The principal characteristics of ADHD are inattention, hyperactivity, and
impulsivity. These symptoms appear early in a child's life. Because many normal
children may have these symptoms, but at a low level, or the symptoms may be
caused by another disorder, it is important that the child receive a thorough
examination and appropriate diagnosis by a well-qualified professional.
Symptoms of ADHD will appear over the course of many months, often with the
symptoms of impulsiveness and hyperactivity preceding those of inattention,
which may not emerge for a year or more. Different symptoms may appear in
different settings, depending on the demands the situation may pose for the
child's self-control. A child who "can't sit still" or is otherwise disruptive
will be noticeable in school, but the inattentive daydreamer may be overlooked.
The impulsive child who acts before thinking may be considered just a
"discipline problem," while the child who is passive or sluggish may be viewed
as merely unmotivated. Yet both may have different types of ADHD. All children
are sometimes restless, sometimes act without thinking, sometimes daydream the
time away. When the child's hyperactivity, distractibility, poor concentration,
or impulsivity begin to affect performance in school, social relationships with
other children, or behavior at home, ADHD may be suspected. But because the
symptoms vary so much across settings, ADHD is not easy to diagnose. This is
especially true when inattentiveness is the primary symptom.
According to the most recent version of the Diagnostic and Statistical Manual of
Mental Disorders2 (DSM-IV-TR), there are three patterns of behavior that
indicate ADHD. People with ADHD may show several signs of being consistently
inattentive. They may have a pattern of being hyperactive and impulsive far more
than others of their age. Or they may show all three types of behavior. This
means that there are three subtypes of ADHD recognized by professionals. These
are the predominantly hyperactive-impulsive type (that does not show significant
inattention); the predominantly inattentive type (that does not show significant
hyperactive-impulsive behavior) sometimes called ADD—an outdated term for this
entire disorder; and the combined type (that displays both inattentive and
hyperactive-impulsive symptoms).
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