Many kids have trouble sitting still or paying attention for long periods of time. But when required, they are able to focus and complete tasks, such as chores and homework. A small percentage of children have difficulty focusing at all and are considered to have ADHD. ADHD stands for attention deficit hyperactivity disorder. People with ADHD have difficulty performing tasks like organizing, following rules, and holding interest.
ADHD starts in early childhood as the brain is developing, although sometimes it is not diagnosed until adulthood. Up to five percent of children are affected.
ADHD used to be called attention deficit disorder, or ADD. Starting in 1994, the name was changed to ADHD and categorized into three different types of developmental disorders; each with slightly different characteristics.
A child with hyperactive-impulse ADHD generally does not have problems paying attention but is excessively active and impulsive. They will constantly fidget, have difficulty staying seated or playing quietly when required, talk too much, and talk out of turn. These symptoms can cause a child to be disruptive.
A child with symptoms of inattentive ADHD is usually first discovered by their teacher since it affects how the child performs schoolwork. Inattentive ADHD is characterized by a child’s failure to pay attention to details. This leads to overlooked mistakes in schoolwork. A child also has difficulty staying focused or following directions during everyday tasks. They can be easily distracted and forgetful, and even display listening problems when being addressed directly.
Combined ADHD is a combination of hyperactivity, impulsiveness, and inattentiveness. It is considered the most common type of ADHD and also the most problematic.
Diagnosing ADHD can be problematic because there is no single test to confirm the condition. Instead, a number of criteria must be met through a comprehensive evaluation. Those criteria include:
• Behavior consistent with hyperactivity, impulsiveness, or inattentiveness. A child must exhibit at least six symptoms for ADHD to be considered.
• These behaviors must be amplified and not considered normal.
• A child must exhibit symptoms for a minimum of six months.
• The symptoms cannot be exclusive to one place. For instance, a child who does not pay attention and is hyperactive at home must also not pay attention and be hyperactive in school and during play.
All of these factors are determined through medical history, a physical exam, observation, and behavioral questionnaires. Interviews may be conducted with childcare professionals and teachers who interact with the child on a regular basis. Psychological testing may also be performed to differentiate ADHD from other learning disabilities.
The American Academy of Pediatrics has developed a list of standard criteria used to diagnose ADHD.
To diagnose inattentive ADHD, at least six of the following symptoms must be met for at least six months:
• Does not pay attention to details in aspects of life ranging from schoolwork to play
• Cannot pay attention for long periods of time
• Looks as if they are not paying attention when spoken to
• Has trouble following instructions, including completing chores and schoolwork
• Has trouble organizing
• Cannot stay focused long enough to complete tasks such as homework
• Easily forgets or loses things important to completing work
To diagnose hyperactive-impulsivity ADHD, a child must show the following symptoms for at least six months:
• Has trouble sitting still for periods of time, often fidgeting
• Cannot sit in a seat when required by an authority figure
• Runs or climbs when inappropriate
• Cannot pay attention or play quietly
• Exhibits boundless energy as if “driven by a motor”
• Talks excessively
Impulse-specific criteria include:
• Talks out of turn
• Does not wait their turn
• Interrupts conversations
Additionally, a child must show some of these symptoms before the age of seven and show the symptoms in more than one setting. These symptoms must impair their ability to interact in social, academic, or work situations, and cannot be a result of other developmental or mental disorders.
A problem with diagnosing ADHD is that it can be confused with other types of disorders. When a doctor performs a physical exam and medical history, he or she tries to rule out all other causes of inattentiveness. Young children displaying symptoms of ADHD may instead have a development, behavioral, or learning disorder. It is also possible that the patient is experiencing stress-induced symptoms from a sudden life change such as a death or divorce. It is important for a doctor to put a person’s family history and current life story into perspective before diagnosing ADHD.
ADHD-like symptoms can even be attributed to unexpected sources, such as lead toxicity, sleep dysfunction, depression, and undetected seizures. Attention to detail on the physician’s part can rule out other disorders and properly diagnose ADHD.