It is impossible to read any information on ADHD without finding out that the three major symptoms of ADHD are inattention, impulsiveness and hyperactivity. But what does this really mean? What do these symptoms look like on a day to day basis?
Each child is different. Each child has symptoms of ADHD that fall somewhere between mild and severe. Each child has a unique combination of symptoms. Ask any parent. They can go into detail on their child's behavior and their description might have some similarities to another parent's stories, but there will be differences as well. If this is the case, how then, can we figure out what is ADHD, what is normal behavior, and what might be something else entirely?
The following lists are compilations of how the three major symptoms may show up. It will be up to each family to decide if the behaviors warrant consideration, accommodations, behavioral interventions or medication to help in reducing symptoms.
Inattention is the inability to focus or concentrate for an extended period of time. But what is "extended?"
Dr. B.D. Schmitt, in an article entitled, "Dealing with Attention Deficit/Hyperactivity Disorder" published by RelayHealth indicates that a normal attention span is between three and five minutes for each year of life. For example, a 5-year-old should be able to concentrate on a task for between 15 and 25 minutes before attention wanes. Dr. Schmitt mentions that watching television should not be considered when determining attention level. If your 5-year-old cannot pay attention for even 15 minutes, he would be below the norm.
Some experts believe the word inattention is not accurate, rather than not being able to pay attention, it is an inability to filter out important stimuli. A child, therefore, would be paying attention to everything around him, rather than filtering out what is not important (at the moment) to focus on one task.
Some of the other ways inattention may show up are:
Careless mistakes in schoolwork because of not paying attention to details. For example, spelling errors on simple words or adding two numbers instead of subtracting.
Does not seem to listen when spoken to. Attention may seem to be moving from place to place, instead of focusing on the person speaking. This also happens during class, as a teacher is talking. Students with ADHD can "space out" missing entire lessons, spending time paying attention to what is going on outside, in the hallway, at the desk next to him, a bug on the floor, anything and everything.
Difficulty following directions or completing tasks. This can be caused by not paying attention to the instructions, being distracted while completing the task or forgetting what was said.
Loses items. All children lose things from time to time, but children with ADHD seem to do so on a daily basis. School work can disappear between putting it in the back pack and the classroom. Toys can be lost walking from room to room. Pens, pencils and other tools needed to finish homework disappear several times a day.
Forgetful. Once finished or completed, activities just seem to disappear from memory. How many times has your child looked at you as if he has no recollection of a conversation that happened a little while ago? Or can't remember what chore to do, even when you told him ten minutes ago?
Trouble with organization. Because of possible executive functioning deficits, organizational skills are often non-existent in children with ADHD. Drawers, closets, backpacks, desks often are, dubbed "the black hole" because it is impossible to find anything once it enters into one of these. One teacher once described the desk of a student with ADHD as "the Bermuda Triangle" because once a paper went into it, it was never seen again. Keeping track of assignments, especially as children get older and must complete a long-term assignment tends to be very difficult. It may be hard for children with ADHD to gauge how long a task will take, or not understand how to break a large project into smaller tasks.
- Avoidance of tasks requiring high attention. Because children with ADHD have a difficult time focusing, many will simply avoid tasks, such as reading, that require paying attention for a period of time. Reading, especially boring, textbook type reading is difficult and may need to be broken down into small segments. Activities that offer high-stimulus, such as video games, are easier to pay attention to.
We've all heard the saying "bouncing off the walls" and for any parent of a child with hyperactivity we know exactly what that means. But hyperactivity isn't always the bouncy, never-ending energy level. Lower levels of hyperactivity can show up as a consistent restless feeling or being fidgety.
Some of the ways hyperactivity can show up:
- Difficulty sitting still. This can be in school, getting up to sharpen a pencil, using the restroom, dropping pencils and pens on the floor. At home this could mean getting up from the dinner table several times or not being able to sit through a television show without talking constantly or getting up to get a drink, get something to eat, go to the bathroom, etc.
Fidgety. Does your child need to have something in their hands, playing with a pencil, or whatever object is handy, even if it is their own hands and feet? Do they squirm or fidget when needing to sit still?
Quiet activities become loud, boisterous activities. When your child sits down to color or play quietly on the floor, do you wonder how long it's going to last? One minute? Two? Maybe five? Then the quiet voice becomes louder, the crayons get broken, the toys crash into one another. Quiet activities often become noisy and aggressive, with your child trying to increase the stimulus level.
Talking, talking, and talking. Talking excessively can be a sign of hyperactivity. Your child may follow you around, talking non-stop, interrupt others when talking, talk throughout a television show or talk throughout any activity.
And of course, there is the endless energy, the jumping, and the running. The diagnostic criteria describe this as if "driven by a motor" and indeed it can seem just that, with parents waiting for a few minutes break from the hurricane that is their child.
Impulsivity is acting without thinking and we have all been guilty of this at one time or another. For children with ADHD, impulsiveness may interfere with social skills, home life and school. It can be the cause getting into trouble. For some parents, the impulsive behaviors are the most difficult to understand, because it can seem as if your child is openly defying you. Children with ADHD, however, seem to live in the moment, not worrying about consequences that may come later. For example, your child may know it is wrong to jump on the couch, but walking by, it just seems like the right to do and next thing he knows, he is bouncing on the soft cushions.
Some other ways impulsivity may appear:
- Blurting out answers or comments. Sometimes a child will yell an answer out in class impulsively, without raising their hand. Or sometimes a child will blurt out an offensive comment, without realizing he is hurting another child's feelings.
Waiting in turn. It can be so difficult to wait your turn, especially if something fun is just ahead, for example, a child may need to wait in line to go down the slide or get a treat. Children with impulsiveness have difficulty standing still, patiently waiting their turn; they may butt ahead in line, causing other children to become angry.
Interrupting others. Waiting in turn can also mean waiting for a turn to talk and children with impulsiveness have just as much trouble with this as waiting in line for the sliding board. They may interrupt other people or begin talking in the middle of a conversation other people are having. They may intrude in a game other children are playing.
In addition to the social aspect, impulsiveness can also cause safety issues. Children with ADHD might walk off in the mall, or in another public place, they may run into the street without looking, jump from inappropriate places, or engage in other behaviors that could place him or other people in danger.
"Attention-Deficit/Hyperactivity Disorder", Updated 2010, May 25, Centers for Disease Control and Prevention
"Dealing with Attention deficit/Hyperactivity Disorder", Reviewed 2008, June 9, B.D.Schmitt, M.D., University of Minnesota, Amplatz Children's Hospital