Once simply called Attention Deficit Disorder or ADD, this condition has been renamed Attention Deficit Hyperactivity Disorder even when hyperactivity is not a component of the patient’s behavior. This has caused some confusion for the public. In order to clarify this here are the 3 subtypes of ADHD:
- Predominantly Hyperactive-Impulsive
- Predominantly Inattentive (mostly girls)
- Combined Hyperactive-Impulsive and Inattentive (most prevalent type)
- Fidgets with hands or feet or squirms in chair.
- Has difficulty remaining seated.
- Runs about or climbs excessively seen in children.
- Extreme restlessness in adults.
- Difficulty engaging in activities quietly.
- Acts as if driven by a motor.
- Adults will often feel inside like they are “driven by a motor.”
- Talks excessively.
- Blurts out answers before questions have been completed.
- Difficulty waiting or taking turns.
- Interrupts or intrudes upon others.
- Fails to give close attention to details or makes careless mistakes.
- Has difficulty sustaining attention.
- Does not appear to listen.
- Struggles to follow through on instructions.
- Has difficulty with organization.
- Avoids or dislikes tasks requiring a lot of thinking.
- Loses things.
- Is easily distracted. Is forgetful in daily activities.
There is no one single test that can diagnose ADHD and because it has features similar to other conditions it can be misdiagnosed. In order to be diagnosed with ADHD certain behavioral criteria must be met based on observations made by parents, teacher, and licensed healthcare provider (usually a pediatrician or mental health professional). The behaviors must be present in at least 2 different settings (ex: school, home, work, or recreational activities) and must be present for at least 6 months to an extent that is greater than that seen in their peers. Additionally, symptoms must appear before the age of 12. Written and/or computerized tests may also be used to further support the diagnosis. A thorough physical exam, psychological evaluation, and other tests as needed can rule out disorders that may mimic or contribute to the ADHD symptoms.
Misdiagnosis and Missed Diagnosis:
The inattentive type is often overlooked because they are quiet and can appear to be paying attention when they aren’t. Some inattentive types are simply labeled as a “daydreamer” when in fact they having are trouble maintaining mental focus. On the other hand a child may be diagnosed with inattentive type ADHD when in fact they are really suffering from a type of seizure disorder known as “absence seizures”.
According to the National Institute of Mental Health the average age of ADHD onset is 7. Boys are 4 times more likely to develop this condition than girls and the number of children being diagnosed with ADHD continues to rise.
In May of 2015 the Centers for Disease Control published the results of their study on the prevalence of ADHD for the period of 2011 – 2013. The percentage of children between the ages of 4 – 17 who have ever been diagnosed with ADHD in the United States indicate 13.3% of boys and 5.6% of girls overall. For boys aged 12 – 17 the number ever diagnosed was an astounding 16.3%.
As a side note a number of medical researchers have recently called into question the accuracy of an ADHD diagnosis in children below age 6. This is due to the widely varying rates of behavioral development and lack of valid diagnostic tools to support it in this age group. Notwithstanding that fact the CDC’s report found that one third of children receiving an ADHD diagnosis are below age 6.
To make matters even more confusing, coexisting conditions are frequently present and can mask ADHD. Conditions often accompanying it include anxiety, depression, dyslexia and other learning disabilities, auditory processing disorder, and more. Tourette’s Syndrome and Obsessive Compulsive Disorder (OCD) may have a common genetic link to ADHD according to researchers at Johns Hopkins. Indeed one or both of these conditions can accompany ADHD.