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