Attention deficit hyperactivity disorder (ADHD) - Symptom
ADD; ADHD; Childhood hyperkinesis
The symptoms of ADHD fall into three groups:
- Lack of attention (inattentiveness)
- Impulsive behavior (impulsivity)
Some children with ADHD primarily have the inattentive type. Others may have a combination of types. Those with the inattentive type are less disruptive and are more likely to not be diagnosed with ADHD.
- Fails to give close attention to details or makes careless mistakes in schoolwork
- Has difficulty keeping attention during tasks or play
- Does not seem to listen when spoken to directly
- Does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace
- Has difficulty organizing tasks and activities
- Avoids or dislikes tasks that require sustained mental effort (such as schoolwork)
- Often loses toys, assignments, pencils, books, or tools needed for tasks or activities
- Is easily distracted
- Is often forgetful in daily activities
- Fidgets with hands or feet or squirms in seat
- Leaves seat when remaining seated is expected
- Runs about or climbs in inappropriate situations
- Has difficulty playing quietly
- Is often "on the go," acts as if "driven by a motor," talks excessively
- Blurts out answers before questions have been completed
- Has difficulty awaiting turn
- Interrupts or intrudes on others (butts into conversations or games)
Signs and tests:
Too often, difficult children are incorrectly labeled with ADHD. On the other hand, many children who do have ADHD remain undiagnosed. In either case, related learning disabilities or mood problems are often missed. The American Academy of Pediatrics (AAP) has issued guidelines to bring more clarity to this issue.
The diagnosis is based on very specific symptoms, which must be present in more than one setting.
- Children should have at least 6 attention symptoms or 6 hyperactivity/impulsivity symptoms, with some symptoms present before age 7.
- The symptoms must be present for at least 6 months, seen in two or more settings, and not caused by another problem.
- The symptoms must be severe enough to cause significant difficulties in many settings, including home, school, and in relationships with peers.
In older children, ADHD is in partial remission when they still have symptoms but no longer meet the full definition of the disorder.
The child should have an evaluation by a doctor if ADHD is suspected. Evaluation may include:
- Parent and teacher questionnaires (for example, Connors, Burks)
- Psychological evaluation of the child AND family, including IQ testing and psychological testing
- Complete developmental, mental, nutritional, physical, and psychosocial examination
- Reviewed last on: 4/11/2011
- David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., Fred K. Berger, MD, Addiction and Forensic Psychiatrist, Scripps Memorial Hospital, La Jolla, California.
Pliszka S; AACAP Work Group on Quality Issues. Practice parameter for the assessment and treatment of children and adolescents with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry. 2007 Jul;46(7):894-921.
Prince JB, Spencer TJ, Wilens TE, Biederman J. Pharmacotherapy of attention-deficit/hyperactivity disorder across the life span. In: Stern TA, Rosenbaum JF, Fava M, Biederman J, Rauch SL, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, Pa: Mosby Elsevier; 2008:chap 49.
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