Signs & Symptoms of Attention Deficit Disorder in Children

When the fourth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM IV) was published, it defined something called attention deficit hyperactivity disorder (ADHD) as distinct from attention deficit disorder (ADD), which became the "predominantly inattentive" subtype of ADHD. Even though some children have behavior that leans more toward either the hyperactive side or the inattentive side, both types of behavior are often combined.

Definition

• ADD is a neurobiological disability that interferes with a child's ability to focus or to control hyperactive and impulsive behavior. This sounds like it could describe almost any child at some point in their life, so it's important to understand that there is a significant difference between behaviors that warrant a diagnosis of ADHD versus typical fidgeting, temper tantrums or shifting attention span.

DSM Criteria

• In order to distinguish ADD from typical behavior, the DSM IV includes very specific criteria. The symptoms must be present before the age of seven and they must have been observed for at least six months. The symptoms must also appear more frequently and be more severe than behaviors seen in typical children of the same age. One of the most important criteria is that the behavior must cause a disruption in the child's ability to successfully function in more than one environment. There are three different subtypes of ADHD; predominantly hyperactive-impulsive, predominantly inattentive, and the combined type.

ADHD - Inattentive Type

• The DSM IV lists nine different behaviors that are the symptoms of inattention. To be diagnosed with ADD, six of the nine must be evident. Children with ADD have a hard time paying attention to details, causing them to make mistakes. They often find it quite difficult to maintain attention for any length of time. They may act bored or seem not to listen when spoken to. They often do not follow instructions and fail to complete schoolwork or chores, but they are not oppositional or defiant, they either have a hard time following instructions or haven't paid attention to them.

  Children with ADD may have difficulty organizing tasks. They often lose items that are important and needed, such as homework or notebooks. They are easily distracted by things that other kids easily tune-out in order to pay attention. They may often forget about daily activities. It is common for children with ADD to try to avoid tasks that require sustained mental effort.

Environments

• To qualify as ADD, symptoms must be seen in more than one environment. This includes home, community, the classroom, playground, and other social settings. This criterion is important because it indicates that the symptoms are pervasive enough to meet the ADD diagnosis. If the symptoms are only seen in one environment then they may be caused by something other than ADD. For example, if your child is only inattentive in the classroom but is fine in the community, on the playground, and at home, then it is likely that something other than ADD is behind the problem.

Co-existing Disorders

• ADD frequently does not exist alone. It often co-exists with other disorders, making it more of a challenge to unravel the symptoms and discern an accurate diagnosis. Two common disorders that co-exist with ADD are depression and anxiety. Mood disorders, oppositional defiant disorder, and obsessive-compulsive disorder are other disabilities that need to be ruled-out by a qualified mental health professional.