Attention-deficit/hyperactivity disorder, or ADHD, is the most common behavioral disorder in children: about 10% of children ages three to 17 years old have been diagnosed with ADHD during their lifetimes. ADHD often begins in childhood: in a class of 25 to 30 children, it’s likely that at least one student will have ADHD.
People with ADHD may have trouble paying attention, sitting still and controlling their impulses. There are three types of ADHD:
- Inattentive presentation (or attention deficit disorder, ADD): difficulties with attention and organization
- Hyperactive-impulsive presentation: difficulties with controlling hyperactivity and impulses
- Combined presentation: difficulties with paying attention and controlling hyperactivity
Signs of ADHD can vary depending on the subtype of disorder a person may have. They also may vary depending on a person’s gender. Here are some of the common signs to be aware of, as well as how to seek help.
Signs of ADHD
For children, it’s normal for them to be easily distracted or have difficulty finishing a task. However, children with ADHD have persistent patterns of behavior that interfere with their ability to focus, stay present or control their impulses to a degree that it negatively impacts their home or school lives.
Signs of inattention ADHD can include six or more of these symptoms that have lasted for at least six months:
- Failing to give close attention to details or making careless mistakes
- Difficulty sustaining attention in tasks or during play
- Appears not to listen when spoken to directly
- Doesn’t follow through on instructions on a task
- Difficulty organizing tasks and activities
- Avoids, dislikes or is reluctant to engage in tasks that require sustained mental effort
- Loses things for tasks or activities – like school materials or eyeglasses
- Easily distracted
- Forgetful in everyday activities
Signs of hyperactive-impulsive ADHD can include six or more of these symptoms that have lasted for at least six months:
- Fidgeting with or tapping hands or feet, or squirming in seat
- Leaving their seat in the classroom or other setting
- Runs around or climbs during inappropriate situations
- Unable to play quietly
- Often “on the go” and has difficulty being still for an extended period of time
- Talks excessively
- Blurts out an answer before a question has been completed
- Difficulty waiting their turn
- Interrupts or intrudes on others
If an individual meets the criteria for both the inattention and hyperactivity subtypes of ADHD, they may have the combined type. Combined ADHD is the most common type of ADHD.
ADHD in boys and girls
Boys are statistically more likely to be diagnosed with ADHD. About 13% of school-aged boys are diagnosed with ADHD, compared to six percent of girls. However, signs of ADHD in girls may be different than in boys – which could contribute to this disparity.
Historically, most referrals for ADHD were boys – as hyperactivity was the main sign that providers were looking for. Many girls with ADHD do not initially present hyperactivity symptoms, and instead experience signs of the inattentive presentation of the disorder – which meant they were not diagnosed.
Often, girls with ADHD may be less disruptive, aggressive, impulsive or hyperactive when compared to boys – which makes their disorder harder to identify. Girls may also be able to hide the any difficulties they may be having.
Effective treatment for ADHD is available. For individuals who have questions about a child’s behavior, first talk with their primary care doctor about what behaviors are a concern to them.
There’s no one test that is used to screen or to diagnose for ADHD. Rather, the child’s behavior is evaluated against guidelines from the American Psychiatric Association’s Diagnostic and Statistical Manual, Fifth edition (DSM-5). It’s recommended that the child’s behavior at home, at school and with their peers be taken into account. A diagnosis of ADHD can be made by a primary care provider or by a mental health professional.
ADHD can affect a child’s ability to focus and perform well in a school setting, which is why it’s important for families to work with a school to ensure supports and services are provided to allow them to thrive. Treatment for ADHD often involves a combination of ADHD medication, therapy and skill development.
A primary care provider can help parents and caregivers begin to navigate available treatment options and referrals to mental health professionals to help a child learn to manage their diagnosis.
Kristyn Gregory, D.O., is a medical director of behavioral health at Blue Cross Blue Shield of Michigan. For more health news and information, visit MIBluesPerspectives.com.
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