Another Daily Dose

The American Academy of Pediatrics and the American Academy of Child Adolescent Psychiatry have published specific criteria and guidelines for diagnosing ADHD.  If ADHD is suspected, the child should have a clinical evaluation, which may include:2. Often gets up from seat when remaining in seat is expected.Attention Deficit/Hyperactivity Disorder affects an estimated 3 to 5 percent of children of school age.  ADHD frequently gets identified when a child is consistently having trouble in school, whether he (significantly more boys than girls are diagnosed with this disorder) is home-schooled or attends public school.  The necessity of sitting still, focusing for relatively long periods of time, performing in spite of distractions, and/or getting along with a number of other children can bring ADHD symptoms to the fore and make very obvious what may have been only suspected before.

ADHD affects a child’s performance in school and his relationships with other people.  Parents of an ADHD child can feel exhausted and frustrated.  The child may feel like he is stupid or bad.  It can be a heart-breaking situation.  The disorder involves problems with being inattentive, over-active, and impulsive–all three together, or in varying combinations.

The following criteria have been specified by the American Psychiatric Association as diagnostic for Attention Deficit/Hyperactive Disorder:

DSM-IV Criteria for ADHD

I. Either A or B:

A.     Six or more of the following symptoms of inattention have been present for at least 6 months to a point that is disruptive and 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 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).

8. Is often easily distracted.

9. Is often forgetful in daily activities.

B. 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.

2. Often gets up from seat when remaining in seat is expected.

3. Often runs about or climbs when and where it is not appropriate (adolescents or adults may feel very restless).

4. Often has trouble playing or enjoying 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).

A diagnosis of ADHD means that the child has at least six symptoms in the inattentiveness category, or six symptoms in the hyperactivity and impulsivity categories.  According to the American Academy of Child Adolescent Psychiatry, the symptoms must have been present for at least six months, and there must be clear evidence of severe impairment in at least two of these major areas of the child’s life:

• in the classroom
• on the playground
• at home
• in the community
• in social settings

Some symptoms must have been present since before the age of seven.  Symptoms cannot be present only during the course of another disorder, or better accounted for by another diagnosis. Three major subtypes of the disorder have been identified: 1) Predominantly Inattentive Type a)Criterion 1A is met but Criterion 1B is not met for the past six months b) Most symptoms are in the inattention category c)Fewer than 6 symptoms of hyperactivity-impulsivity are present i)Children with this subtype are less likely to have problems getting along with other children. ii)They may sit quietly, but are having trouble paying attention to what they are doing; symptoms of ADHD may therefore not be noticed. 2) Predominantly Hyperactive-Impulsive Type a)Criterion 1B is met but Criterion 1A is not met for the past six months. b)Most symptoms (6 or more) are in the hyperactivity-impulsivity categories. c)Fewer than 6 symptoms of inattentiveness are present 3)Combined Type:  hyperactive-impulsive and inattentive a) Both Criteria 1A and 1B are met for the past 6 months b)Six or more symptoms of inattention and six or more symptoms of hyperactivity-impulsivity are present. c)Most children have this type of ADHD. If a child is having problems in one situation only—maybe is too active at play, but not in the classroom—the problem might be something other than ADHD. There are other conditions that can elicit behaviors resembling ADHD behaviors, such as:

• A loss, such as the death of a pet, a family member
• A sudden stressful change, like parents divorcing, or a parent’s job loss
• An exposure to violence or emotional stress
• An undetected illness
• An undetected hearing or vision loss
• A learning disability
• Anxiety or depression
• Lack of sleep
• Undetected seizures

ADHD has come to be a popular diagnosis when a child is difficult to handle, and an incorrect label is easy.  There are a number of other disorders that can look like ADHD, and  children with ADHD may have an accompanying mood disorder, such as anxiety, depression, or bipolar disorder.

The American Academy of Pediatrics and the American Academy of Child Adolescent Psychiatry have published specific criteria and guidelines for diagnosing ADHD.  If ADHD is suspected, the child should have a clinical evaluation, which may include:

Parent and teacher questionnaires

• Psychological evaluation of the child and family
• A complete work-up, including developmental, mental, nutritional, physical, and psychosocial evaluations

ADHD can be difficult to pin down, and doubly difficult to live with, for both the parents and the child in question.  The first step in dealing with the problem is correct diagnosis.

Jennifer K. Gray is the Director of Operations for LessonPathways.com.

Lesson Pathways is an innovative online curriculum created entirely from INTERNET RESOURCES, making it easy for educators to use educational resources and links, with limited pre-planning time!

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