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ADHD

Attention deficit hyperactivity disorder (ADHD) is a condition that affects people's behaviour. People with ADHD can seem restless, may have trouble concentrating and may act on impulse.

 

The symptoms of attention deficit hyperactivity disorder (ADHD) can be categorised into 2 types of behavioural problems:

  • inattentiveness (difficulty concentrating and focusing)

  • hyperactivity and impulsiveness

 

Many people with ADHD have problems that fall into both these categories, but this is not always the case.

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Inattentiveness (difficulty concentrating and focusing)

 

The main signs of inattentiveness are:

  • having a short attention span and being easily distracted

  • making careless mistakes – for example, in schoolwork

  • appearing forgetful or losing things

  • being unable to stick to tasks that are tedious or time-consuming

  • appearing to be unable to listen to or carry out instructions

  • constantly changing activity or task

  • having difficulty organising tasks

 

Hyperactivity and impulsiveness

 

The main signs of hyperactivity and impulsiveness are:

  • being unable to sit still, especially in calm or quiet surroundings

  • constantly fidgeting

  • being unable to concentrate on tasks

  • excessive physical movement

  • excessive talking

  • being unable to wait their turn

  • acting without thinking

  • interrupting conversations

  • little or no sense of danger

 

These symptoms can cause significant problems in a person's life, such as underachievement at school or work, poor social interaction with other people, and problems with discipline, following rules and the law.

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For assessment and diagnosis of ADHD, the following types of specialists conduct a formal assessment:

  • a specialist child or adult psychiatrist

  • a paediatrician – a specialist in children's health

  • an appropriately qualified healthcare professional with training and expertise in the diagnosis of ADHD

 

Diagnosing ADHD depends on a set of strict criteria. The Diagnostic and Statistical Manual of Mental Disorders (5th Edition) (DSM-5) is a medical reference book for experts and professionals, which provides diagnostic criteria for mental health and brain-related conditions and disorders.

 

DSM V Criteria for ADHD:

 

People with ADHD show a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development.

 

Inattention: Six or more symptoms of inattention for children up to age 16, or five or more for adolescents 17 and older and adults; symptoms of inattention have been present for at least 6 months, and they are inappropriate for developmental level:

  • Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or with other activities.

  • Often has trouble holding attention on 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 the workplace (e.g., loses focus, side-tracked).

  • Often has trouble organizing tasks and activities.

  • Often avoids, dislikes, or is reluctant to do tasks that require mental effort over a long period of time (such as schoolwork or homework).

  • Often loses things necessary for tasks and activities (e.g. school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones).

  • Is often easily distracted

  • Is often forgetful in daily activities.

 

Hyperactivity and Impulsivity: Six or more symptoms of hyperactivity-impulsivity for children up to age 16, or five or more for adolescents 17 and older and adults; symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for the person’s developmental level:

  • Often fidgets with or taps hands or feet, or squirms in seat.

  • Often leaves seat in situations when remaining seated is expected.

  • Often runs about or climbs in situations where it is not appropriate (adolescents or adults may be limited to feeling restless).

  • Often unable to play or take part in leisure activities quietly.

  • Is often “on the go” acting as if “driven by a motor”.

  • Often talks excessively.

  • Often blurts out an answer before a question has been completed.

  • Often has trouble waiting his/her turn.

  • Often interrupts or intrudes on others (e.g., butts into conversations or games)

 

In addition, the following conditions must be met:

  • Several inattentive or hyperactive-impulsive symptoms were present before age 12 years.

  • Several symptoms are present in two or more setting, (e.g., at home, school or work; with friends or relatives; in other activities).

  • There is clear evidence that the symptoms interfere with, or reduce the quality of, social, school, or work functioning.

  • The symptoms do not happen only during the course of schizophrenia or another psychotic disorder. The symptoms are not better explained by another mental disorder (e.g. Mood Disorder, Anxiety Disorder, Dissociative Disorder, or a Personality Disorder).

 

Based on the types of symptoms, three kinds (presentations) of ADHD can occur:

  • Combined Presentation: if enough symptoms of both criteria inattention and hyperactivity-impulsivity were present

  • Predominantly Inattentive Presentation: if enough symptoms of inattention, but not hyperactivity-impulsivity, were present for the past six months

  • Predominantly Hyperactive-Impulsive Presentation: if enough symptoms of hyperactivity-impulsivity but not inattention were present for the past six months.

 

Because symptoms can change over time, the presentation may change over time as well.

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Try our free online questionnaires to see whether you or your child may benefit from a full diagnostic assessment for ADHD.

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