According to the Centers for Disease Control and Prevention, the prevalence of attention deficit hyperactivity disorder, or ADHD, in children between the ages of 5 and 17 in the United States is 7 percent. It was also found that this diagnosis is twice as likely to be found in boys than girls. This disorder significantly affects children's abilities to sustain attention and control feelings of hyperactivity and impulsivity. It has a lasting effect on their ability to function in school and other settings. The growing rate of diagnosis, a 3 percent increase from 1997 to 2006, according to the CDC, makes the understanding of this diagnosis and these symptoms even more critical.
Definition
ADHD is a disorder in which children demonstrate a consistent pattern of difficulties with attention and hyperactivity-impulsivity. Symptoms usually become apparent by the time the child reaches school age but are often present for some time beforehand. The symptoms demonstrated by the child must be more extreme than would be expected for other children their age. There are three types of ADHD that can be diagnosed--predominantly inattentive, predominantly hyperactive-impulsive and combined.
Core Symptoms
In diagnosing ADHD, psychologists use the "Diagnostic and Statistical Manual of Mental Disorders," fourth edition, text revision. It outlines five specific criteria that must be met. First, significant symptoms of either inattention and hyperactivity-impulsivity must have been present and interfering with the individual's functioning for the previous six months. Second, these symptoms must have been present before the age of 7. Third, the difficulties caused by these symptoms must occur in at least two settings, such as school and home. Fourth, the symptoms must cause considerable difficulties in the individual's functioning. Fifth, the symptoms must not be the result of symptoms of other psychological disorders, which may include pervasive developmental disorder and schizophrenia, or the presence of other disorders.
Inattention
As required in the "Diagnostic and Statistical Manual of Mental Disorders," a child must demonstrate six symptoms of inattention to qualify for that diagnosis. The child may lack attention to detail or continuously make careless mistakes when completing tasks. It may be difficult to keep his attention on a task. The child may appear as though he is not listening when others are speaking to him. When given instructions, an inattentive child may not follow through or complete tasks, often moving from one task to another before taking the time to complete it. Organization is often difficult for these children. Tasks that require these children to apply themselves mentally with sustained concentration are often disliked and avoided. A child with inattention difficulties often loses needed materials, such as pencils, schoolbooks or toys, and appears careless with his belongings. These children are often easily distracted, turning away from tasks by attending to outside noise or events that are irrelevant to the task at hand. Finally, these children may be forgetful, forgetting lunches or needed materials regularly.
Hyperactivity
To meet criteria for the hyperactive-impulsive type, children must have six or more symptoms of either hyperactivity or impulsivity, according to the "Diagnostic and Statistical Manual of Mental Disorders." Hyperactive symptoms may include fidgeting in their seat or leaving their seat when they are supposed to be sitting. Children with hyperactivity may also demonstrate a tendency to run or climb when they are not supposed to, difficulty playing quietly, appear constantly active and on the move and talk excessively. Depending on the child's age, different levels of hyperactivity are acceptable. In children with ADHD, their symptoms of hyperactivity are extreme and out of the ordinary for children their age. Children with these symptoms often appear restless and have the need to be constantly moving and doing things.
Impulsivity
As noted in the "Diagnostic and Statistical Manual of Mental Disorders," symptoms for the hyperactive-impulsive type may also be satisfied with impulsive symptoms. This may include impatience or blurting out answers before hearing the question. This may also manifest as difficulty waiting to take a turn and constantly interrupting what others are doing. These symptoms lead the child to act without thinking. They may jump into others' activities, grab things, knock things over or place themselves in dangerous situations.
Conclusion
A diagnosis of ADHD can look different for different children. Children with the combined type demonstrate most of the symptoms of inattention, hyperactivity and impulsivity. Children with the hyperactive-impulsive type demonstrate those interfering behaviors that are most noticeable. However, children with the inattentive type can sometimes be more difficult to diagnose. Their symptoms are not as obvious and disruptive but can be just as detrimental to their ability to function. A thorough assessment and observation of the child is needed to obtain an accurate diagnosis.
References
- Centers for Disease Control and Prevention: Summary of Health Statistics for U.S. Children
- "Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision"; American Psychiatric Association; 2000
- Centers for Disease Control and Prevention: Diagnosed Attention Deficit Hyperactivity Disorder and Learning Disability
