Attention-deficit hyperactivity disorder (ADHD) is one of the most common childhood disorders with an estimated 5.4 million diagnosed children in the U.S.
Known as both ADD and ADHD, both terms refer to the same condition.
While still commonly used in conversation, ADD is the antiquated term for ADHD. In medical literature, the term ADD has been dropped, as the condition, briefly classified as two separate entities, envelopes three different kinds of ADHD.
In May 2013, the American Psychiatric Association released the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), changing the criteria to diagnose a person with ADHD.
While the majority of ADHD symptoms remained the same, the DSM-5 made small changes to how experts can diagnose the disorder that affects approximately 9.5 percent of American children ages 4 to 17, according to the U.S. Centers for Disease Control and Prevention.
ADHD and Its Symptoms
While any child can be fidgety or have trouble paying attention, when these symptoms become a distraction at home or in the classroom, some extra therapy may be needed to control the child.
ADHD presents itself with persistent pattern of inattention, hyperactivity, impulsivity, or a combination or all three.
To be diagnosed with ADHD, a child must meet the requirements set forth in the DMS-5:
ADHD and Inattention
The number of criteria for inattention that need to be met vary by age. Children up to age 16 must show six or more symptoms, while anyone over the age of 17 only need five.
All must have symptoms present for at least six months and be inappropriate for a child’s developmental level. For example, if a person can’t pay attention is distracted in calculus class, it’s acceptable if he or she is a toddler.
The DSM-5 states a child or adult may have an inattentive symptom of ADHD if he or she often:
- Is easily distracted
- Is forgetful, even in daily activities
- Fails to give close attention to details in school work or other activities, including making careless mistakes
- Has trouble keeping attention on tasks or activities
- Ignores a speaker, even when spoken to directly
- Does not follow instructions, fails to finish schoolwork or chores, and loses focus or is easily side-tracked.
- Has trouble with organization
- Dislikes and avoids tasks that require long periods of mental effort, such as homework
- Loses vital things needed for tasks and activities, such as books, keys, wallet, phones, etc.
ADHD, Hyperactivity and Impulsivity
Just like the inattentive criteria, a child under the age of 16 must show six or more symptoms of hyperactivity and impulsivity, while those older than that only need to meet five. Again, the symptoms must be present for at least six months, be disruptive, and inappropriate for their developmental level.
The DSM-5 states a child or adult may have a hyperactive or impulsive symptom of ADHD if he or she often:
- Appears to be “driven by a motor” and always “on the go”
- Excessively talks
- Has trouble waiting his or her turn
- Squirms in his seat, taps his hands or feet, or fidgets
- Gets up from a seat when remaining seated is expected
- Runs around or climbs in inappropriate situations
- Unable to quietly play or take part in leisure activities
- Blurts out an answer before a question has been finished
- Intrudes on and interrupts others
Along with meeting the aforementioned criteria for inattention and impulsivity, a child or adult must meet the following conditions:
- Several symptoms began showing before the age of 12
- Symptoms are present in more than one setting, such as school, at home, with friends, or other activities
- There is clear evidence that the symptoms interfere with a person’s functioning at school or work, or impact a person’s ability to socialize with others.
- The symptoms are not explained by another condition, such as a psychotic disorder such as mood disorder or anxiety disorder
Three Types of ADHD
ADHD has three subtypes. They are:
- Predominantly Inattentive Presentation: This is what is typically referred to when someone uses the term ADD. This means a person shows enough symptoms of inattention, but doesn’t meet the full criteria for hyperactivity and impulsivity.
- Predominantly Hyperactive-Impulsive Presentation: Inversely, this type occurs when a person has enough symptoms of hyperactivity and impulsivity but not enough for inattention.
- Combined Presentation: This type is when a person meets the criteria of both inattention and hyperactivity and impulsivity.
In all subtypes, the symptoms must be present for more than six months. But, as symptoms can change as a person ages, he or she may change subtypes over a period of time.
Adults with ADHD have typically had the disorder since childhood, but it may not have been diagnosed until later in life. An evaluation usually occurs at the prompting of a peer, family member, or coworker who has observed problems at work or in relationships.
Adults can be diagnosed with any of the three subtypes of ADHD discussed above. However, due to the relative maturity of adults, as well as physical differences between adults and children, adult ADHD symptoms can be somewhat different from those experienced by children. For example, adults with hyperactive/impulsive ADHD are unlikely to run and jump around.
ADD and ADHD Severity
The symptoms of ADD and ADHD can range from mild to severe, depending on a person’s neurobiology and environment. Some experience mild inattentiveness or hyperactivity when they perform a task they do not enjoy, but have the ability to focus on tasks they like. Others may experience more severe symptoms, which can have a negative impact in school, at work, and in social situations.
Symptoms seem to be more severe in unstructured group situations (e.g. on the playground) than in more structured situations where rewards are given (e.g. in the classroom). Other conditions, such as depression, anxiety, or a learning disability may worsen the symptoms of ADD or ADHD . Some patients report that symptom severity diminishes with age. For example, an adult with ADHD who was hyperactive as a child may find that he or she is now able to remain seated or curb some impulsivity.
The good news is that by determining your type of attention deficit disorder and its severity, you are one step closer to finding the right treatment to help you cope. Be sure to discuss all your symptoms with your doctor to ensure an accurate diagnosis.