ADHD Symptoms In Kids

Identifying symptoms of ADHD is on the one hand a very simple task, but on the other quite difficult and confusing. There are specific criteria that are listed in the Diagnostic and Statistical manual for Mental Disorders – Fifth Edition (DSM-5), which fall into two categories: inattentive symptoms and hyperactive–impulsive symptoms.

Inattention Symptoms

General Qualifications

  • If the individual is 16 years old or younger – need 6 or more of the following
  • If the individual is 17 and older – need 5 or more of the following
  • These symptoms of inattention need to be present for at least 6 months
  • Need to be inappropriate for the child’s developmental level

Symptoms

  • 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

General Qualifications

  • If the individual is 16 years old or younger – need 6 or more of the following
  • If the individual is 17 and older – need 5 or more of the following
  • These symptoms of inattention need to be disruptive and inappropriate for the person’s developmental for at least 6 months

Symptoms

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

In addition to these criteria there are also several other important conditions that must be met for an accurate diagnosis:

  • Several inattentive or hyperactive-impulsive symptoms need to have been present before age 12 years.
  • Several symptoms are present in two or more settings, (such as 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 are not better explained by another mental disorder (such as a mood disorder, anxiety disorder, dissociative disorder, or a personality disorder). The symptoms do not happen only during the course of schizophrenia or another psychotic disorder.

Types of presentation

The DSM lists three types of presentations of ADHD based on the symptom list which are:

Importantly, researchers have noted that these may not actually be different disorders but rather different:

  • Levels of severity of the ADHD symptoms
  • Presentations of ADHD based on maturity level (i.e., adult ADHD looks different than child ADHD)
    confusion with a different disorder known as sluggish cognitive tempo (SCT)

Severe ADHD symptoms

Given the criteria listed above, indication of severe ADHD are the extreme versions of those symptoms. For example, a child who has difficulty maintaining focus 30% of the time will present very differently than a child who has this difficulty 90% of the time. Also, some children occasionally forget where they put their homework, books, coat, etc., but other children struggle with this every day.

In addition, the level of severity can be judged by the functional impairment caused by the disorder. For some individuals, their ADHD symptoms lead them to struggles in school (e.g., their grades are lower). However, for others, their lack of ability to regulate themselves can lead to truancy, substance abuse, risky sexual behaviors, significant financial problems, and physically dangerous actions. For example, teenagers with ADHD at over 30% more likely to have accidents and get traffic tickets, and those with more severe symptoms are at double the risk of these dangerous behaviors.

Girl specific ADHD symptoms

ADHD in girls and women is often overlooked by adults and treating professionals. This is largely due to the fact that girls with ADHD usually present as inattentive rather than hyperactive. Because they do not present with the obvious behavioral dysregulation, parents and teachers do not think of them as having a regulation disorder. Instead, they are thought of as “moody”, “lazy”, or “slow”, when in fact they may be intelligent and motivated, yet highly frustrated with their inability to perform like everyone else.

Importantly, if left untreated, these girls are at risk for emotional difficulties such as low self-esteem, depression and anxiety as well as a higher incidence of teenage pregnancy, addiction, and low achievement in school.

In addition, like many boys with ADHD, girls with ADHD can see the childhood problems of being distracted in class and forgetting homework, become adult problems of missing deadlines, maxing out credit cards, and getting fired from their job.

Boy specific ADHD symptoms

For boys with ADHD, there is a higher incidence of hyperactive behaviors, especially in the early childhood years. These physical symptoms usually taper off toward the beginning and middle of adolescence, as the disorder becomes more about difficulties with planning, organization, and attention.

For some individuals, they experience restlessness due to their ADHD, but this can often be a symptom of an underlying anxiety rather than sign of adult ADHD. In addition, men with ADHD and especially those with childhood conduct problems engage in more verbal aggression and physical violence with romantic partners than those without ADHD.

ADHD symptoms in toddlers

Is it terrible two’s or something more? This is a question that can be very difficult for most parents to answer, especially if they are first-time parents. As ADHD is a developmental disorder and toddlers often show a range of abilities, many ADHD children cannot be diagnosed accurately at this age. Nevertheless, there are several important symptoms to watch out for.

  • Developmental abilities: Because ADHD is a developmental disorder, there is a high correlation between it and other developmental deficits. Researchers have noted that children with ADHD are 2 to 7 times more likely to have significant developmental deficits and these can be in speech functioning as well as motor functioning. The presence of these developmental delays alone, is not indicative of ADHD, but they put the child at much greater risk of having the disorder.

Aside from correlational risk factors, there are also several core symptoms of ADHD that can be observed in toddlers. These include:

  • Significant behavioral difficulty
  • Severe and continual emotional dysregulation
  • Overly-hyperactive behavioral presentation

However, assessing where these symptoms cross from the normal spectrum of child development to early markers of a disorder can be difficult for a parent to do. In addition, there are many other factors that can contribute to these behaviors in a young child that are not caused by ADHD such as poor diet, sleep problems, intellectual disability, medical issues (especially stomach problems), trauma, and environmental stress.

3-12 year old ADHD symptoms

Once children start attending school, their ADHD symptoms often become more apparent to both parents and teachers. They tend to have difficulty following lessons in the classroom as well as controlling their impulses when around other students.

Teen ADHD symptoms

Although ADHD is a developmental disorder and many children present with symptoms at an early age, there is a subset of children whose symptoms do not appear until they reach adolescence. These children are often capable in other areas which has allowed them to function effectively despite their disability. In addition, parents and teachers and usually more supportive in the earlier childhood years, which may have masked the underlying problems. When the child goes to high school or college and loses those supports, their underlying difficulty can emerge.

Importantly, the “hyperactive” symptoms of ADHD are often less pronounced as a child goes through adolescence, which complicates the diagnosis.

Some common teenage symptoms of ADHD include:

  • Inability to schedule time to fulfill responsibilities
  • Difficulty organizing themselves
  • Problems maintaining focus in school
  • Making careless mistakes in schoolwork, at work, or with other activities.
  • Difficulty following through or finishing schoolwork, chores, or duties in the workplace
  • Avoidance of work and responsibilities (more than a typical teenager)
  • Tendency to lose important things (e.g. school materials, wallets, keys, cellphone)
  • Impulsivity and reckless behavior

Difficulty diagnosing ADHD in teenagers

Although the disorder can have dire effects for children during their teenage years, it can be difficult to assess it correctly. This is because of several factors:

  • The disorder often does not appear with the same hyperactive symptoms during this period
  • The symptoms must have been present before 12, making a developmental history critical to the diagnosis
  • Parents and teachers spend significantly less time with these children and may not be able to report as reliably
  • Adolescents can have other disorders than may appear like ADHD but are in fact separate. These include oppositional defiant disorder, anxiety, depression, substance abuse, and other psychiatric disorders (i.e., bipolar; schizophrenia). For example, a 13 year old boy may not be able to focus in school, have difficulty keeping up with school work and constantly lose his things, but this may be due to an underlying anxiety that is constantly interfering with his ability to direct himself toward his future goals

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