ADHD Signs and Symptoms
Signs and symptoms of attention-deficit hyperactivity disorder develop during early childhood (i.e., before 7 years of age) and affect behavior at home, in school, and in social settings. Primary symptoms of the disorder, which include inattention, impulsivity, and hyperactivity, usually appear over the course of several months and often vary, depending on the situation.
Because ADHD symptoms occur in most children to some degree, the disorder can be difficult to diagnose. According to the current Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), there are three types of ADHD. Some children with the disorder are consistently inattentive (called predominantly inattentive, or attention deficit disorder [ADD]), some are consistently hyperactive and impulsive (called predominantly hyperactive-impulsive), and some demonstrate all three behaviors (called combined ADHD). In children who have combined ADHD, impulsivity and hyperactivity usually develop before inattention.
Children with inattention become bored with activities quickly and are easily distracted. They have difficulty following directions, focusing on and completing tasks, and learning new skills. Children who have inattention often appear forgetful, unorganized, and lazy. They make frequent mistakes on assignments and forget homework (or bring home the wrong book). Children who are inattentive usually get along with others better than children with other types of ADHD. They often are seen as being, "daydreamers."
Children with hyperactivity-impulsivity appear to be constantly moving and unable to "sit still." They may squirm, fidget, wiggle, or roam during quiet activities. Hyperactive-impulsive children often have a difficult time curbing reactions. They may interrupt frequently, blurt out answers and inappropriate comments, display emotions without restraint, and act out with no regard for the consequences. These children often have difficulty taking turns and waiting for things they want.
Adolescents with hyperactivity-impulsivity often feel restless. They may keep themselves very busy and try to do several things at once. Impulsive teenagers may choose activities that provide an immediate but small payoff, rather than activities that require substantial effort but provide greater, delayed rewards. For example, they may use their money to make a number of small purchases instead of saving for a car. Symptoms of hyperactivity usually improve after childhood.
Stressful situations, such as family problems (e.g., serious illness, financial difficulties, separation) often worsen symptoms of ADHD in children. Other symptoms include physical aggression (more common in boys with ADHD) and fear, depression, anxiety, and mood swings (more common in girls with the disorder).