The symptoms of ADHD are generally noticed by those around the child when he or she starts primary school, around the age of 7. However, usually the symptoms characteristic of this syndrome appear much earlier. Some sources state that they can be observed from the child’s birth). However, during the first period of his or her life, a diagnosis cannot be made because of the impossibility of assessing disorders from all groups and of meeting all diagnostic criteria.

Who has ADHD?

ADHD is an acronym derived from the English name – Attention Deficit Hyperactivity Disorder, meaning Attention Deficit Hyperactivity Disorder, also known as hyperkinetic syndrome. ADHD affects about 5% of children of younger school age and it is estimated that this rate may be even higher. It is the most common developmental disorder and occurs regardless of culture. According to various data, it is 2-4 times more frequently diagnosed in boys than in girls. It appears early – usually within the first five years of a child’s life, although it is usually difficult to catch the initial onset of symptoms.

Most often, parents seek help when it becomes clear that the characteristics of hyperactivity are preventing their child from attending school. For this reason, many children are referred to specialists at the age of seven, even though an interview with the parents often shows that the hyperactivity traits were already evident earlier.

Hyperactivity in ADHD

The symptoms of ADHD can be divided into three main categories including: excessive motor activity, excessive impulsivity and attention deficit disorder. Characteristic of people with Attention Deficit Hyperactivity Disorder are difficulty persevering in an activity that requires cognitive engagement and a tendency to abandon one activity in favour of another without completing both. Hyperreflexivity is defined as such a child’s motor activity that is significantly higher compared to the motor activity of other children of the same age and developmental level. In fact, a child affected by ADHD stands out very much among his or her peers for his or her motor activity. This is particularly evident when they enter primary school. One of the situations that best illustrates the problem is the inability to ‘sit still’ during a lesson that lasts 45 minutes, standing up, walking around the room. This does not mean, of course, that every child rolling around in a chair during class should be seen as having ADHD. To summarise, the characteristic behaviours of hyperactivity include:

  • marked motor restlessness,
  • inability to remain motionless even for a short period of time,
  • picking up from a standstill,
  • aimless walking,
  • aimless running,
  • running rather than walking,
  • waving arms and legs,
  • talking,
  • bumping into things,
  • constantly making even small movements, e.g. rocking on a chair, playing with all objects within reach.

However, it should be emphasised once again that ADHD cannot be diagnosed on the basis of just one of the listed symptoms, as it is likely that most of us will repeatedly behave in at least one of the listed ways, if only in a stress-inducing situation.

Impulsivity in ADHD

Another characteristic feature of people with ADHD is impulsivity, which is significantly increased in the cases described. This means that affected children act uncontrollably, that is, they are unable to stop what they are doing. They are usually aware of the abnormality of their behaviour because they know the rules. However, they are not able to control their actions and do not think about the consequences of their actions. Excessive impulsivity is the inability to defer or inhibit a reaction. It manifests itself in the immediate execution of ideas without first thinking about the consequences of one’s actions. In other words, a person with ADHD will ‘do first and think later’. Illustrative examples of the situation may include behaviours such as:

  • frequent intrusion into other people’s conversations,
  • disrupting silence, despite frequent reminders,
  • running out into the street,
  • outbursts of anger,
  • overreaction to environmental stimuli,
  • rashness in acting out,
  • susceptibility to suggestion – a child with ADHD is easily persuaded to do something stupid,
  • problems with planning, which is particularly noticeable when the child has to carry out a task on their own and has to keep track of what they have already done and what they still have to do,
  • inadvertent breaking of toys,
  • frequent irritability,
  • lack of patience – the child cannot wait for a reward.

Attention deficit disorder in ADHD

As mentioned earlier, the ADHD picture is further compounded by symptoms in the area of attention deficit disorder. In people with this syndrome, the ability to focus one’s attention on the task at hand is significantly impaired. This includes a reduction in the amount of time a child is able to focus their attention on one activity. The problem also lies in the inability to select from external stimuli the most important one. For this reason, children with ADHD often appear to be daydreaming.

In addition, they are unable to focus their attention on two activities at the same time, e.g. listening to the teacher and taking notes at the same time. An increase in these symptoms is mainly observed in situations where the child is required to concentrate for a longer period of time, e.g. listening to someone speak or reading a text. Also, being in a larger group of people, e.g. at school, can cause increased attention deficit disorder. It should be noted, however, that children with ADHD are able to focus their attention even for very long on something they find interesting. However, they are not able to do this ‘by force’. In everyday life, attention deficit disorder can result in the following situations:

  • difficulty in completing a longer task consisting of several instructions,
  • forgetting to bring books, exercise books, etc. to school
  • forgetting to do homework or what exercises have been done,
  • excessive absent-mindedness,
  • starting another activity without finishing the previous one.

A child with ADHD is easily distracted, concentrates for a short time, memorises details poorly, has difficulty following instructions, often loses and forgets things, does not transcribe accurately from the blackboard.

Types of ADHD

Of course, the picture of the condition is not the same in every child. Also, not all symptoms occur with the same intensity. Sometimes one group of symptoms is much more pronounced than the others, dominating. For this reason, a division into 3 subtypes of ADHD has been introduced:

  • ADHD with predominant symptoms of hyperactivity and impulsivity,
  • ADHD with predominant attention deficit disorder,
  • mixed subtype (most commonly diagnosed).

Which symptoms are predominant and, consequently, which type is most likely in a particular case, in some ways depends on gender and age. This is based on many years of observations, which have led to the following conclusions:

  • boys are more likely to have the mixed subtype, while girls tend to be dominated by symptoms related to attention deficit disorder;
  • with age, the picture of the disease, the severity of the individual symptoms and thus the type of dominant symptoms changes. It is estimated that approximately 30% of individuals diagnosed with ADHD in childhood will have their symptoms disappear by adolescence, and that the majority of hyperactivity and impulsivity will give way to attention deficit disorder;

Additional criteria necessary for the diagnosis of ADHD

It is important to bear in mind that the mere presence of several symptoms matching those listed above is not sufficient to make a confident diagnosis. Some classification systems state that the diagnosis requires, for example, the presence of 6 symptoms from the hyperactivity or hyperreflexia group and 6 from the attention deficit disorder group. In addition, additional conditions must still be met. These have been collected into a group of additional diagnostic criteria. These include:

  • onset of symptoms under the age of 7,
  • the symptoms must be observed in at least two situations, e.g. at home and at school,
  • the presenting problem must lead to suffering or impairment of social functioning,
  • the symptoms must not be part of another disorder, meaning that the child must not have been diagnosed with another conduct disorder.

Behavioural disorders in ADHD

Conduct disorders are repetitive aggressive, rebellious and antisocial behaviours. Diagnostic criteria assume persistence of symptoms for at least 12 months. In practice, conduct disorders take the form of disobedience to social rules, use of profanity, outbursts of anger, getting into conflicts (oppositional defiant disorder). Acute forms of conduct disorder include lying, stealing, notorious running away from home, bullying, rape, arson.

The co-occurrence of ADHD and conduct disorder is estimated at 50-80%, with several percent for severe conduct disorder. On the one hand, it is caused by impulsivity and the inability to anticipate the consequences of one’s behaviour, and on the other hand by difficulties in establishing social contacts. Children with ADHD often rebel and behave aggressively. An additional risk factor is the ease of falling into ‘bad company’, which is often the only environment that accepts a young person with hyperactivity. As with other complications of ADHD, prevention is essential. An opportunity to eliminate a child’s challenging and risky behaviour is early therapy.

What to look out for in a child’s behaviour?

Already in early childhood, certain symptoms may appear in the child which are a harbinger for the later development of ADHD. You may observe:

  • accelerated or delayed speech development,
  • sleep disturbances,
  • problems with eating – there may be vomiting or a weakened sucking reflex,
  • colic attacks,
  • inability to learn from one’s mistakes,
  • significantly increased time to perform normal daily activities compared to peers,
  • excessive mobility at the onset of walking,
  • frequent injuries, because the child prefers chasing and often behaves in a risky manner.

It is important to remember that the symptoms and conditions mentioned can occur with many other conditions, so do not immediately think of ADHD when they occur. A link between symptoms characteristic of ADHD and the existence of other disorders such as autism, Asperger’s syndrome, affective disorders or anxiety disorders should be excluded.

Diagnosis of ADHD

The diagnosis of ADHD requires the dedication of a great deal of time and the involvement of many people. It is a lengthy process, consisting largely of observation of the child. The diagnosis of ADHD can be divided into the following stages:

Stage 1: Interview with the parents, during which the doctor tries to determine the course of the pregnancy and birth, to identify possible risk factors related to the fetal period. Questions should also be asked about the child’s development, relationships with other people in the child’s environment and any problems occurring in daily life.

Stage 2: Interview with the child’s teacher. The aim is to gather information about the child’s behaviour at school, his/her relationships with peers, possible learning problems. It is important that the teacher asked to talk has known the child for more than six months.

Stage 3: Observation of the child. This is a difficult stage of investigation due to the unstable nature of ADHD symptoms and their variability depending on the environment in which the child happens to be.

Stage 4: Talking to the child. It is important to remember that this should also be carried out in the absence of the parents to see how the child behaves without their supervision.

Stage 5: Scales and diagnostic questionnaires with questions for parents and teachers.

Stage 6: Psychological tests to assess intelligence, motor, speech and problem-solving abilities. These have some value in ruling out other conditions that have symptoms similar to ADHD.

Stage 7: Paediatric and neurological examination. It is important that vision and hearing are checked during these examinations.

Stage 8: In addition, an electronic measurement of eye movement frequency and speed may still be carried out to assess hyperreflexia or a computerised continuous attention test to assess concentration disorders. However, these methods are not routinely used and are therefore not available everywhere.

Source

  • https://portal.abczdrowie.pl/objawy-adhd
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