Attention-Deficit Hyperactivity Disorder is difficult to diagnose because the symptoms are largely influenced by the patient’s environment and can also resemble symptoms of other disorders. Among children, the situation is further complicated because the symptoms may be difficult to distinguish from normal childhood behavior, such as occasional hyperactivity or inattention.
Thus, diagnosis may be based on clinical symptoms combined with a patient’s overall performance in the classroom or another particular environment. If academic performance is notably below average or an individual’s social life is taking a beating, a daydreaming student may merit closer scrutiny.
Compared to other maladies, parents and teachers may play a major role in diagnosing ADHD. However, only competent medical officials should be trusted to make a final diagnosis.
The principal characteristics of Attention-Deficit Hyperactivity Disorder are inattention, hyperactivity, and impulsivity, which appear early in a child’s life. A thorough examination by a professional can help determine if such symptoms, which afflict many normal children, are caused by another disorder.
Symptoms of ADHD appear over the course of many months. Symptoms of impulsiveness and hyperactivity often appear first, with inattention emerging a year or more later. Inattentive daydreamers are more likely to be overlooked than hyperactive students who repeatedly disrupt class. Different symptoms may appear in different settings, depending on the demands the situation may pose for the child’s self-control.
According to the most recent version of the Diagnostic and Statistical Manual of Mental Disorders2 (DSM-IV-TR), there are three patterns of behavior that indicate ADHD:
1. Consistent
inattentiveness
2. Hyperactivity and impulsivity that is far beyond normal for a patient’s
age
3. All three types of behavior
Thus, professionals recognize three subtypes of Attention-Deficit Hyperactivity Disorder, based on the above symptoms.
Hyperactive children are constantly fidgeting, squirming in their seats, wiggling their feet, tapping their pencils, roaming around the room or displaying similar behavior. Hyperactive teenagers or adults may feel internally restless. They often report needing to stay busy and may try to do several things at once.
Impulsive patients are lacking in self-restraint, or discipline. They are likely to act before they think, speak out inappropriately or display their emotions with abandon. Their impulsivity may translate into an impatience that causes them to grab toys from other children or hit when they’re upset. Their impatience may persist into adulthood.
Below are some specific signs of hyperactivity-impulsivity:
• Restlessness while seated (squirming, fidgeting,
tapping feet, etc.)
• Running, jumping or leaving a seat in situations where sitting
or
quiet
behavior is expected
• Blurting out answers before hearing the whole question
• Having difficulty waiting in line or taking turns.
Children who are inattentive may be able to focus on things they enjoy, but more mundane tasks may be a challenge. They may get bored with a task after only a few minutes. Thus, they may be constantly left behind in the classroom.
Homework is particularly hard for these children—especially if they forget to write down an assignment or leave their assignment or book at school. When they do finish their homework, it may be full of errors and erasures. Obviously, homework isn’t a fun experience for child or parent.
Unfortunately, children manifesting the Predominantly Inattentive Type of Attention-Deficit Hyperactivity Disorder are hard to diagnose and are frequently overlooked because they don’t draw attention to themselves the way hyperactive or impulsive children do. An inattentive child may sit quietly and even appear to be working, even though the child has a hard time understanding a teacher’s instructions. Inattentive children may not even have the same social problems. They are generally characterized as lethargic or "spacey," rather than hyperactive or disruptive.
The DSM-IV-TR gives these signs of inattention:
• Often becoming easily distracted by irrelevant sights
and sounds
• Often failing to pay attention to details and making careless mistakes
• Rarely following instructions carefully and completely losing or forgetting
things like toys, or pencils, books, and tools needed for a task
• Often skipping from one uncompleted activity to another.