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It is sometimes hard to match the behavior we observe in our children with the formal terms used by pediatricians and other medical professionals. We rarely think of our children as having “hyperactive problems.” Instead, we think, “Why can’t he ever settle down?”
Hyperactivity means a person seems to move about constantly, including in situations in which it is not appropriate; or excessively fidgets, taps, or talks.
Inattention and hyperactivity/impulsivity are the key behaviours of ADHD. Some people with ADHD only have problems with one of the behaviours, while others have both inattention and hyperactivity-impulsivity. Most children have the combined type of ADHD. In preschool, the most common ADHD symptom is hyperactivity.
It is normal to have some inattention, unfocused motor activity, and impulsivity, but for people with ADHD, these behaviours are more severe, occur more often, interfere with or reduce the quality of how they function socially or at school1
The term “ADD” (attention deficit disorder) was once commonly used, and referred primarily to the form of ADHD with “inattentive only” symptoms. These children are not overly active, and their symptoms may even go unnoticed by many adults because their behavior is not disruptive. Parents of children with ADHD continue to see the same behaviors on a daily basis, and for extended periods—long after other children have progressed. 2
Usually by the time a child with ADHD reaches the age of 7, his parents have already become aware that their child’s inattentiveness, level of activity, or impulsiveness is greater than is typical. You may have noticed that your child finds it nearly impossible to focus on a workbook for even a very short period, even when you are there to assist him. Or you may still feel as worn out at the end of a day with your overly active 8-year-old as you did when he was 2. 2
Here are some examples of what parents with predominantly inattentive ADHD type says:
- He seems like he’s always daydreaming. He never answers when I talk to him. I wonder if he hears me.”
- “He loses everything. I’ve had to buy four new lunchboxes since school started.”
- “I’ll ask him to go up to his room and get dressed, and ten minutes later I find him playing with his toys with only his shirt on.”
- “He can’t remember what he learns because he misses instructions and explanations in school. Even though we work so hard on his schoolwork at night, by the next day he’s forgotten everything.” 2
Diagnosis of ADHD requires a comprehensive evaluation by a licensed clinician, such as a pediatrician, psychologist, or psychiatrist with expertise in ADHD. ] The doctor will also ensure that any ADHD symptoms are not due to another medical or psychiatric condition.
ADHD symptoms can appear as early as between the ages of 3 and 6 and can continue through adolescence and adulthood. ADHD symptoms can change over time as a person ages. In young children with ADHD, hyperactivity-impulsivity is the most predominant symptom. As a child reaches elementary school, the symptom of inattention may become more prominent and cause the child to struggle academically. In adolescence, hyperactivity seems to lessen and may show more often as feelings of restlessness or fidgeting, but inattention and impulsivity may remain. Many adolescents with ADHD also struggle with relationships and antisocial behaviors. Inattention, restlessness and impulsivity tend to persist into adulthood.1
Dr. Lydia Serhal
Pediatric Gastroenterologist, Hepatologist, and Allergologist
