| Attention Deficit Hyperactivity Disorder (ADHD), is a | | | | Some signs of hyperactivity-impulsivity are: |
| condition that becomes apparent in some children in | | | | Feeling restless, often fidgeting with hands or feet, or |
| the preschool and early school years. It is hard for | | | | squirming while seated Running, climbing, or leaving a |
| these children to control their behavior and/or pay | | | | seat in situations where sitting or quiet behavior is |
| attention. | | | | expected Blurting out answers before hearing the |
| It is estimated that between 3 and 5 percent of | | | | whole question Having difficulty waiting in line or taking |
| children have ADHD, or approximately 2 million children | | | | turns. |
| in the United States. This means that in a classroom of | | | | Inattention Children who are inattentive have a hard |
| 25 to 30 children, it is likely that at least one will have | | | | time keeping their minds on any one thing and may get |
| ADHD. | | | | bored with a task after only a few minutes. If they are |
| ADHD was first described by Dr. Heinrich Hoffman in | | | | doing something they really enjoy, they have no trouble |
| 1845. A physician who wrote books on medicine and | | | | paying attention. But focusing deliberate, conscious |
| psychiatry, Dr. Hoffman was also a poet who became | | | | attention to organizing and completing a task or |
| interested in writing for children when he couldn't find | | | | learning something new is difficult. |
| suitable materials to read to his 3-year-old son. | | | | Homework is particularly hard for these children. They |
| The result was a book of poems, complete with | | | | will forget to write down an assignment, or leave it at |
| illustrations, about children and their characteristics. "The | | | | school. They will forget to bring a book home, or bring |
| Story of Fidgety Philip" was an accurate description of | | | | the wrong one. The homework, if finally finished, is full |
| a little boy who had attention deficit hyperactivity | | | | of errors and erasures. Homework is often |
| disorder. | | | | accompanied by frustration for both parent and child. |
| Yet it was not until 1902 that Sir George F. Still | | | | The DSM-IV-TR gives these signs of inattention: |
| published a series of lectures to the Royal College of | | | | Often becoming easily distracted by irrelevant sights |
| Physicians in England in which he described a group of | | | | and sounds. |
| impulsive children with significant behavioral problems, | | | | Often failing to pay attention to details and making |
| caused by a genetic dysfunction and not by poor child | | | | careless mistakes. |
| rearing-children who today would be easily recognized | | | | Rarely following instructions carefully and completely |
| as having ADHD. Since then, several thousand | | | | losing or forgetting things like toys, or pencils, books, |
| scientific papers on the disorder have been published, | | | | and tools needed for a task. |
| providing information on its nature, course, causes, | | | | Often skipping from one uncompleted activity to |
| impairments, and treatments. | | | | another. Children diagnosed with the Predominantly |
| A child with ADHD faces a difficult but not | | | | Inattentive Type of ADHD are seldom impulsive or |
| insurmountable task ahead. In order to achieve his or | | | | hyperactive, yet they have significant problems paying |
| her full potential, he or she should receive help, | | | | attention. They appear to be daydreaming, "spacey," |
| guidance, and understanding from parents, guidance | | | | easily confused, slow moving, and lethargic. |
| counselors, and the public education system. This | | | | They may have difficulty processing information as |
| document offers information on ADHD and its | | | | quickly and accurately as other children. When the |
| management, including research on medications and | | | | teacher gives oral or even written instructions, this child |
| behavioral interventions, as well as helpful resources on | | | | has a hard time understanding what he or she is |
| educational options. | | | | supposed to do and makes frequent mistakes. Yet the |
| Because ADHD often continues into adulthood, this | | | | child may sit quietly, unobtrusively, and even appear to |
| document contains a section on the diagnosis and | | | | be working but not fully attending to or understanding |
| treatment of ADHD in adults. | | | | the task and the instructions. |
| Symptoms | | | | These children don't show significant problems with |
| The principal characteristics of ADHD are inattention, | | | | impulsivity and overactivity in the classroom, on the |
| hyperactivity, and impulsivity. These symptoms appear | | | | school ground, or at home. They may get along better |
| early in a child's life. Because many normal children | | | | with other children than the more impulsive and |
| may have these symptoms, but at a low level, or the | | | | hyperactive types of ADHD. They may not have the |
| symptoms may be caused by another disorder. It is | | | | same sorts of social problems so common with the |
| important that the child receive a thorough examination | | | | combined type of ADHD. So often their problems with |
| and appropriate diagnosis by a well-qualified | | | | inattention are overlooked. But they need help just as |
| professional. | | | | much as children with other types of ADHD, who |
| Symptoms of ADHD will appear over the course of | | | | cause more obvious problems in the classroom. |
| many months, often with the symptoms of | | | | Is It Really ADHD? |
| impulsiveness and hyperactivity preceding those of | | | | Not everyone who is overly hyperactive, inattentive, or |
| inattention. Which may not emerge for a year or more. | | | | impulsive has ADHD. Since most people sometimes |
| Different symptoms may appear in different settings, | | | | blurt out things they didn't mean to say, or jump from |
| depending on the demands the situation may pose for | | | | one task to another, or become disorganized and |
| the child's self-control. A child who "can't sit still" or is | | | | forgetful, how can specialists tell if the problem is |
| otherwise disruptive will be noticeable in school, but the | | | | ADHD? |
| inattentive daydreamer may be overlooked. | | | | Because everyone shows some of these behaviors |
| The impulsive child who acts before thinking may be | | | | at times, the diagnosis requires that such behavior be |
| considered just a "discipline problem," while the child | | | | demonstrated to a degree that is inappropriate for the |
| who is passive or sluggish may be viewed as merely | | | | person's age. The diagnostic guidelines also contain |
| unmotivated. Yet both may have different types of | | | | specific requirements for determining when the |
| ADHD. | | | | symptoms indicate ADHD. |
| All children are sometimes restless, sometimes act | | | | The behaviors must appear early in life, before age 7, |
| without thinking, sometimes daydream the time away. | | | | and continue for at least 6 months. Above all, the |
| When the child's hyperactivity, distractibility, poor | | | | behaviors must create a real handicap in at least two |
| concentration, or impulsivity begin to affect | | | | areas of a person's life such as in the schoolroom, on |
| performance in school, social relationships with other | | | | the playground, at home, in the community, or in social |
| children, or behavior at home, ADHD may be | | | | settings. So someone who shows some symptoms |
| suspected. But because the symptoms vary so much | | | | but whose schoolwork or friendships are not impaired |
| across settings, ADHD is not easy to diagnose. This is | | | | by these behaviors would not be diagnosed with |
| especially true when inattentiveness is the primary | | | | ADHD. Nor would a child who seems overly active on |
| symptom. | | | | the playground but functions well elsewhere receive an |
| According to the most recent version of the | | | | ADHD diagnosis. |
| Diagnostic and Statistical Manual of Mental Disorders2 | | | | To assess whether a child has ADHD, specialists |
| (DSM-IV-TR), there are three patterns of behavior that | | | | consider several critical questions: Are these behaviors |
| indicate ADHD. People with ADHD may show several | | | | excessive, long-term, and pervasive? That is, do they |
| signs of being consistently inattentive. They may have | | | | occur more often than in other children the same age? |
| a pattern of being hyperactive and impulsive far more | | | | Are they a continuous problem, not just a response to |
| than others of their age. Or they may show all three | | | | a temporary situation? Do the behaviors occur in |
| types of behavior. | | | | several settings or only in one specific place like the |
| This means that there are three subtypes of ADHD | | | | playground or in the schoolroom? The person's pattern |
| recognized by professionals. These are the | | | | of behavior is compared against a set of criteria and |
| predominantly hyperactive-impulsive type (that does | | | | characteristics of the disorder as listed in the |
| not show significant inattention); the predominantly | | | | DSM-IV-TR. |
| inattentive type (that does not show significant | | | | Diagnosis |
| hyperactive-impulsive behavior) sometimes called | | | | Some parents see signs of inattention, hyperactivity, |
| ADD-an outdated term for this entire disorder; and the | | | | and impulsivity in their toddler long before the child |
| combined type (that displays both inattentive and | | | | enters school. The child may lose interest in playing a |
| hyperactive-impulsive symptoms). | | | | game or watching a TV show, or may run around |
| Hyperactivity-Impulsivity | | | | completely out of control. |
| Hyperactive children always seem to be "on the go" or | | | | But because children mature at different rates and are |
| constantly in motion. They dash around touching or | | | | very different in personality, temperament, and energy |
| playing with whatever is in sight, or talk incessantly. | | | | levels, it's useful to get an expert's opinion of whether |
| Sitting still at dinner or during a school lesson or story | | | | the behavior is appropriate for the child's age. Parents |
| can be a difficult task. They squirm and fidget in their | | | | can ask their child's pediatrician, or a child psychologist |
| seats or roam around the room. Or they may wiggle | | | | or psychiatrist, to assess whether their toddler has an |
| their feet, touch everything, or noisily tap their pencil. | | | | attention deficit hyperactivity disorder or is, more likely |
| Hyperactive teenagers or adults may feel internally | | | | at this age, just immature or unusually exuberant. |
| restless. They often report needing to stay busy and | | | | ADHD may be suspected by a parent or caretaker or |
| may try to do several things at once. | | | | may go unnoticed until the child runs into problems at |
| Impulsive children seem unable to curb their immediate | | | | school. Given that ADHD tends to affect functioning |
| reactions or think before they act. They will often blurt | | | | most strongly in school, sometimes the teacher is the |
| out inappropriate comments, display their emotions | | | | first to recognize that a child is hyperactive or |
| without restraint, and act without regard for the later | | | | inattentive and may point it out to the parents and/or |
| consequences of their conduct. | | | | consult with the school psychologist. |
| Their impulsivity may make it hard for them to wait for | | | | Because teachers work with many children, they |
| things they want or to take their turn in games. They | | | | come to know how "average" children behave in |
| may grab a toy from another child or hit when they're | | | | learning situations that require attention and self-control. |
| upset. Even as teenagers or adults, they may | | | | However, teachers sometimes fail to notice the needs |
| impulsively choose to do things that have an immediate | | | | of children who may be more inattentive and passive |
| but small payoff rather than engage in activities that | | | | yet who are quiet and cooperative, such as those with |
| may take more effort yet provide much greater but | | | | the predominantly inattentive form of ADHD. |
| delayed rewards. | | | | |