A key criticism to the current approach to the diagnosis of ADHD is a failure to recognize the condition as dimensional disorder that may contain different sub-classifications, comorbidity patterns, symptom trajectories, and neurobiological correlates ( Epstein and Loren, 2013). These classifications are (1) Predominantly Inattentive, (2) Predominately Hyperactive/Impulsive, and (3) Combined Type. Three sub-types of ADHD were introduced with the publication of the DSM-IV and these presentations were retained in the 5th edition. None-the-less, in the United States and other countries, ADHD diagnosis is based upon evaluation by a licensed medical professional using the Diagnostic and Statistical Manual, 5th edition (DSM-5, American Psychiatric Association, 2013) “yes/no” approach to symptom presentation. Despite being the most commonly diagnosed mental disorder in children in the United States ( Centers for Disease Control and Prevention, 2018), ADHD remains a heterogeneous disorder that is not fully understood (or agreed upon) within the medical and scientific communities. Given the call from the National Institute of Health to move toward a more dimensional diagnostic process for mental health concerns, and away from the more routine categorical diagnostic process, we suggest sensory over-responsivity as a dimension in the diagnostic process for children with ADHD.Īttention Deficit Hyperactivity Disorder (ADHD), is a neurodevelopmental disorder characterized by ongoing patterns of inattention and/or hyperactivity and impulsivity that impacts an individual’s functioning across multiple environments. We link these findings with research conducted both prior to and after our own work and emphasize that there a growing knowledge supporting a relationship between ADHD and sensory over-responsivity, but more research is needed. Findings suggest that sensory responsivity differentiates among children with ADHD and warrants consideration. In addition, we have examined the relationship between these physiologic measures, and reports of behavioral sensory over-responsivity and anxiety. Drawing on early work of McIntosh and co-investigators, we examined response to sensory challenge in children with ADHD, measuring HPA activity and electrodermal response (EDR) secondary to sensory stressors. Here, we present a compilation of findings examining ADHD both behaviorally and using neurophysiologic markers. There is a need for, and ongoing interest in, developing a deeper understanding of this disorder to optimally identify risk and better inform treatment. None-the-less there is still much that is poorly understood. Years of research have added to our understanding of Attention Deficit Hyperactivity Disorder (ADHD).
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