What is ADHD?

Apr 30, 2006 Greg Cruey

Attention Deficit Hyperactivity Disorder (ADHD) is among the most controversial and troublesome of educational and child health issues of our day.

Gaining an understanding of ADHD is only made more difficult by the controversy that surrounds it.

The National Institute of Mental Health says this:

  • "Attention Deficit Hyperactivity Disorder (ADHD) is a condition that becomes apparent in some children in the preschool and early school years. It is hard for these children to control their behavior and/or pay attention. It is estimated that between 3 and 5 percent of children have ADHD, or approximately 2 million children in the United States. This means that in a classroom of 25 to 30 children, it is likely that at least one will have ADHD."

Oh, if it was that simple...

Let me list some of the difficulties faced in a discussion of ADHD:

  • The subjectivity of ADHD's symptoms, the difficult nature of diagnosing it.
  • The vested interests that educators are sometimes perceived as having as they contribute to the diagnosis of ADHD.
  • The pliability of the average family doctor when faced with parents who seem to want (or not want) such a diagnosis.
  • The risks and controversies associated with medicines for the disorder.

All of these have made ADHD one of the most troublesome of medical and educational issues.

The problem is simple. Most professionals agree that ADHD exists (which is also to say that there are some in the field who don't agree that the disorder is even real). The main symptoms are inattention, hyperactivity, and impulsivity; but these can all be caused by some other problem and exist to some lesser extent in perfectly normal children. And the symptoms develop over time. A child may exhibit one of the symptoms, that symptom may get worse over a course of months (or years), and then other symptoms may emerge.

To confuse the issue even further, ADHD comes in three different types, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM IV-TR). There are kids who are predominately hyperactive, kids who are predominately inattentive, and kid who have combined those first two types.

Some absolute standards do exist in the diagnosis of ADHD. First, the child has to have exhibited the symptoms of ADHD before age seven. And those symptoms have to have continued for at least six months. In addition, the behaviors must be bad enough to create "a real handicap" in at least two areas of the child's life. So if the child's only problem is school, it's almost certainly not ADHD. To be ADHD, the symptoms have to create problems in the sandbox at the park or at home, as well. The symptoms have to be "excessive, long-term, and pervasive."

The NIMH's page has much more on diagnosing ADHD.

A number of good resources on ADHD exist online. Among them:

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The copyright of the article What is ADHD? in Special Needs Education is owned by Greg Cruey. Permission to republish What is ADHD? in print or online must be granted by the author in writing.
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Comments

May 1, 2006 8:22 AM
kerry ann padget :
I have 3 children, the eldest is 9 and has a rare genetic disorder. My middle child is 4 and my youngest is nearly 3. My two younger children were tested at birth and have no genetic abnormalities. I am unsure who to ask, where to go or how to go about retrieving info about ADHD but the little i have been told is from a mother who's son has ADHD. Some of the traits which her son has seem to appear in my middle child such as the hyperactivity, lack of concentration, bad behaviour, hard to cope with and acting out at home and school. I realise some of these are common in a middle child or any "normal" child for that matter and i'd like to know how you tell the difference and if there is anywhere i can go to get a test for ADHD. I appreciate any replies regarding this matter as i am at a dead end and don't know where else to turn.
May 1, 2006 12:50 PM
ReneeBlixt :
Hello: I'd say one important thing to remember is that ADHD is tagged on MANY children--some of whom do not have that disorder at all. It's an easy "out" for some doctors. I have a copy of the DSM-IV-TR, 4th edition, and ADHD's description is on page 85. This book currently costs about $70.00, but it is available at most libraries. I would never profess to be a psychiatrist, but reading this may help point you in the right direction. Incidentally, some of these "diagnosis" were what pushed me into homeschooling my children. Hope that helps! Renée http://homeschooling.suite101.com/
May 1, 2006 6:13 PM
Greg Cruey :
Take a look at this link to the <A HREF="http://www.ldhope.com/adhdinfo.htm#DIAGNOSTIC_CRITERIA" target=sne>diagnostic criteria</A> from DSM-VI (1994). I don't think they've changed much.

Part of the controversy that surrounds ADHD is that there is not a test. There was a time when treatment was often considered the test. Children with ADHD were thought to have a "paradoxical response" to treatment with stimulants like Ritalin. Giving a dose of that medication to a "normal" child without ADHD would make the bounce off the walls, so to speak. But if the child was genuinely ADHD, the drug had a calming effect for reasons never full understood. At least that was the thought at one time. But the paradoxical response has received a lot of scrutiny in recent years and it is no longer clear that all ADHD kids have a paradoxical response or that all "normal" kids don't.
Bottom line, a diagnosis of ADHD is a judgment made by a professional. And if you get a second opinion you may get a different judgment.
One of the quandaries faced by parents whose children really have ADHD is that the disorder is possibly the dingle most over-diagnosed medical problem in America.
Wish I could be more helpful, but there just not a "test," really...
Mar 4, 2009 12:28 PM
Guest :
I have ADHD, and it took me close to 3 years to convince my parents to get me "evaluated" (or tested, whetever you want to say) for it. they finally agreed and i was diagnosed with it my sophmore year in high school. I'm now a senior in high school. Before i started taking medication (not saying what med iI take for it), I was distracted alot, acting without thinking and not sitting still for more than 5 minutes. Any opinions reguarding if I should keep taking the medication I'm on for ADHD or if I should stop taking it would be appreciated
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