Recognizing the symptoms of ADHD in children

by E. Wayne Combs
U.S. Army Public Health Command

Most healthy children occasionally have trouble sitting still, paying attention or controlling impulses. Maybe you have noticed these behaviors in your own children. That’s normal. But for some children, the problem is so bad it interferes with their daily lives at home, at school and in social settings.

Attention-deficit/hyperactivity disorder, or ADHD, is characterized by not being able to pay attention, hyperactivity (highly or excessively active) and impulsive behavior (acting without thinking first). There are three identified types of ADHD. Here are the symptoms for each type.

A child who has the predominantly inattentive type of ADHD exhibits the following symptoms:
• 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 sustained mental effort.
• Loses things.
• Is easily distracted.
• Is forgetful in daily activities.

A child who has the predominantly hyperactive-impulsive type of ADHD exhibits the following symptoms:
• Fidgets with hands or feet or squirms in chair.
• Has difficulty remaining seated.
• Runs about or climbs excessively.
• Has difficulty engaging in activities quietly.
• Acts as if driven by a motor.
• Talks excessively.
• Blurts out answers before questions have been completed.
• Has difficulty waiting or taking turns.
• Interrupts or intrudes upon others.

Finally, children who have the combined type of ADHD meet both sets of inattention and hyperactive/impulsive criteria.

There is no simple test (like a blood test or a short written test) to determine whether someone has ADHD. Diagnosis can be difficult and should be made only by an expert (school psychologist, clinical psychologist, clinical social worker, nurse practitioner, neurologist, psychiatrist or pediatrician) after an extensive evaluation. This evaluation should include ruling out other possible causes for the symptoms, a physical examination, and a series of interviews with the individual and other key persons in the individual’s life (parents, spouse, teachers and others).

A diagnosis of ADHD can be very scary. However, with early diagnosis and the right treatment, including medication and appropriate counseling and behavior therapy, most children with ADHD grow up to be normal, successful adults. The best results usually occur when a team approach is used, with teachers, parents, therapists, doctors and nurses working together.

If you’re concerned that your child is displaying signs of ADHD, talk to your pediatrician or primary care manager. Your doctor may refer you to a specialist, but it’s important to have a medical evaluation first to check for other causes of your child’s difficulties.

For more information on ADHD:
• Attention-Deficit/Hyperactivity Disorder,
• Centers for Disease Control and Prevention,