ADHD: Symptoms and Diagnosis
Any parent who has been summoned to school for the 'umpteenth time' to discuss their child's bad behaviour or lack of educational progress in class could be forgiven for feeling a combination of anger, frustration, anxiety and concern for their child. However, this pattern of behaviour may not be a simple case of naughtiness, cunningly orchestrated by a bright child to frustrate everyone in authority; there may be a medical cause underlying the problems.
The child could very well be exhibiting traits that are associated with attention deficit hyperactivity disorder.
Diagnosing Attention Deficit Hyperactivity DisorderAttention Deficit Hyperactivity Disorder (ADHD) is a disease that is recognised and diagnosed solely by its symptoms. Unlike a metabolic illness such as diabetes, there is no simple definitive blood test or physical characteristic that can be identified to return a positive or a negative diagnosis. Instead, ADHD must be identified by a set of behaviours that are consistently and persistently shown by a child in both a social setting and at home and school.
In broad terms, attention deficit disorder is characterised by the inability of an affected individual to concentrate and pay attention, combined with hyperactive and impulsive behaviour. There are three primary types of this syndrome:
- Where the child predominantly shows hyperactive and impulsive behaviour
- Where the child predominantly shows an inability to pay attention to a single task in hand, and cannot concentrate or easily understand tasks given to them
- Where a child shows a combination of both hyperactivity-impulsivity and is unable to pay attention
Almost any child will exhibit these behaviours at some time in their lives, but not every child will have ADHD - so how can a diagnosis be made, and what should be looked for?
Visiting the GPThe first stage in a diagnosis will be to rule out a wide range of physical and psychological illnesses that can mask or mimic ADHD. For this reason, any assessment must be carried out by a qualified and expert health professional who will work closely with a child's parents and teachers to determine if the behavioural problems arise from ADHD or some other cause.
As a first step, a concerned parent must visit their GP, and it is usually very useful if a parent can go to this first appointment with a 'Behaviour Diary' to help the GP see exactly why help is being sought. A Behaviour Diary is where both the parent and teachers catalogue the behaviour patters of a child at home and school over a period of some weeks, highlighting problem areas and possible symptoms.
General SymptomsThe behaviours shown in ADHD will emerge over the course of many months, or years. Often, the traits of impulsiveness and hyperactivity will appear first, with attention problems becoming apparent up to a year or more later. However, if the duration of problems has been short and they were not apparent in any way before the child reached seven years of age, it is unlikely that they have the disorder.
Different symptoms may appear in different environments. A child who constantly fidgets or is otherwise disruptive will be noticeable in school, but a quiet daydreamer may be overlooked. An impulsive child who consistently acts before thinking may be considered to simply be lacking in discipline, whilst a child who is lethargic may be thought to be lacking in motivation or enthusiasm. Yet both sets of children may have different types of ADHD.
Behaviours ChecklistAn ADHD child may show any combination (but not necessarily all) of the following behaviours:
- Does the child find it impossible to sit still, when such behaviour is expected?
- Does the child lose or forget everything, consistently?
- Does the child find it impossible to take their turn for anything, for example blurting out answers without waiting to fully hear questions, snatching toys or lashing out when expected to wait?
- Is the child easily distracted by sights and sounds that are irrelevant to the task or activity that they should be concentrating on?
- Does the child skip from one task to another without completing anything?
- Does the child find it difficult to pay attention to detail, and often make careless mistakes?
The following two questions must be answered positively for an ADHD diagnosis to be made:
- Has the child shown these symptoms consistently at home and at school for at least six months?
- Were these symptoms apparent before the child was seven years old?