ADHD is a childhood disorder that interferes with a child's ability to maintain attention and/or control symptoms of hyperactivity and impulsivity. The prevalence of this disorder in children between the ages of 5 and 17 has been reported at 7% by the Center for Disease Control (CDC). There are three types of ADHD: predominantly inattentive, predominantly hyperactive-impulsive, and combined. As each child may present with different types of symptoms and behavior, diagnosis can be difficult. A more thorough understanding of the disorder can provide clarification.
Definition
Attention Deficit/Hyperactivity Disorder, otherwise known as ADHD, is a disorder that begins in childhood. Children with the disorder have symptoms of inattention and/or hyperactivity and impulsivity that create a pattern that significantly interferes with their ability to function in at least two settings. These symptoms must be present before the age of seven in order to meet diagnostic criteria; however, they are often present prior to this time. In order to meet the criteria presented in the "Diagnostic and Statistical Manual of Mental Disorders," children must have experienced six or more symptoms of inattention and/or hyperactivity/impulsivity that are significantly interfering with their functioning over the past six months. Additionally, these symptoms must be outside the norm for children of that age.
Types
As described in the DSM-IV-TR, there are three types of ADHD. The first type is predominantly inattentive, meaning that the child mostly demonstrates symptoms of inattention. The second type is predominantly hyperactive-impulsive, indicating that the child mostly demonstrates the hyperactive and impulsive traits of ADHD, and few or none of the traits of inattention. The third type is combined, meaning that the child demonstrates both types of symptoms, having traits of inattention as well as hyperactivity/impulsivity.
Inattention
Some children with inattention have difficulty remaining on task, at times daydreaming or seeming distracted. A child may make careless mistakes, paying little attention to detail. They may not listen when others speak to them and struggle to follow directions. Their ability to remain organized is impacted, and they may avoid tasks that require them to concentrate and put forth considerable effort, such as schoolwork. Children with inattention difficulties may be easily distracted from the task they are working on by outside sounds or objects. For example, other children playing outside may easily distract a child who sits near a window in their classroom. Additionally, these children may be seen as forgetful and often losing items such as pencils, lunches, schoolwork, etc.
Hyperactivity
Children diagnosed with ADHD who demonstrate hyperactivity often appear to be constantly moving. They are often seen fidgeting, moving parts of their body and having trouble remaining seated. They may run, jump, or climb in situations where they are expected to remain seated. These children often struggle to engage in quiet activities, seeming to be restless and having difficulty sitting still. They may also talk quickly and to excess.
Impulsivity
Impulsive symptoms often occur in conjunction with hyperactive symptoms. Children with these symptoms often act before thinking. They may interrupt others in their rush to blurt out a response. These children often have trouble waiting to take turns and may jump into others' games or activities without asking. They have trouble inhibiting their impulses, tending to jump into an activity or conversation without considering the rules or appropriate way to behave.
Diagnosis
The diagnosis of this disorder can be a challenge because each child may present with different symptoms. As noted by Robert Weis (2008), children under seven are more likely to meet criteria for the hyperactive-impulsive type, but this may be a result of their developmental age. It is possible that many will later meet criteria for the combined type, but that at a young age their inattention difficulties are not as obvious. Those children with only inattentive symptoms often go undetected until a later age because they produce no interfering behavior. Their symptoms may not be noticed until they interfere with school performance. Additionally, children must demonstrate difficulties in more than one setting. Their symptoms cannot only exist during school hours or at home. There must be a pattern to their behavior that pervades throughout various parts of their lives.
References
- "Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision"; American Psychiatric Association; 2000
- "Introduction to Abnormal Child and Adolescent Psychology"; Robert Weis; 2008
- Centers for Disease Control and Prevention: Summary of Health Statistics for U.S. Children
