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AD/HD: An overview

Sometimes your child doesn't pay attention or follow directions, but is it AD/HD? A guide to diagnosing and dealing with this disorder.

By Jan Baumel, M.S.

What is AD/HD?

Attention-deficit/ hyperactivity disorder (AD/HD) is a neurobehavioral disorder that affects an estimated 3% to 7% of the school-age population. The Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV), published by the American Psychiatric Association, describes three subtypes of AD/HD:

  • Inattentive: A child can't seem to get or stay focused on a task or activity
  • Hyperactive-impulsive: Very active and often acts without thinking
  • Combined: Inattentive, impulsive, and too active

How is AD/HD diagnosed?

Currently, there are no medical tests, such as blood tests or electrical imaging (like an MRI), that diagnose AD/HD. However, research in this area is being conducted with the hope that making the diagnosis can be more precise in the near future.

At this time, behavior criteria from DSM-IV are used to make the determination of AD/HD. Some of these behaviors are seen more often at certain periods of child development, and behaviors may vary for boys and girls. Individual clinicians may interpret the criteria differently, so it's important that you choose a qualified professional to make the diagnosis.

Because of inconsistencies in diagnosis by medical professionals, the American Academy of Pediatrics (AAP) came out with its guidelines in May 2000. It recommends a comprehensive assessment that relies on direct information from parents (or caregivers) and the classroom teacher (or other school professional) using developmental history, rating scales, observations, and available test results.

Information from all of the sources is reviewed carefully. The clinician has to make a judgment about whether the symptoms of AD/HD impair academic achievement, classroom performance, family and social relationships, independent functioning, self-esteem, leisure activities, and/or self-care. So it usually takes two or more visits to the clinician before a diagnosis can be made.

Behaviors generally are observed before age 7. Symptoms need to be present in at least two places — for example, at school or home or in a childcare setting — and for at least six months. They should occur more often and be more severe than for other kids of the same age or developmental level.

A few of the symptoms of AD/HD are:

  • A child doesn't pay close attention to details
  • Doesn't seem to listen when spoken to directly
  • Is easily distracted
  • Has difficulty organizing and finishing tasks
  • Fidgets with hands and feet; has difficulty remaining seated
  • Runs about or climbs excessively when inappropriate (seems "motor-driven")
  • Talks continually
  • Interrupts conversations and intrudes upon other kids' games
  • Avoids tasks that require sustained mental effort (e.g. schoolwork, homework, games)
  • Does things that are dangerous without thinking about possible outcomes

Jan Baumel, M.S., Licensed Educational Psychologist, spent 35 years in education as a teacher, school psychologist, and special education administrator before joining Schwab Learning. Today she is a consultant to local school districts and university field supervisor for student teachers.

Comments from readers

" we have fought a middle school for 2 1/2 years for an IEP program which a doctor recommeded would accomadate our granddaughter's needs. she has AD/HD and Asperger's. The Team keeps trying the same thing over and over each year, but not consistenly by just giving her help writing down her assignments and making sure she hands in her classwork and homework. We see to it her homework is completed, but with the AdHd, she does not pass it in always, and this counts as half her grade which causing her to have failing grades, yet she passes because she has very good SOL scores. Of course, this makes the school look good, but if they only knew the battle we are having to get the proper education the doctor feels would better suit her they would be appalled.She also has very poor social skills. She finally after 2 1/2 years there has three friends, one has a hearing problem ( and she has that also), one is a very shy little girl, so, they too, have some problems. On a whole, the majo! rity of her class and students just pass her off when she speaks to them. we have seen it in the hallway and classrooms when we have visited on those special days. We feel the teachers and adminstration of this school do not really know what to look for in these problems. We are still fighting and will continue until she has the proper education due her. the doctor said she was very smart and could go far in this world with the proper education and we will she is being cheated at this particular school. "
"I'm a 16 year-old girl in highschool. I know I have AD/HD, but my mom and step-dad won't believe me. They refuse to get me checked out and say that there's nothing wrong with me, except I do stupid stuff and act a lot younger than I am. I've read several articles on AD/HD, and found that I definately have it, but still can't convince my mom to take me to a doctor. What can I do?"
"'My daughter is 4 years old and will start school in the fall. She has a really hard time sitting still and an even harder time coloring but when it comes to sitting and watching a t.v show she will sit for while. I have taken her to therpist in years past about getting her still long enough to eat and she has made some progress with thier idea of letting her play at somewhere's like the playground to get her energy out. They basically thought she had too much energy but now a couple years later I still have the same problems. I worry and wonder about AD/HD? I just know something isn't quiet right? "
"My son is 5 and he will be starting kindergarten in the fall. I am very concerened that he may have ADHD. All of the things listed, he does, consistently. In Fact, he was expelled from preschool when he was 2 1/2. And then when we came back (at 3), the teachers (though very good sports) asked me if they could watch him for their ADHD study. Ofcourse I said yes, because I too think something is going on there and wanted to see what they found. They found that he is an excellent candidate for it..They gave me a paper that had ideas for controlling ADHD by diet which does lessen the affects of his inability to pay attention. My question is, do I let his new kindergarten know or do I let it be, and see if they confront me? I know that it is extremely hard for me to deal with on a daily basis, and for my own sake, I'm wondering if I should do something more to get this problem under control; I am worried about his ability to control himself and pay attention at school. By the way! , Bi-polar disorder AND ADHD run in my family. :("
"Does the state of Maryland public school system still offer a 504 plan to a child diagnosed with adhd"
"I thought sometimes a child with ADHD pays to much attention and is overwhelmed. How can I focus the child on what he/she needs to focus on?"
"Hi,I'm a mother of two ADHD boys,ages 4&8.They are under medication at this time but not in a special education class.My 4 year old was recently exspelled from his school so I had to place him in daycare where he was doing great.He was put in a different school again and almost got exspelled again.he had an IEP test but was found without a disability.What should I do?"