What is Attention-Deficit Hyperactivity Disorder (ADHD)?

ADHD is a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development as characterized by symptoms of inattention and/or hyperactivity and impulsivity. Distinguishing features of ADHD are short attention span and high levels of distractibility for chronological age and developmental level. This condition is also referred to as ADD (Attention Deficit Disorder), which is old terminology.

A diagnosis of ADHD is given based on symptoms of “inattention” or based on symptoms of “hyperactivity and impulsivity.” In addition, “other specified ADHD disorder” or “unspecified ADHD disorder” may be given as a diagnosis when a patient does not meet the full criteria for ADHD but the symptoms still cause significant distress or impairment in social, occupational, or other important areas of functioning.

Inattention Symptoms

A diagnosis of ADHD based on inattentive symptoms requires that six or more of the following symptoms have persisted for at least 6 months, negatively impacting directly on social and occupational activities. For older adolescents and adults, at least five symptoms are required.

• Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or during other activities.
• Often has difficulty sustaining attention in tasks or play activities, including remaining focused during lectures, conversations, or lengthy reading.
• Often does not seem to listen when spoken to directly (mind seems elsewhere, even in the absence of any obvious distraction).
• Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace.
• Often has difficulty organizing tasks and activities; has poor time management; fails to meet deadlines.
• Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (e.g., schoolwork or homework).
• Often loses things necessary for tasks or activities (e.g., school materials, pencils, books, tools, wallets, keys, eyeglasses, paperwork, mobile phones).
• Is often easily distracted by extraneous stimuli (for older adolescents and adults, may include unrelated thoughts).
• Is often forgetful in daily activities (doing chores, running errands, returning calls, paying bills, keeping appointments).

Hyperactivity and Impulsivity

A diagnosis of ADHD based on hyperactive-impulsive symptoms requires that six or more of the following symptoms have persisted for at least 6 months, negatively impacting directly on social and occupational activities. For older adolescents and adults, at least five symptoms are required.

• Often fidgets with or taps hands or feet, or squirms in seat.
• Often leaves seat in situations when remaining seated is expected.
• Children often run about in situations where it is inappropriate. In adolescents or adults, this may be limited to feeling restless.
• Often unable to play or engage in leisure activities quietly.
• Is often “on the go,” acting as if “driven by a motor,” is uncomfortable being still for an extended time, as in restaurants or meetings).
• Often talks excessively.
• Often blurts out an answer before a question has been completed, completed people’s sentences, cannot wait for their turn in the conversation.
• Often has difficulty waiting for his or her turn.
• Often interrupts or intrudes on others, such as butting into conversations, games, or activities. May start using other people’s things without asking or receiving permission.

A diagnosis of ADHD based on either inattentive or hyperactive-impulsive symptoms requires that several of the symptoms were present prior to age 12. Moreover, there is clear evidence that the symptoms interfere with social, academic, or occupational functioning. Also, the symptoms are not better explained by another mental health disorder, substance intoxication, or withdrawal.

What is the rate of ADHD/ADD among children and adults?

Evidence suggests that ADHD occurs in about 5 percent of youth including children and adolescents, and in up to 4 percent of adults. ADHD is at least twice as prevalent in boys than in girls. Symptoms of ADHD are often present by age 3, but the diagnosis is often not made until kindergarten or elementary school.