ADHD. Some children have symptoms that
suggest a mainly hyperactive–impulsive type. To meet
criteria for this subtype, a child must exhibit six or
more symptoms (including restlessness, frequent interrupting, or talking excessively; see Table 2 for the list of core symptoms). The second subtype emphasizes inattention. To have a diagnosis of this subtype of ADHD, a child must have difficulty following directions, fail to pay close attention to details, be forgetful in daily activities, or become easily distracted. In the third subtype, the combined type, a child must display six or more symptoms of both inattention and of hyperactivity–impulsivity.
At what age does ADHD most often surface?
The disorder affects individuals of all ages. Of the millions
of visits for ADHD to community physicians,
about 5% are preschoolers, approximately 66% were
elementary school-age, 20% were teenagers, and 15%
were adults. ADHD is, however, most often diagnosed
in elementary school-age children. Some children are
diagnosed later during their junior high school and
high school years. It also is not unusual for individuals
to receive their first diagnosis of ADHD as adults.
Interestingly, many parents first recognize that they
have ADHD when it is diagnosed in their child. As
this disorder was not diagnosed very frequently years
ago, many individuals went through their school years
with undiagnosed ADHD. Subsequently, when parents
see their children experiencing similar difficulties,
they remember their own history, are able to relate,
and confirm their own undiagnosed disorder.
ADHD can be diagnosed in preschoolers. Indeed, the
peak age of onset, which is different from the age at
diagnosis, may be between ages 3 and 4. Not surprisingly,
severity affects the age at which ADHD is first
noticed, with those more severely affected presenting
at a younger age.
DSM-IV-TR Core Symptoms of ADHD in Children Hyperactivity–Impulsivity
• Often fails to pay attention to details or makes careless mistakes in schoolwork,
work, or other activities
• Often has difficulty in sustaining attention in tasks or play
• Often does not listen when spoken to directly
• Often does not follow through on instructions and fails to finish a project, etc.
• Often has difficulty in organizing tasks and activities
• Often avoids, dislikes, or is reluctant to engage in tasks that require sustained
mental effort
• Often loses things necessary for tasks or activities
• Is often distracted by extraneous stimuli
• Is often forgetful in daily activities
Hyperactivity
• Often fidgets with hands or feet or squirms in seat
• Often leaves seat in classroom or in other situations in which it is inappropriate;
in adults or adolescents, may be limited to subjective feelings of restlessness
• Often runs or climbs excessively in situations in which it is inappropriate; in adolescents
or adults, may be limited to subjective feelings of restlessness
• Often has difficulty in playing or engaging in leisure activities quietly
• Is often “on the go” or acts as if “driven by a motor”
• Often talks excessively
Impulsivity
• Often blurts out answers before questions have been completed
• Often has difficulty in awaiting turn
• Often interrupts or intrudes on others
• Some hyperactive–impulsive or inattentive symptoms that caused impairment present
before age 7
• Some impairment from the symptoms present in two or more settings (school,
work, home)
• Clear evidence of significant impairment in social, academic, or occupational
functioning
• Symptoms not accounted for by another disorder and do not occur exclusively during
another disorder
Read More: Different types of ADHD
