What is ADHD?

Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD) are essentially the same disorder, however ADHD is the official term used by the American Psychiatric Association, as it encompasses hyperactive, impulsive, and/or inattentive behaviors. The symptoms of ADHD are all changes in behavior relating to executive dysfunction, impulsivity, attention, and activity.

When looking at the symptoms of ADHD in children, it is helpful to understand the three main types of ADHD:

  • Predominantly Hyperactive/Impulsive
  • Predominantly Inattentive
  • Combined

Interestingly, there have been some gender differences seen in diagnoses in that girls tend to be diagnosed as Predominantly Inattentive, whereas boys are more likely to be diagnosed with Predominantly Hyperactive/Impulsive.

Partly because the symptoms of the disorder are all changes in behavior, partly because of the wide variety of methods for making a diagnosis, and in part because of the lack of objective medical tests to make the diagnosis, ADHD is a controversial disorder that is often debated. Nevertheless, it is one of the most researched problems in pediatric medicine and the research is quite clear: ADHD is a medical and neurological condition with a strong genetic basis, which occurs relatively frequently in both children and adults. While positive aspects of ADHD are frequently discussed (creativity, outgoing nature, etc.), ADHD can be very disabling in a culture that places a premium on organization and the ability to plan and anticipate the future.

Overall, ADHD is one of the best researched disorders in medicine and the overall data on its validity are far more compelling than for many medical conditions.” Council on Scientific Affairs, American Medical Association, 1998

What are the symptoms of ADHD?

Children with ADHD often exhibit most (but rarely all) of the following behaviors:

Executive Dysfunction

  • Difficulty developing or following a plan for schoolwork or other activities
  • Trouble organizing books, schedules, and locker
  • Poor memory
  • No recognition of salience (important vs. unimportant)

Impulsivity

  • Blurts out answer before question has been completed
  • Difficulty awaiting turn
  • Acts without considering the consequences
  • Interrupts or intrudes on others (i.e. butts into conversations or games, or talks out of turn)

Attention

  • No attention to detail
  • Trouble listening
  • Difficulty following directions
  • Makes careless mistakes
  • Difficulty maintaining attention for longer periods of time
  • Does not finish what is started
  • Reluctant to do challenging tasks requiring prolonged mental effort (like schoolwork, homework, or chores)
  • Loses things necessary for tasks or activities (e.g., toys, school assignments, or books)
  • Easily distracted

Activity

  • Fidgets or squirms in seat
  • Leaves seat in classroom or in other situations in which remaining seated is expected (for example, mealtimes)
  • Runs about or climbs excessively when she/he knows she/he should not
  • Has difficulty playing quietly
  • Talks a lot

How does ADHD affect a child in school?

It is not difficult to understand how these behaviors would be frustrating for both a teacher and a student. Most traditional classrooms are not set up to teach a child how to develop better attention and organization. Rather, when a teacher does address these behaviors, it is usually in a critical way, bringing negative attention to the child. Eventually, such frequent criticism has a significant impact on self-esteem.

The eventual result of this cycle is a lack of motivation. Many children work extra hard to overcome their ADHD. They might require four hours to finish a project, while another child needs only two. But they often seem to be able to marshal their internal resources to rise to the occasion.

However, this level of motivation is difficult to maintain. After years of criticism from teachers and after putting out Herculean efforts to overcome their difficulty with organization and staying on task, children with ADHD can maintain that effort for only so long. As the work gets harder and the academic demands greater, they are more likely to give up. One child said, “No matter how hard I try, I keep doing the wrong thing”.

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