Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood disorders and can continue through adolescence and adulthood. Symptoms include difficulty staying focused and paying attention, difficulty controlling behavior, and hyperactivity (over-activity). Inattention, hyperactivity, and impulsivity are the key behaviors of ADHD. It is normal for all children to be inattentive, hyperactive, or impulsive sometimes, but for children with ADHD, these behaviors are more severe and occur more often. This paper focuses on definition, diagnoses, symptoms, characteristics and outcomes. Some children with ADHD also have other illnesses or conditions. This author also points out here what conditions can coexist with ADHD.
ADHD- HYPERACTIVE/IMPULSIVE SUBTYPE (H/I) Children with hyperactivity and impulsivity are easy to notice, interesting to watch, and difficult to ignore. They will not show inattention, unless they are in the combined subtype of ADHD. If they have pure H/I they may have social and relationship problems, and if they have the combined subtype, they may have both social and academic impairments. It is also possible, however, that these children will function well socially and academically in the inclusion classroom with few if any modifications. In other words, hyperactivity can also be represented on normal distribution and it is only at the extremes of this distribution that qualitative differences in functionality may be observed.
Definition DSM-IV-TR (APA, 2000, p. 92), requires 6 (or more) of the following symptoms of hyperactivity-impulsivity that have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:
(a) often fidgets with hands or feet or squirms in seat
(b) often leaves seat in classroom or in other situations in which remaining seated is expected
(c) often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness)
(d) often has difficulty playing or engaging in leisure activities quietly
(e) is often "on the go" or often acts as if "driven by a motor"
(f) often talks excessively
(g) often blurts out answers before questions have been completed
(h) often has difficulty awaiting turn
There are no specific tests for this disorder; it is usually based on ratings by adults who are familiar with the child (teachers and parents) across settings and in comparison to other children of the same age (Aman et al., 2005). Identification of the hyperactive/impulsive subtype typically occurs during preschool (Barkley, 2003).
Prevalence The hyperactive/impulsive subtype is more typically observed in younger children and represents about 15%-18% of the total number of children with ADHD. The combined subtype (hyperactive/impulsive and inattentive) represents half to three-quarters of all children with ADHD.
“The symptoms of ADHD may be present in more than 30 other disorders, ranging from problems with sensory systems, to mental illness, to scholastic, psychosocial, and medical problems” (Haber, 2003, p. 37). By age 7, 54-67% of children referred to clinics with ADHD will also be diagnosed with oppositional defiant disorder (ODD) and by adolescence, 44-50% diagnosed with conduct disorder (CD) (Barkley, 2003). ADHD-HI was strongly linked to CD with a shared genetic heritability of 37% and to ODD with shared genetic heritability of 42%, but there were lower correlations with ADHD-C and ADHD-I (Martin et al., 2006). In addition, ADHD appears in at least 50% of clinic-referred individuals with Tourette Disorder, but most individuals with ADHD do not have accompanying Tourette Disorder. Internalizing symptoms are also present. That is about one third of students with ADHD have co-occurring anxiety disorders (Berkley, 2003).