Chapter 8 – ADHD
ADHD: describes children who display persistent age inappropriate symptoms of inattention,
hyperactivity and impulsivity that are sufficient to cause impairment in life activities.
Inattentive: not focusing on mealtime demands and behaving carelessly
Hyperactive: constantly in motion
Impulsive: acting without thinking
Can only be identified by characteristic behavior, that vary from child to child. The behavior of
children with ADHD is a constant source of stress and frustration for the child and for parents,
siblings, teachers and classmates. Also high costs for society.
The disorder that we now call ADHD has had many different names, primary symptoms and
presumed causes and views of the disorder are still evolving.
Core characteristics:
ADHD is a neurodevelopmental disorder because it has an early onset and persistence course.
Overlap with ASD and SLD.
Diagnostic criteria ADHD-DSM-5:
- Persistent pattern of inattention and/or ADHD that interferes with functioning or
development, characterized by:
o Inattention: 6 or more of the following symptoms for at least 6 months:
Fails to give close attention to details
Difficulty sustaining attention in tasks
Doesn’t seem to listen when spoken to directly
Doesn’t follow through on instructions and fails to finish work
Difficulty organizing tasks and activities
Avoids, dislikes or is reluctant to engage in tasks that require sustained
mental effort
Loses things necessary for tasks or activities
Easily distracted by extraneous stimuli
Forgetful in daily activities
o Hyperactivity and impulsivity: 6 or more of the following symptoms for at least 6
months:
Fidgets with or taps hands of feet
Leaves seat in situations when remaining seated is expected
Often runs about or climbs in inappropriate situations
Unable to play or engage in leisure activities quietly
Often on the go acting as if driven by a motor
Talks excessively
Blurts out answers before a question had been completed
Difficulty waiting for turn
Interrupts of intrudes on others
- Several inattentive or hyperactive-impulse symptoms were present <12
- Several symptoms are present in 2 or more settings
- Must be a clear evidence that the symptoms interface with social academic, or occupational
functioning
- Symptoms do not occur exclusively during the course of schizophrenia or other psychotic
disorders and are not better explained by other mental disorders
, Mild:
Few symptoms in excess of those required to make the diagnosis are present. Minor impairments.
Moderate:
Symptoms or functional impairment between mild and severe are present.
Severe:
Many symptoms in excess for those required to make the diagnosis are present. Or symptoms result
in marked impairment in social or occupational functioning.
Inattention: inability to sustain attention or stick to tasks or play activities to remember and follow
through on instructions or rules, and to resist distractions, difficulty planning, organizations and
staying alert. Deficit in:
- Attentional capacity: Amount of information we can remember and attend to for a short
time. Same as other persons.
- Selective attention: The ability to concentrate on relevant stimuli and ignore the task-
irrelevant stimuli in the environment.
- Distractibility: To indicate a deficit in selective attention.
- Sustained attention (vigilance): Maintain a persistent focus over time on unchallenging,
uninteresting tasks or activities core feature of ADHD
- Alerting: Initial reaction to a stimulus.
Hyperactivity-impulsivity: under control of motor behavior, poor sustained inhibition of behavior,
the inability to delay a response of defer gratification or an inability to inhibit dominant responses in
relation to ongoing situational demands.
- Cognitive impulsivity:
Disorganization hurried thinking and need for supervision.
- Behavioral impulsivity:
Calling out or acting without considering the consequences.
Predict problems with academic achievement, particularly in reading.
Emotional impulsivity/dysregulation: impatience, low frustration tolerance, hot temper, quickness
to anger and irritability.
Presentation type: a group of individuals with something in common.
1. Predominantly inattentive presentation (ADHD-PI):
Meet symptom criteria for attention but not hyperactivity.
Three diagnostic groups:
o Who display both symptoms, but still substantial levels of HI
o Are linked to problems with arousal and sluggish cognitive tempt (SCT): cluster that
includes symptoms as daydreams, sleepy, slow moving, tired (core component of
some forms of ADHD, can be a different disorder).
o Who originally met criteria for ADHD-C, but experience an age-related reduction in
symptoms of HI.
2. Predominantly hyperactive-impulse presentation (ADHD-HI)
Meet symptoms criteria for hyperactivity-impulsivity but not inattention.
3. Combined presentation (ADHD-C):
Meet symptom criteria for both, most common referred for treatment.
ADHD: describes children who display persistent age inappropriate symptoms of inattention,
hyperactivity and impulsivity that are sufficient to cause impairment in life activities.
Inattentive: not focusing on mealtime demands and behaving carelessly
Hyperactive: constantly in motion
Impulsive: acting without thinking
Can only be identified by characteristic behavior, that vary from child to child. The behavior of
children with ADHD is a constant source of stress and frustration for the child and for parents,
siblings, teachers and classmates. Also high costs for society.
The disorder that we now call ADHD has had many different names, primary symptoms and
presumed causes and views of the disorder are still evolving.
Core characteristics:
ADHD is a neurodevelopmental disorder because it has an early onset and persistence course.
Overlap with ASD and SLD.
Diagnostic criteria ADHD-DSM-5:
- Persistent pattern of inattention and/or ADHD that interferes with functioning or
development, characterized by:
o Inattention: 6 or more of the following symptoms for at least 6 months:
Fails to give close attention to details
Difficulty sustaining attention in tasks
Doesn’t seem to listen when spoken to directly
Doesn’t follow through on instructions and fails to finish work
Difficulty organizing tasks and activities
Avoids, dislikes or is reluctant to engage in tasks that require sustained
mental effort
Loses things necessary for tasks or activities
Easily distracted by extraneous stimuli
Forgetful in daily activities
o Hyperactivity and impulsivity: 6 or more of the following symptoms for at least 6
months:
Fidgets with or taps hands of feet
Leaves seat in situations when remaining seated is expected
Often runs about or climbs in inappropriate situations
Unable to play or engage in leisure activities quietly
Often on the go acting as if driven by a motor
Talks excessively
Blurts out answers before a question had been completed
Difficulty waiting for turn
Interrupts of intrudes on others
- Several inattentive or hyperactive-impulse symptoms were present <12
- Several symptoms are present in 2 or more settings
- Must be a clear evidence that the symptoms interface with social academic, or occupational
functioning
- Symptoms do not occur exclusively during the course of schizophrenia or other psychotic
disorders and are not better explained by other mental disorders
, Mild:
Few symptoms in excess of those required to make the diagnosis are present. Minor impairments.
Moderate:
Symptoms or functional impairment between mild and severe are present.
Severe:
Many symptoms in excess for those required to make the diagnosis are present. Or symptoms result
in marked impairment in social or occupational functioning.
Inattention: inability to sustain attention or stick to tasks or play activities to remember and follow
through on instructions or rules, and to resist distractions, difficulty planning, organizations and
staying alert. Deficit in:
- Attentional capacity: Amount of information we can remember and attend to for a short
time. Same as other persons.
- Selective attention: The ability to concentrate on relevant stimuli and ignore the task-
irrelevant stimuli in the environment.
- Distractibility: To indicate a deficit in selective attention.
- Sustained attention (vigilance): Maintain a persistent focus over time on unchallenging,
uninteresting tasks or activities core feature of ADHD
- Alerting: Initial reaction to a stimulus.
Hyperactivity-impulsivity: under control of motor behavior, poor sustained inhibition of behavior,
the inability to delay a response of defer gratification or an inability to inhibit dominant responses in
relation to ongoing situational demands.
- Cognitive impulsivity:
Disorganization hurried thinking and need for supervision.
- Behavioral impulsivity:
Calling out or acting without considering the consequences.
Predict problems with academic achievement, particularly in reading.
Emotional impulsivity/dysregulation: impatience, low frustration tolerance, hot temper, quickness
to anger and irritability.
Presentation type: a group of individuals with something in common.
1. Predominantly inattentive presentation (ADHD-PI):
Meet symptom criteria for attention but not hyperactivity.
Three diagnostic groups:
o Who display both symptoms, but still substantial levels of HI
o Are linked to problems with arousal and sluggish cognitive tempt (SCT): cluster that
includes symptoms as daydreams, sleepy, slow moving, tired (core component of
some forms of ADHD, can be a different disorder).
o Who originally met criteria for ADHD-C, but experience an age-related reduction in
symptoms of HI.
2. Predominantly hyperactive-impulse presentation (ADHD-HI)
Meet symptoms criteria for hyperactivity-impulsivity but not inattention.
3. Combined presentation (ADHD-C):
Meet symptom criteria for both, most common referred for treatment.
