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ADHD is an ongoing behavior disorder typically diagnosed at age five or six, though the symptoms have usually been observed much earlier than this age. The three key symptoms are hyperactivity, impulsivity, and inattention. These symptoms typically interfere with the child's functioning in social and academic settings. The diagnostic criteria were outlined in 1994 in the Diagnostic and Statistical Manual of Mental Health (DSM-IV; American Psychiatric Association). To meet the diagnostic criteria, these symptoms, exemplified below, must have been present for at least six months.
ADHD symptom - inattention
- often fails to give attention to details or makes careless mistakes in schoolwork, work, or other activities;
- often has difficulty sustaining attention in tasks or play activities;
- often does not seem to listen when spoken to directly;
- often does not follow through on instructions and fails to finish schoolwork, chores, or duties (in adults, this includes duties in the workplace) - not due to oppositional behavior or failure to understand instructions;
- often has difficulty organizing tasks and activities;
- often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework);
- often loses things necessary for tasks or activities (for example, toys, school assignments, pencils, books, or tools);
- is often easily distracted by extraneous stimuli;
- is often forgetful in daily activities.
ADHD symptom - hyperactivity
- often fidgets with hands or feet or squirms in seat;
- often leaves his or her seat in the classroom or in other situations in which remaining seated is expected;
- often runs about or climbs excessively in situations in which it is inappropriate;
- often has difficulty playing or engaging in leisure activities quietly;
- often talks excessively.
ADHD symptom - impulsivity
- often blurts out answers before the questions have been completed;
- often experiences difficulty awaiting turn;
- often interrupts or intrudes on others (for example, butts into conversations or games).
One can see why there is an age limitation on these behaviors being defined as "abnormal," as the majority of them are typical of much younger children. But in the non-ADHD child, these behaviors are typically outgrown. And, of course, there are a variety of other conditions in which these symptoms occur but are not ADHD. Your doctor must carry out a very detailed evaluation before the diagnosis of ADHD is made. But please don't delay! If you or your child's teachers suspect ADHD, begin the evaluation as soon as possible. The early recognition and treatment of ADHD is critical in your child's long-term success.
Medically reviewed by Margaret Walsh, MD; American Board of Pediatrics
"Attention deficit hyperactivity disorder in children and adolescents: Clinical features and diagnosis"