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ADHD: The distracted child
Hyperactivity, short attention span, distractibility and impulsiveness are normal developmental characteristics of children. However, adults dealing with children who exhibit these characteristics in excess often question when these behaviors are no longer age appropriate or in which circumstances they are no longer normal.
Usually these characteristics are inappropriate beginning at age 5 or 6 when children begin school. A note from school saying that a child won't listen to the teacher or causes trouble in class may be a warning sign. Although many possible reasons for this kind of behavior exist, one of which to be especially aware is attention deficit/hyperactivity disorder (ADHD).
Signs of ADHD
Even though the child with attention deficit hyperactivity disorder (ADHD) wants to be a good student, he or she is impulsive and unable to pay proper attention in class. Parents, teachers and friends know that the child is misbehaving or different, but they might not be able to tell exactly what is wrong.
ADHD is usually accompanied excessive running or climbing in young children or extremely restless or fidgety behavior in older children. Such hyperactivity is haphazard, poorly organized, and not goal-directed -- in contrast to children's normal high level of activity.
Although the hyperactivity usually lessens by 10 to 12 years of age, the basic problem of attention continues. Children do not grow out of ADHD, but they do exhibit less hyperactivity. Recent research points to biological causes for ADHD, but the exact mechanism is unknown. However, the earlier the diagnosis and treatment, the better the outcome.
ADHD can be suspected when a child exhibits a substantial number of the characteristics listed below over several months in most surroundings:
- often fails to finish things he or she starts
- often doesn't seem to listen
- is easily distracted
- has difficulty concentrating on schoolwork or other tasks requiring sustained attention
- has difficulty sticking to a play activity
- often acts before thinking
- shifts excessively from one activity to another
- has difficulty organizing work (when this is not due to a cognitive impairment)
- needs a lot of supervision
- frequently calls out in class
- has difficulty awaiting his or her turn in games or group situations
- runs about or climbs on things excessively
- has difficulty sitting still or fidgets excessively
- moves about excessively during sleep
- is always on the go or acts as if driven by a motor
A diagnosis based on the above criteria should be made by a child and adolescent psychiatrist or a mental health professional or pediatrician with training and experience in the diagnosis and treatment of ADHD.
Comprehensive treatment
Treatment is long (measured in years) and sometimes difficult, but worthwhile. It can increase self-esteem, teach mastery of problem-solving skills and successfully change the bad kid image to one of a good kid.
Scientific studies show that untreated youngsters with attention deficit hyperactivity disorder (ADHD) are at high risk of school failure, juvenile delinquency and substance abuse.
School intervention: Children with ADHD need special help in school, depending upon their potential and whether or not they have a concurrent learning disability. Youngsters with average or below average intelligence need more intense special help earlier. Very bright youngsters with no learning problems may only need help in junior high in organizing their time and schoolwork. The typical ADHD youngster does not finish work during class time, fails to remember assignments or does the assignment and forgets to turn it in.
Psychotherapy: Children with ADHD tend to alienate friends and frustrate adults. Parents and siblings need to learn what is and what is not under the individual's control. The individual needs to learn social skills, how to stop from going too far and how to solve problems. Mastering problem-solving skills will significantly increase self-esteem.
Medication: Medication is necessary, but only as an aid in helping ADHD youngsters focus their attention and in making sustained effort easier. Medication will not make youngsters pick up their clothes, stop fighting, or change mood. Instead, they may pick up their clothes because they heard the parent tell them to or because they remember to do this job. They may not fight because they can recall the rule forbidding it or because they can curb their impulses and think before they act. And finally, their moods will be better because they can accomplish more.
Related Links
Attention deficit hyperactivity disorder (ADHD): Overview
Source: American Academy of Child and Adolescent Psychiatry; Behavioral Health Services of Allina Hospitals & Clinics
First published: 09/13/99
Last updated: 08/26/2005
Reviewed by: Tim Gibbs, MD, medical director, Outpatient Clinic, Abbott Northwestern Hospital Behavioral Health Services; Paul Goering, MD, medical director, United Hospital Behavioral Health Services; Donna Krzmarzick, RN, director, Cambridge Medical Center Behavioral Health Services; Mary Beth Lardizabal, DO, child and adolescent psychiatry, Allina Behavioral Health Services - St. Paul Clinic; Susan Tabor, RN, BSN, director, United Hospital Behavioral Health Services; Dianne Timmer, RN, behavioral health services lead, Abbott Northwestern Hospital; Mark Zipper, PhD, behavioral health services director, Allina Medical Clinic