ADHD is a problem with inattentiveness, over-activity, impulsivity, or a combination. For these problems to be diagnosed as ADHD, they must be out of the normal range for a child's age and development.
Causes, incidence, and risk factors
Imaging studies suggest that the brains of children with ADHD are different from those of other children. These children handle neurotransmitters (including dopamine, serotonin, and adrenaline) differently from their peers. ADHD may run in families, but it is not clear exactly what causes it. Whatever the cause may be, it seems to be set in motion early in life as the brain is developing. Depression, lack of sleep, learning disabilities, tic disorders, and behavior problems may be confused with, or appear with, ADHD. Every child suspected of having ADHD should have a careful evaluation to determine what is contributing to the behaviors that are causing concern. ADHD is the most commonly diagnosed behavioral disorder of childhood. It affects about 3 - 5% of school aged children. ADHD is diagnosed much more often in boys than in girls. Most children with ADHD also have at least one other developmental or behavioral problem. They may also have another psychiatric problem, such as depression or bipolar disorder.
The symptoms of ADHD are divided into inattentiveness, and hyperactivity and impulsivity. Some children with ADHD primarily have the inattentive type, some the hyperactive-impulsive type, and some the combined type. Those with the inattentive type are less disruptive and are more likely to miss being diagnosed with ADHD. Inattention symptoms:
1. Fails to give close attention to details or makes careless mistakes in schoolwork 2. Has difficulty sustaining attention in tasks or play
3. Does not seem to listen when spoken to directly
4. Does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace 5. Has difficulty organizing tasks and activities
6. Avoids or dislikes tasks that require sustained mental effort (such as schoolwork) 7. Often loses toys, assignments, pencils, books, or tools needed for tasks or activities 8. Is easily distracted
9. Is often forgetful in daily activities
1. Fidgets with hands or feet or squirms in seat
2. Leaves seat when remaining seated is expected
3. Runs about or climbs in inappropriate situations
4. Has difficulty playing quietly
5. Is often "on the go," acts as if "driven by a motor," talks excessively Impulsivity symptoms:
1. Blurts out answers before questions have been completed 2. Has difficulty awaiting turn
3. Interrupts or intrudes on others (butts into conversations or games)
Signs and tests
Too often, difficult children are incorrectly labeled with ADHD. On the other hand, many children who do have ADHD remain undiagnosed. In either case, related learning disabilities or mood problems are often missed. The American Academy of Pediatrics (AAP) has issued guidelines to bring more clarity to this issue. The diagnosis is based on very specific symptoms, which must be present in more than one setting. • Children should have at least 6 attention symptoms or 6 hyperactivity/impulsivity symptoms, with some symptoms present before age 7. • The symptoms must be present for at least 6 months, seen in two or more settings, and not caused by another problem. • The symptoms must be severe enough to cause significant difficulties in many settings, including home, school, and in relationships with peers. In older children, ADHD is in partial remission when they still have symptoms but no longer meet the full definition of the disorder. The child should have an evaluation by a doctor if ADHD is suspected. Evaluation may include: • Parent and teacher questionnaires (for example, Connors, Burks) • Psychological evaluation of the child AND family, including IQ testing and psychological...
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