Attention deficit hyperactivity disorder (ADHD) is one of the most frequently diagnosed disorders in childhood. It is chronic in nature and often continues into adulthood. It is diagnosed two to four times more often in boys than girls. Symptoms include inattentiveness (difficulty focusing and paying attention), impulsivity (difficulty controlling behavior), and hyperactivity (overactive, excessive movement/restless).
According to the DSM-IV-TR five criteria must be present for a person to be diagnosed with ADHD:
- Persistent pattern of inattention and/or hyperactivity and impulsivity more frequent and severe than others of same age or developmental level
- Some symptoms are present before age 7
- Symptoms are present in more than one setting
- Symptoms are severe enough to cause problems in social, academic, or work settings
- Symptoms are not due to other psychological disorders
There are three subtypes of ADHD:
- Predominantly hyperactive-impulsive: Most symptoms (six or more) are in the hyperactivity-impulsivity categories. Fewer than six symptoms of inattention are present, although inattention may still be present to some degree.
- Predominantly inattentive : Children with this subtype are less likely to act out or have difficulties getting along with other children. They may sit quietly, but they are not paying attention to what they are doing. Therefore, the child may be overlooked, and parents and teachers may not notice that he or she has ADHD.
- Combined hyperactive-impulsive and inattentive : Most children have the combined type of ADHD.
Symptoms of Inattention:
- Fails to give close attention to details or makes careless mistakes in schoolwork, misses details, and frequently switches from one activity to another
- Has difficulty maintaining 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 other tasks
- Has difficulty organizing tasks and activities and focusing attention to complete a task or learn something new
- 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, has difficulty focusing on one thing
- Is often forgetful in daily activities
- Daydream, become easily confused, and move slowly
Symptoms of Hyperactivity
- 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
Symptoms of Impulsivity
- Blurts out answers before questions have been completed or inappropriate comments
- Has difficulty waiting their turn or waiting for something they want
- Interrupts or intrudes on others
- Acts without regards to consequences
Treatment can include medication and therapeutic support to improve daily functioning. With treatment, most people with ADHD can be successful in school and lead productive lives. Medication is not usually recommended before other therapeutic options are explored which may include psychotherapy, behavioral therapy, occupational therapy and/or making lifestyle changes. There may be a variety of factors that contribute to a child struggling with attention issues. An Occupational Therapist can determine if a child has sensory processing challenges such as tactile sensitivities, vestibular/proprioceptive difficulties, visual processing difficulties, motor planning difficulties and/or regulatory issues. A Speech and Language Pathologist can determine if a child is struggling with auditory processing and/or language processing challenges. A Mental Health worker can determine if a child is struggling with emotional challenges or regulatory disorders. Researchers are developing more effective treatments and interventions, and using new tools such as brain imaging, to better understand ADHD and to find more effective ways to treat and prevent it.
Tips to Help Kids Stay Organized and Follow Directions
Schedule. Keep the same routine every day, from wake-up time to bedtime. Include time for homework, outdoor play, and indoor activities. Keep the schedule on the refrigerator or on a bulletin board in the kitchen. Write changes on the schedule as far in advance as possible. Provide visual schedules for any daily routines your child needs support with to complete.
Organize everyday items. Have a place for everything, and keep everything in its place. This includes clothing, backpacks, and toys. Separate bins and storage units are much better options than toy boxes or large empty containers to hold many different toys/objects.
Use homework and notebook organizers. Use organizers for school material and supplies. Set up a plan with your child’s teacher to make sure your child has written down assignments. Arrange to have a duplicate set of books at home to reduce organizational demands. Designate a specific spot for homework (preferably in an area with minimal distractions but within adult supervision), have supplies organized and available at designated spot.
Be clear and consistent. Children with ADHD need consistent rules they can understand and follow.
Give praise or rewards when rules are followed. Children with ADHD often receive and expect criticism. Look for good behavior, and praise it.