Attention deficit hyperactivity disorder (ADHD) is a psychiatric disorder characterized by a short attention span, impulsivity and hyperactivity. It is present in childhood and can be classified into predominantly inattentive, predominantly hyperactive-impulsive, or combined type ADHD. ADHD affects between 5% and 15% of school-age children in the United States. Symptoms must be carefully accessed to ensure children have ADHD and are not simply understimulated or have another disorder.
Diagnosis
The Diagnostic and Statistical Manual of Mental Disorders, fourth edition text revision (DSM-IV-TR) is the standard by which doctors diagnose ADHD and other psychiatric disorders. The DSM-IV-TR states that symptoms of ADHD must be present in at least two situations. The symptoms must also occur before age 7 years. For children with predominantly inattentive ADHD, at least six of the nine inattentive symptoms must be present. For children with predominantly hyperactive-impulsive ADHD, at least six of the nine hyperactivity and impulsivity symptoms must be present. For children with combined-type ADHD, at least six each of the inattentive and the hyperactivity-impulsivity symptoms must be present.
Inattention
The nine symptoms of inattention are forgetfulness, not listening when spoken to, not following through on tasks, losing things easily, being easily distracted, not paying attention to details, problems paying attention in school, problems organizing tasks, and avoidance of tasks that require concentration.
Impulsivity
The three symptoms of impulsivity are problems waiting for a turn to speak or play, interrupting others and answering questions before the questions are finished.
Hyperactivity
The six symptoms of hyperactivity are talking excessively, problems playing quietly, running around excessively, fidgeting with the hands and feet, leaving seat often in the classroom or other environment, and acting as if "driven by a motor."
Ruling Out Other Disorders
To reach a diagnosis of ADHD, several disorders and environmental conditions must be ruled out. First, the behaviors of the child must be accessed as to whether they are age appropriate or indeed are disruptive and hyperactive behavior that can be characterized as ADHD symptoms. An understimulating environment, such as a regular classroom for a genius-level child, may be frustrating enough for a child to not pay attention in class and be disruptive, exhibiting ADHD symptoms without having ADHD. Also, learning disorders and mental retardation must be ruled out. Other disorders that should also be ruled out are mood disorders, oppositional defiant disorder (ODD), developmental disorders and substance abuse disorders.
