stimulant ADHD prescription drugs “good-grade pills.” (Footnote 6: Schwarz, 2012.)
• What are the long-term effects of drug treatment?
• Why the increased diagnoses worldwide?

Under this bulleted list in the Skeptics note section is an illustration of a pile of pills on top of a paper with the words A plus. Excellent work!

On the right of this panel in the second section, the heading reads, Supporters note: A bulleted list begins.

• More diagnoses reflect increased awareness.
• open quote ADHD is a real neurobiological disorder whose existence should no longer be debated close quote. (Footnote 8: World Federation for Mental Health, 2005.)
• ADHD is associated with abnormal brain structure, abnormal brain activity patterns, and future risky or antisocial behavior. (Footnote 9: Barkley et al., 2002; Hoogman et al., 2017.)

Under this bulleted list in the Supporters note section is an illustration of a right-facing brain.

The next panel has the heading Causes? A bulleted list begins.

• May co-exist with a learning disorder or with defiant and temper-prone behavior.
• May be genetic. (Footnote 10: Nikolas & Burt, 2010; Poelmans et al., 2011; Volkow et al., 2009; Williams et al., 2010.)

Beside this bulleted list is an illustration of a strand of DNA.

The next panel has the heading, Treatment. A bulleted list begins.

• Stimulant drugs (Ritalin and Adderall) calm hyperactivity, and increase ability to sit and focus. (Footnote 11: Barbaresi et al., 2007.) So do behavior therapy and aerobic exercise. (Footnote 12: Cerrillo-Urbina et al., 2015; Pelham et al., 2016.)
• Psychological therapies help with the distress of ADHD. (Footnote 13: Fabiano et al., 2008.)

The illustrations in this panel are an open bottle of pills on the left, and on the right, a young woman with her head in her hands. Another woman with a clipboard is looking at her.

The last panel has the heading, The bottom line: The text reads, Extreme inattention, hyperactivity, and impulsivity can derail social, academic, and work achievements. These symptoms can be treated with medication and other therapies. But the debate continues over whether normal high energy is too often diagnosed as a psychiatric disorder, and whether there is a cost to the long-term use of stimulant drugs in treating ADHD.