Attention Deficit Hyperactivity Disorder (ADHD) is a developmental disorder that is categorised into three main presentations:
Inattentive presentation – students who struggle with attention span or concentration but who are not usually hyperactive or impulsive.
Hyperactive-Impulsive presentation – students who struggle with hyperactivity and impulsivity
Combined presentation – students who struggle with symptoms of both inattentive and hyperactive-impulsive presentations.
The following terms are frequently used when discussing behaviours related to ADHD
when a person wanders off task, lacks persistence, has difficulty sustaining focus, and is disorganized; and these problems are not due to defiance or lack of comprehension.
when a person seems to move about constantly, including in situations in which it is not appropriate; or excessively fidgets, taps, or talks. In adults, it may be extreme restlessness or wearing others out with constant activity.
when a person makes hasty actions in the moment without first thinking about them, a desire for immediate rewards or inability to delay gratification. An impulsive person may be socially intrusive and excessively interrupt others.
It is important to remember ADHD affects young people in different ways although most children with this condition are likely to experience long-term difficulties in areas related to their executive functioning such as focusing on a task, switching attention, planning, organising time, making decisions, regulating emotions and memory. ADHD often co-occurs with other conditions and mental health problems, such as oppositional defiant disorder, conduct disorder, learning disability, autism, anxiety, depression , Tourette’s syndrome and sleep problems.
The presence of ADHD symptoms can result in children being labelled as “difficult” or “defiant” by others. Emotional outbursts and defiance are not themselves symptoms of ADHD. However, children with ADHD are at higher risk for developing these behaviours as a consequence of feeling overwhelmed.
There can often be a delay in diagnosing ADHD in girls due to the subtlety of their symptoms. Girls are more likely to present with only inattentive symptoms with hyperactive/impulsive symptoms often interpreted as being overemotional or very talkative. Girls may mask their symptoms which can contribute to mood and social disorders. There is still a lot of stigma and lack of understanding around ADHD which contributes to families and young people often suffering in silence, leading to underachievement and emotional and social problems. In some cases, it can be long into adulthood before diagnoses of ADHD are actually made.
Signs to look out for:
Inattention and hyperactivity/impulsivity are the key behaviors of ADHD. Some people with ADHD only have problems with one of the behaviors, while others have both inattention and hyperactivity-impulsivity. Most children have the combined presentation of ADHD.
It is normal to have some inattention, unfocused motor activity, and impulsivity, but for people with ADHD, these behaviors: are more severe, occur more often, and interfere with or reduce the quality of how they function socially, at school, or in a job
People with symptoms of inattention may often:
Overlook or miss details, make careless mistakes in schoolwork, at work, or during other activities
Have problems sustaining attention in tasks or play, including conversations, lectures, or lengthy reading
Not seem to listen when spoken to directly
Not follow through on instructions and fail to finish schoolwork, chores, or duties in the workplace or start tasks but quickly lose focus and get easily sidetracked
Have problems organizing tasks and activities, such as what to do in sequence, keeping materials and belongings in order, having messy work and poor time management, and failing to meet deadlines
Avoid or dislike tasks that require sustained mental effort, such as schoolwork or homework, or for teens and older adults, preparing reports, completing forms, or reviewing lengthy papers
Lose things necessary for tasks or activities, such as school supplies, pencils, books, tools, wallets, keys, paperwork, eyeglasses, and cell phones
Be easily distracted by unrelated thoughts or stimuli
Be forgetful in daily activities, such as chores, errands, returning calls, and keeping appointments
People with symptoms of hyperactivity-impulsivity may often:
Fidget and squirm in their seats
Leave their seats in situations when staying seated is expected, such as in the classroom or the office
Run or dash around or climb in situations where it is inappropriate or, in teens and adults, often feel restless
Be unable to play or engage in hobbies quietly
Be constantly in motion or “on the go,” or act as if “driven by a motor”
Blurt out an answer before a question has been completed, finish other people’s sentences, or speak without waiting for a turn in a conversation
Have trouble waiting for his or her turn
Interrupt or intrude on others, for example in conversations, games, or activities.
People with combined presentation of ADHD will exhibit signs from both lists above. This is often described as the most severe presentation of ADHD.
These are common ADHD behaviours however ADHD is often more complex that most people realise, many characteristic related to ADHD are not visible but result in difficulties for children and young people. There is also a certain amount of overlap between ADHD behaviours and other areas of wellbeing; for example, child who is inattentive may be distracted by their difficult thoughts and feelings that could be as a result of bullying or a worrying situation at home.
Other difficulties include weak executive functioning, impaired sense of time, sleep disturbances, 3 year delayed brain maturation, coexisting mental health issues, learning problems and low frustration tolerance.
The above signs are associated with ADHD but can also be a result of other factors from just being younger than classmates to anxiety or trauma.
Children who appear not to be listening and unable to focus on their school work may be attributed to a learning disability affecting their ability to complete school work. A child who appears to be fidgeting in class could be experiencing sensory issues, anxiety or frustration with being unable to complete school work. Being unable to follow rules, wait their turn or to experience emotional outbursts are associated with both ADHD, mood disorders and trauma.