Curious About ADHD and ADD?
When a child or teen is struggling at school, parents often have questions about how attention problems (e.g., easily distracted, problems with focus or concentration, daydreaming) and behavior challenges (e.g., can’t sit still, too much energy, trouble with personal space, impulsive) could be related to an attention disorder, such as ADHD or ADD. A few common misunderstandings about ADHD include:
- My child can pay attention when they want to (e.g., technology), so they cannot have ADHD.
- When we are motivated, interested, and rewarded in some way, it’s much easier to pay attention. Problems arise when a child cannot pay attention, and they need to. As we grow up and the frontal lobe of the brain matures, we learn to self-regulate so we can pay attention even when we are bored, tired, or challenged. The child with ADHD/ADD has very weak self-regulation due to delays in how the brain matures.
- My child is very bright and does well academically, so they cannot have ADHD.
- Intellectual and academic functioning are independent. A child can be high achieving or gifted, but still struggle to self-regulate their attention (and behavior) when needed.
- My child isn’t hyperactive and they don’t have behavior problems so they cannot have ADHD.
- You’ll notice below that there are 3 different subtypes of ADHD. The predominantly inattentive subtype (previously called ADD) includes only problems with attention. These children may zone out, daydream, disengage, and/or have low energy and slower processing.
- My child’s attention problems and high level of energy are related to being a boy (or young child) and he will grow out of it.
- Families assume that gender differences and age are relevant to whether a child has ADHD. Indeed, symptoms of ADHD may present differently for boys vs. girls and in young children vs teens/adults. However, a qualified clinician will know how to tease apart what is normal for age and what is a clinically significant problem regardless of age or gender.
Following a detailed developmental history, rating scales from family (and hopefully teachers), and possibly an evaluation of your child’s overall strengths and weaknesses, the DSM-V (the diagnostic manual for behavioral health experts) helps determine if criteria are met. Here are 3 subtypes of ADHD, along with symptoms for each (that start during childhood):
ADHD, predominantly inattentive (previously called ADD, but this is no longer used)
- Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or during other activities
- Often has difficulty sustaining attention
- Often does not appear to listen when spoken to directly
- Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in workplace
- Often has difficulty with organization and time management
- Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort
- Often loses things necessary for tasks or activities
- Often easily distracted by extraneous stimuli, including unrelated thoughts
- Often forgetful in daily activities
ADHD, predominantly hyperactive-impulsive
- Often fidgets with or taps hands or feet or squirms in seat
- Often leaves seat in situations when remaining seated is expected
- Often runs about or climbs in situations where inappropriate; adolescents or adults may feel restlessness
- Often unable to play or engage in activities quietly
- Is often “on the go”, as if “driven by a motor”
- Often talks excessively
- Often blurts out answers before questions have been completed
- Often has difficulty waiting or taking turns
- Often interrupts or intrudes upon others
ADHD, combined
- When an individual meets criteria for BOTH inattentive and hyperactive-impulsive subtypes.
NOTE: Importantly, these symptoms need to be problematic in more than one setting (e.g., home and school/work).
The tricky thing about attention problems is that they can occur for other reasons. That’s why the DSM-5 also states that “the symptoms are not better explained” by another disorder or condition.
For this reason, a psychoeducational or neuropsychological evaluation may be helpful to explain the reasons why your child may have attention and/or self-regulation problems, along with whether they are abnormal for age. The right diagnosis will help ensure you have the right intervention to support your child.
To check out more on this topic, read the following:
https://pedneurocenter.com/attention-problems-is-it-adhd-or-something-else/
https://pedneurocenter.com/why-is-my-child-acting-out-at-school/
https://pedneurocenter.com/does-my-child-need-help/
If you have concerns about your child and believe an evaluation for attention problems is needed, contact us to learn more: [email protected]
