ADHD has been called attention-deficit disorder (ADD) in the past. But, ADHD is now the preferred term because it describes both primary aspects of the condition: inattention and hyperactive-impulsive behavior.
While many children who have ADHD tend more toward one category than the other, most children have some combination of inattention and hyperactive-impulsive behavior. ADHD symptoms become more apparent during activities that require focused mental effort.
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In order to be diagnosed with ADHD, signs and symptoms of the disorder must appear before the age of 7. In some children, signs of ADHD are noticeable as early as 2 or 3 years of age.
Signs and symptoms of inattention may include:
- Often fails to pay close attention to details or makes careless mistakes in schoolwork or other activities
- Often has trouble sustaining attention during tasks or play
- Seems not to listen even when spoken to directly
- Has difficulty following through on instructions and often fails to finish schoolwork, chores or other tasks
- Often has problems organizing tasks or activities
- Avoids or dislikes tasks that require sustained mental effort, such as schoolwork or homework
- Frequently loses needed items, such as books, pencils, toys or tools
- Can be easily distracted
- Often forgetful
Signs and symptoms of hyperactive and impulsive behavior may include:
- Fidgets or squirms frequently
- Often leaves his or her seat in the classroom or in other situations when remaining seated is expected
- Often runs or climbs excessively when it’s not appropriate or, if an adolescent, might constantly feel restless
- Frequently has difficulty playing quietly
- Always seems on the go
- Talks excessively
- Blurts out the answers before questions have been completely asked
- Frequently has difficulty waiting for his or her turn
- Often interrupts or intrudes on others’ conversations or games
ADHD behaviors can be different in boys and girls:
- Boys are more likely to be primarily hyperactive, whereas girls are more frequently undiagnosed as they tend to be quietly inattentive.
- Girls who have trouble paying attention often daydream, but inattentive boys are more likely to play or fiddle aimlessly.
- Boys tend to be less compliant with teachers and other adults, so their behavior is often more conspicuous.
You may suspect your child’s behavior is caused by ADHD if you notice consistently inattentive or hyperactive, impulsive behavior that:
- Lasts more than six months
- Occurs in more than just one setting (typically at home and at school)
- Regularly disrupts school, play and other daily activities
- Causes problems in relationships with adults and other children
Normal behavior vs. ADHD
Most healthy children are inattentive, hyperactive or impulsive at one time or another. For instance, parents may worry that a 3-year-old who can’t listen to a story from beginning to end may have ADHD. But it’s normal for preschoolers to have short attention spans and be unable to stick with one activity for long. Even in older children and adolescents, attention span often depends on the level of interest. Most teenagers can listen to music or talk to their friends for hours but may be a lot less focused about homework.
The same is true of hyperactivity. Young children are naturally energetic — they often wear their parents out long before they’re tired. And they may become even more active when they’re tired, hungry, anxious or in a new environment. In addition, some children just naturally have a higher activity level than do others. Children should never be classified as having ADHD just because they’re different from their friends or siblings.
Children who have problems in school but get along well at home or with friends are likely struggling with something other than ADHD. The same is true of children who are hyperactive or inattentive at home, but whose schoolwork and friendships remain unaffected.
When to see a doctor
If you’re concerned that your child is displaying signs of ADHD, such as trouble concentrating, difficulty sitting still, or an inability to control his or her behavior, see your pediatrician or family doctor. Your doctor may refer you to a specialist, but it’s important to have a medical evaluation first to check for other causes of your child’s difficulties.
If your child is already being treated for ADHD, he or she should see the doctor regularly — at least every six months if his or her symptoms are stable. Be sure to discuss how often your child should be seen for appointments with his or her doctor. Call the doctor if your child has any medication side effects, such as loss of appetite, trouble sleeping or increased irritability. Some children taking stimulant medications may lose their appetite and have difficulty maintaining the same height and weight growth rate. However, they will most likely reach their full growth potential by adulthood.