Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder affecting 11 percent of school-age children.
Symptoms continue into adulthood in more than three-quarters of cases. ADHD is characterized by developmentally inappropriate
levels of inattention, impulsivity and hyperactivity.
It’s more common in boys than in girls. It’s usually discovered during the early school years, when
a child begins to have problems paying attention. Adults with ADHD may have trouble managing time, being organized,
setting goals, and holding down a job. They may also have problems with relationships, self-esteem, and addiction.
Individuals with ADHD can be very successful in life. However, without identification and proper treatment, ADHD may have
serious consequences, including school failure, family stress and disruption, depression, problems with relationships,
substance abuse, delinquency, accidental injuries and job failure. Early identification and treatment are extremely important.
Medical science first documented children exhibiting inattentiveness, impulsivity and hyperactivity in 1902.
Since that time, the disorder has been given numerous names, including minimal brain dysfunction, hyperkinetic
reaction of childhood, and attention-deficit disorder with or without hyperactivity. With the Diagnostic and Statistical Manual,
Fifth Edition (DSM-5) classification system, the disorder has been renamed attention-deficit/hyperactivity disorder or ADHD.
The current name reflects the importance of the inattention aspect of the disorder as well as the other characteristics of the disorder
such as hyperactivity and impulsivity.
Symptoms in Children
Typically, ADHD symptoms arise in early childhood. According to the DSM-5, several symptoms are required to be present
before the age of 12.
Many parents report excessive motor activity during the toddler years, but ADHD symptoms can be hard
to distinguish from the impulsivity, inattentiveness and active behavior that is typical for kids under the age of four.
In making the diagnosis, children should have six or more symptoms of the disorder present; adolescents 17 and older and adults
should have at least five of the symptoms present.
The DSM-5 lists three presentations of ADHD—Predominantly Inattentive,
Hyperactive-Impulsive and Combined. The symptoms for each are adapted and summarized below.
ADHD throughout the lifespan
Many children affected by ADHD can also have mild delays in language, motor skills or social development that are not part
of ADHD but often co-occur. Also having experience delays in independent functioning and may behave younger than their peers. They tend to have low frustration tolerance, difficulty controlling their emotions and often experience mood swings
Children with ADHD are at risk for potentially serious problems in adolescence and adulthood: academic failure or delays,
driving problems, difficulties with peers and social situations, risky sexual behavior, and substance abuse. There may be
more severe negative behaviors with co-existing conditions such as oppositional defiant disorder or conduct disorder.
Adolescent girls with ADHD are also more prone to eating disorders than boys. As noted above, ADHD persists from childhood
to adolescence in the vast majority of cases (50–80 percent), although the hyperactivity may lessen over time.
Teens with ADHD present a special challenge. During these years, academic and life demands increase. At the same time,
these kids face typical adolescent issues such as emerging sexuality, establishing independence, dealing with peer pressure
and the challenges of driving.
More than 75 percent of children with ADHD continue to experience significant symptoms in adulthood. In early adulthood, ADHD
may be associated with depression, mood or conduct disorders and substance abuse. Adults with ADHD often cope with difficulties
at work and in their personal and family lives related to ADHD symptoms.
Many have inconsistent performance at work or in their careers;
have difficulties with day-to-day responsibilities; experience relationship problems; and may have chronic feelings of frustration, guilt
or blame.
Individuals with ADHD may also have difficulties with maintaining attention, executive function and working memory. Recently,
deficits in executive function have emerged as key factors affecting academic and career success. Executive function is the brain’s
ability to prioritize and manage thoughts and actions. This ability permits individuals to consider the long-term consequences of
their actions and guide their behavior across time more effectively.