ADHD is characterized by inattentive, hyperactive, or impulsive behavior that begins during childhood. ADHD is characteristically diagnosed in children under the age of seven, although the disorder can be present in adolescents and adults as well. Individuals with ADHD often seem to be disorganized or preoccupied. They may be poor listeners, and frequently change the subject or become distracted by unimportant interruptions. Individuals with ADHD may appear to be impatient, interrupting others frequently, or blurting out tactless comments. Some impulsive people engage in high-risk sports or other activities. While similar symptoms can occur in normal children and adults, people with ADHD show a persistent pattern that is more frequent and more severe than that of others in the same age group.
Some people with ADHD have mostly inattentive symptoms, while others exhibit mostly hyperactive and impulsive behavior. Most people with ADHD have features of both subtypes Table 01. Inattention may manifest itself as carelessness at work or at home, or difficulty completing projects. Individuals with ADHD often seem to be disorganized or preoccupied.
Hyperactivity can manifest as fidgetiness or an inability to engage in tasks or leisure activities that require a person to sit still. People with these symptoms often seem to be “on the go.” Hyperactive people sometimes describe having accelerated or multiple thoughts at the same time.
Table 1. Symptoms of ADHD by Subtype
Inattentive Hyperactive/impulsive Fails to pay close attention to details or makes careless mistakes Fidgets with hands or feet or squirms in seat Has difficulty sustaining attention Leaves seat in situations where remaining seated is expected Does not seem to listen Runs about or climbs excessively (in adults, may be limited to feelings of restlessness) Does not follow through on instructions and fails to finish tasks Has difficulty paying attention or engaging in leisure activities quietly Has difficulty organizing tasks and activities ?On the go? or acts as if ?driven by a motor? Avoids or dislikes tasks that require sustained mental effort Talks excessively Loses things necessary for tasks or activities Blurts out answers before questions completed (impulsivity) Easily distracted by extraneous stimuli Has problems waiting turns (impulsivity) Forgetful in daily activities Interrupts or intrudes on others (impulsivity)
Other troubling features are commonly seen in individuals with ADHD Table 02. Possibly as a result of frequently being “in trouble” or regarded as lazy, many people with ADHD have low self-esteem. They may have a low tolerance for frustration, and have frequent temper outbursts and mood changes. Some very impulsive people become “class clowns.” More troubling consequences of ADHD include possible drug abuse and conduct disorder, often involving anti-social behavior and skirmishes with the law.
Table 2. Learning/Behavior Problems In Children or Adolescents with ADHD
Possible problems identified by parents/family members Possible problems identified by school personnel Possible problems identified by patients Noncompliance Fidgety, restless behavior Dislike of school Aggression Hyperactivity Lack of close or long-term friendships Anger management problems Fidgety, restless behavior Frustration with certain teachers or subjects Impulsivity Inattention, off-task behavior, distractibility Excessive conflict with parents Engaging in physically dangerous activity Social interaction problems (impulsivity, intrusiveness) Low self-esteem Task completion difficulty Underachievement, school failure ? Disorganized, messy Disruptive classroom behavior Appearing ?spaced out? or ?zoned out? Excessive talking, blurting out answers Changeable moods Poor listening Absent-mindedness Incomplete, missing homework Social/emotional ?immaturity? Messy, disorganized work ?Hyper,? ?in constant motion?
ADHD is more common in boys than in girls.
ADHD tends to run in families
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