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ADHD in Children

Typically ADHD becomes apparent in children during their preschool and early school years. The National Institute of Mental Health estimates that three to five percent of children have ADHD. This means that in any given classroom of 25 children at least one will probably have ADHD. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) ADHD is characterized by three behaviors: inattention, hyperactivity, and impulsivity. Of course, these behaviors are also found in normal children but they tend to occur sporadically and at a much lower level. It is the frequency and intensity of these behaviors that usually lead to an assessment and a diagnosis of ADHD.

The overactive child and the sluggish child exhibit different types of behavior but both may have ADHD. There are three subtypes of ADHD that have currently beenidentified:

  • Predominantly hyperactive-impulsive (but stillable to be attentive to tasks)
  • Predominantly inattentive (unable to focus on tasks but can control impulsive behavior)
  • Combined type (displays both inattentive and hyperactive-impulsive symptoms)

Because so many children normally display similar behaviors, diagnosis relies on demonstrating whether or not these behaviors seem appropriate or inappropriate for their age. The DSM-IV-TR breaks down these subtype symptomsof ADHD as follows:

Hyperactivity-Impulsivity

Hyperactive children always seem to be "on the go" or constantly in motion. Impulsive children seem unable to curb their immediate reactions or to think before they act. Signs of hyperactivity-impulsivity are:

  • Feeling restless, often fidgeting with hands or feet, or squirming while seated
  • Running, climbing, 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

Inattention

Children who are inattentive have a hard time keeping their minds on any one thing and may get bored with a task after only a few minutes. Yet if they are doing something they really enjoy, they have no trouble paying attention. Signs of inattention are:

  • Becoming easily distracted by irrelevant sights and sounds
  • Failing to pay attention to details and making careless mistakes
  • Rarely following instructions carefully and completely losing or forgetting things liketoys, or pencils, books, and tools needed for a task
  • Skipping from one uncompleted activity to another.

A diagnosis of childhood ADHD is made when a child exhibits some or all of the symptoms of either type of ADHD for a period of six months or more. The diagnosis includes a full medical examination, discussion of medical history and an exploration of other probable causes including, but not limited to, thyroid and anxiety problems.

Merln Hurd PhD; BCN, QEEGT

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