Attention-Deficit/Hyperactivity Disorder (ADHD) is a disorder that can significantly hinder one’s ability to pay attention and control hyperactivity and/or impulsivity. ADHD is one of the most commonly diagnosed childhood disorders; however, ADHD also affects teenagers and adults. The Center for Disease Control estimates that in the U.S. 7 percent of children between ages 6 and 11 have ADHD (Bloom & Cohen, 2006). The prevalence rate for boys is twice as high as for girls. The buzz over ADHD has resonated over the past ten years. Treatment centers for teens with ADHD, such as Shepherd’s Hill Academy, experience a very high rate of applicants that have been previously diagnosed with ADHD. It is estimated that, before intake, 50% of Shepherd’s Hill Academy residents have been diagnosed with ADHD.
DSM-IV Criteria for ADHD
I. Either A or B:
Six or more of the following symptoms of inattention have been present for at least 6 months to a point that is inappropriate for developmental level: Inattention
1) Often does not give close attention to details or makes careless mistakes in schoolwork, work, or other activities.
2) Often has trouble keeping attention on tasks or play activities.
3) Often does not seem to listen when spoken to directly.
4) Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions).
5) Often has trouble organizing activities.
6) Often avoids, dislikes, or doesn’t want to do things that take a lot of mental effort for a long period of time (such as schoolwork or homework).
7) Often loses things needed for tasks and activities (e.g. toys, school assignments, pencils, books, or tools).
Is often easily distracted.
9) Is often forgetful in daily activities.
Six or more of the following symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for developmental level: Hyperactivity
1) Often fidgets with hands or feet or squirms in seat when sitting still is expected.
2) Often gets up from seat when remaining in seat is expected.
3) Often excessively runs about or climbs when and where it is not appropriate (adolescents or adults may feel very restless).
4) Often has trouble playing or doing leisure activities quietly.
5) Is often “on the go” or often acts as if “driven by a motor”.
6) Often talks excessively.
Impulsivity
1) Often blurts out answers before questions have been finished.
2) Often has trouble waiting one’s turn.
3) Often interrupts or intrudes on others (e.g., butts into conversations or games).
II. Some symptoms that cause impairment were present before age 7 years.
III. Some impairment from the symptoms is present in two or more settings (e.g. at school/work and at home).
IV. There must be clear evidence of clinically significant impairment in social, school, or work functioning.
V. The symptoms do not happen only during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder. The symptoms are not better accounted for by another mental disorder (e.g. Mood Disorder, Anxiety Disorder, Dissociative Disorder, or a Personality Disorder).
Based on these criteria, three types of ADHD are identified:
IA. ADHD, Combined Type: if both criteria IA and IB are met for the past 6 months
IB. ADHD, Predominantly Inattentive Type: if criterion IA is met but criterion IB is not met for the past six months
IC. ADHD, Predominantly Hyperactive-Impulsive Type: if Criterion IB is met but Criterion IA is not met for the past six months.
Many argue that ADHD is “over-diagnosed.” Whether or not this is the case is much less important than determining the best course of action if your child has been diagnosed with ADHD. The simple fact that a diagnosis exists indicates the presence of a struggle. Many parents find that once some basic changes are made in their child’s life that some of the symptoms subside. It is important to help the child find out how to stay organized, for teachers to make class more interesting and interactive, and for the child to be less stimulated by tv, music, or internet and to be more stimulated by “simpler” pleasures. Parents are encouraged to take an active role in understanding what is influencing their child’s struggle with ADHD, and to help their children make appropriate adjustments that counteract symptoms.
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC, American Psychiatric Association, 2000.
Bloom B, Cohen RA. Summary health statistics for U.S. children: National Health Interview Survey, 2006. National Center for Health Statistics. Vital Health Statistics 10(234). 2007.