ADHD: What Is It?

 

ADHD: What Is It?

Attention deficit hyperactivity disorder (ADHD) is a condition that robs children of their ability to focus and pay attention. Kids with ADHD are fidgety and easily distracted. This makes it difficult to stay "on task," whether it's listening to a teacher or finishing a chore. The National Institute of Mental Health estimates 3% to 5% of kids have ADHD, but some experts believe that figure could be as high as 10%.

Types of ADHD

There are three different types of ADHD, including:

• combined ADHD (the most common type), which involves all of the symptoms
• inattentive ADHD (previously known as ADD), which is marked by impaired attention and concentration
• hyperactive-impulsive ADHD, which is marked by hyperactivity without inattentiveness

For a diagnosis of ADHD, some symptoms that cause impairment must be present before age seven. Also, some impairment from the symptoms must be present in more than one setting. For instance, the person may be impaired at home and school or home and work. Also, there must be clear evidence the symptoms interfere with the person's ability to function at home, in social environments, or in work environments.

Symptoms of ADHD

There are three different categories of ADHD symptoms: inattention, hyperactivity, impulsivity.
Inattention may not become apparent until a child enters the challenging environment of school. In adults, symptoms of inattention may manifest in work or in social situations.
A person with ADHD may have some or all of the following symptoms:

• difficulty paying attention to details and tendency to make careless mistakes in school or other activities; producing work that is often messy and careless
• easily distracted by irrelevant stimuli and frequently interrupting ongoing tasks to attend to trivial noises or events that are usually ignored by others
• inability to sustain attention on tasks or activities
• difficulty finishing schoolwork or paperwork or performing tasks that require concentration
• frequent shifts from one uncompleted activity to another
• procrastination
• disorganized work habits
• forgetfulness in daily activities (for example, missing appointments, forgetting to bring lunch)
• failure to complete tasks such as homework or chores
• frequent shifts in conversation, not listening to others, not keeping one's mind on conversations, and not following details or rules of activities in social situations

Hyperactivity symptoms may be apparent in very young preschoolers and are nearly always present before the age of seven. Symptoms include:

• fidgeting, squirming when seated
• getting up frequently to walk or run around
• running or climbing excessively when it's inappropriate (in teens this may appear as restlessness)
• having difficulty playing quietly or engaging in quiet leisure activities
• being always on the go
• often talking excessively

Hyperactivity may vary with age and developmental stage.

Disciplining a Child With ADHD

Carla Counts Allan, PhD, director of psychological services at the ADHD Specialty Clinic at Children's Mercy Hospitals and Clinics in Kansas City, Mo., outlines a time-out strategy that she says works effectively with all kids -- whether or not they have ADHD -- when used consistently.

• Contrast time-out with time-in. That means that if you put your child in time-out for hitting his sister, you should have been praising him earlier for playing well with his sister, and should praise him afterward for having a good attitude. "If there isn't a big difference between time-out and time-in, kids don't understand the consequences," Allan says.
• Keep time-outs brief and consistent with the infraction. "Long time-outs can start a battle of wills," she says. "For younger children, 1-2 minutes is plenty. A minute per year of age is more an upper limit for time-out, but for preschoolers, sometimes a 30-second or one-minute time-out is plenty if they show me quiet feet, quiet hands, and quiet mouth."
• Remain calm. If you tell the child to go to time-out and he ignores you, add one minute to his time-out. If he doesn't go again, add another minute. But if he ignores you a third time, don't pick him up and drag him to time-out -- that just escalates things. "Instead, impose a consequence that means a lot, such as no video games for the rest of the day," Allan says. "Deliver that consequence calmly and don't talk about it further. Even if he says, ‘I'll listen, I'll go into time-out now,' don't give in then!"
• Practice time-outs. Ask your child to pretend that he hit his sister, and that he is sent to time-out. "'If you go willingly when I tell you to, you earn a point on a behavior chart and earn privileges,'" she says. "Have them practice going to time-out without putting up a fight."