Attention-Deficit / Hyperactivity Disorder
In this article we'll be talking about Attention Deficit Hyperactivity Disorder, also known as ADHD. Some of the most common questions I get either in my office or on the playground with my kids are related to ADHD: What is it? What are the symptoms? Is it normal childhood behavior? Will my child outgrow this condition? These questions and others will be answered today as we discuss what ADHD is.
What Does ADHD Stand For?
ADHD stands for Attention Deficit Hyperactivity Disorder. It is the most commonly diagnosed mental disorder in children. It often continues through adulthood, but I'll be focusing on this condition in childhood. It's more commonly seen in boys than girls and it can be very disruptive to both home and school life. The symptoms of ADHD can be broken down into two groups. Those that are symptoms of inattention and those that are symptoms of hyperactivity/impulsivity.
9 Signs of Inattention
• Often fails to give close attention to details and makes careless mistakes in schoolwork.
• Often has difficulty sustaining attention in tasks or play activities.
• Often does not seem to listen when spoken to directly.
• Often does not follow through on instructions and fails to finish schoolwork.
• Often has difficulty organizing tasks and activities.
• Often avoids, dislikes or is reluctant to engage in activities that require a lot of mental effort.
• Often loses things necessary for a job or activity.
• Often distracted by things going on around him or her.
• Often forgetful in daily activities.
- Diagnostic of Statistical Manual of Mental Disorders 2013
Three Presentations of ADHD
There are three presentations, or what we used to call subtypes of ADHD. The Predominately Inattentive Presentation means the child displays six or more of those inattentive symptoms described previously. If the child presents with six or more hyperactive/impulsive symptoms, then we call that the Predominantly Hyperactive/Impulsive Presentation of ADHD. If the child presents with both hyperactive/impulsive and inattentive symptoms, he/she is described as having the Combined Presentation of ADHD.
Simply presenting with those symptoms is not enough to qualify someone for that diagnosis. There are other things to consider. Some symptoms must appear before the age of twelve. The symptoms must be persistent for more than six months. The child must show some symptoms in more than one environment, and there has to be some interference with school, home or social relationships.
9 Symptoms of Hyperactivity and Impulsivity
• Often fidgets or taps hands and feet.
• Often leaves the seat when remaining seated is expected.
• Often runs around or climbs when inappropriate.
• Often unable to play or engage in leisure activities quietly.
• Often on-the-go, acting as if he or she is driven by a motor.
• Often talks too much.
• Often blurts out answers before the question has been completed.
• Often has difficulty waiting his or her turn.
• Often interrupts or intrudes on others.
Is ADD the Same Thing as ADHD?
Most of the time when people describe something as ADD, they’re saying there is not the hyperactive component. When I talked about the presentations earlier, we would now call that Attention Deficit Hyperactivity Disorder Predominantly Inattentive Presentation. Years ago in a different diagnosing book, ADD was there, but now we would call it the inattentive presentation.
Isn't This Just Normal Childhood Behavior?
The answer is no. Kids can be active, kids can be impulsive, kids can be talkative. But to get the diagnosis of ADHD, we’re talking about a level of symptoms above and beyond those considered normal for the child’s age or level of development. In other words, kids can be active, but ADHD is not just normal kid behavior.
Can ADHD be Outgrown?
The answer is sometimes. Really what we think is the symptoms change, so we see less hyperactivity and impulsivity. So less running, jumping and getting out of your seat when it’s inappropriate. We see more of the inattentive symptoms or what are also called dis-executive symptoms, meaning that the person has difficulty with organization and time management. Although some of the symptoms of ADHD may be outgrown, think of it more as the symptoms change, rather than go away entirely.
Does My Child Choose to Pay Attention?
Why can my child pay attention to some things like video games or television and not others like homework? The reality is doing things we don’t like can be hard for everyone, but it is especially difficult for children with ADHD. Does a child with ADHD have intellectual deficits? The answer is no. Typically children with ADHD have average or above average intelligence. ADHD does not indicate below average intelligence.
Is ADHD the Same as a Learning Disability?
Not exactly. ADHD is about development. It’s about a child not meeting developmental expectations within the same time frames as others that age. Learning disorders are a little different. However, ADHD can absolutely have a very significant impact on a child’s academic performance. Do children with ADHD have a hard time with friendships? The answer is yes, very often they do. It can be very bothersome to peers, classmates and teammates when a child has a hard time maintaining appropriate behavior. In other words, a lot of times the impulsivity can make it difficult to have friends. The good news is that with some education, training and working with children with ADHD, we can often help them have much better friendships.
The final question is related to ADHD and other conditions. Usually that question comes to me in the form of something like, “My son has ADHD, but it seems like there are other issues going on. Could a child have ADHD and something else?” The answer is yes, more often than not. In fact, 80% of the time a child with ADHD also has a co-occurring condition. So if your child is diagnosed with ADHD, be sure you have a good evaluation so you know what other factors might be present. As you can see, ADHD, or Attention Deficit Hyperactivity Disorder is a very common condition in childhood. It is more than just normal behavior, and it can cause significant difficulties at home, at school and with friendships. So now that you know what ADHD is and what it isn’t, I’m sure this information will be helpful for you as you’re out there, chasing a child’s potential.
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