What is ADHD? | Symptoms of ADHD | How to Diagnose ADHD

ADHD is a common behavioural disorder that affects an estimated 8% to 10% of school-age children. Boys are about three times more likely than girls to be diagnosed with it, though it's not yet understood why. Children with ADHD act without thinking, are hyperactive, and have trouble focusing. They may understand what's expected of them but have trouble following through because they can't sit still, pay attention, or attend to details.

Of course, all children (especially younger ones) act this way at times, particularly when they're anxious or excited. But the difference with ADHD is that symptoms are present over a longer period of time and occur in different settings. They impair a child's ability to function socially, academically, and at home.

The good news is, with proper treatment, children with ADHD can learn to successfully live with and manage their symptoms.

ADHD used to be known as attention deficit disorder, or ADD. In 1994, it was renamed ADHD and broken down into three subtypes, each with its own pattern of behaviours:

1. an inattentive type, with signs that include:

• inability to pay attention to details or tendency to make careless errors in schoolwork or other activities
  
• difficulty with sustained attention in tasks or play activities
  
• apparent listening problems
  
• difficulty following instructions
  
• problems with organization
  
• avoidance or dislike of tasks that require mental effort
  
• tendency to lose things like toys, notebooks, or homework
  
• distractibility
  
• forgetfulness in daily activities
  

2. a hyperactive-impulsive type, with signs that include:

• fidgeting or squirming
  
• difficulty remaining seated
  
• excessive running or climbing
  
• difficulty playing quietly
  
• always seeming to be "on the go"
  
• excessive talking
  
• blurting out answers before hearing the full question
  
• difficulty waiting for a turn or in line
  
• problems with interrupting or intruding
  

3. a combined type, which involves a combination of the other two types and is the most common

• Although it can often be challenging to raise kids with ADHD, it's important to remember they aren't "bad", "acting out" or being difficult on purpose. And children who are diagnosed with ADHD have difficulty controlling their behaviour without medication or behavioural therapy.

Most cases of ADHD are treated by primary care doctors. Because there's no test that can determine the presence of ADHD, a diagnosis depends on a complete evaluation. When the diagnosis is in doubt, or if there are other concerns, such as Tourettes syndrome, a learning disability, or depression, a child may be referred to a neurologist, psychologist, or psychiatrist. Ultimately, though, the primary care doctor gathers the information, makes the diagnosis, and starts treatment.

To be considered for a diagnosis of ADHD:

• a child must display behaviours from one of the three subtypes before age 7
  
• these behaviours must be more severe than in other kids the same age
  
• the behaviours must last for at least 6 months
  
• the behaviours must occur in and negatively affect at least two areas of a child's life (such as school, home, day-care settings, or friendships)
  

The behaviours must also not be linked to stress at home. Children who have experienced a divorce, a move, an illness, a change in school, or other significant life event may suddenly begin to act out or become forgetful. To avoid a misdiagnosis, it's important to consider whether these factors played a role in the onset of symptoms

First, your child's doctor will perform a physical examination of your child and ask you about any concerns and symptoms, your child's past health, your family's health, any medications your child is taking, any allergies your child may have, and other issues. This is called the medical history, and it's important because research has shown that ADHD has a strong genetic link and often runs in families.

Your child's doctor may also perform a physical exam as well as tests to check hearing and vision so other medical conditions can be ruled out. Because some emotional conditions, such as extreme stress, depression, and anxiety, can also look like ADHD, you'll probably be asked to fill out questionnaires that can help rule them out as well.

You'll also likely be asked many questions about your child's development and his or her behaviours at home, at school, and among friends. Other adults who see your child regularly (like teachers, who are often the first to notice ADHD symptoms) will probably be consulted, too. An educational evaluation, which usually includes a school psychologist, may also be done. It's important for everyone involved to be as honest and thorough as possible about your child's strengths and weaknesses.