Attention-Deficit/Hyperactivity Disorder

Do you know someone who might have Attention-Deficit/Hyperactivity Disorder? If so, review the following checklist. Have any of the following symptoms lasted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:

GROUP A
___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities often has difficulty sustaining attention in tasks or play activities often does not seem to listen when spoken to directly often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions. often has difficulty organizing tasks and activities often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork, or homework) often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools) is often easily distracted by extraneous stimuli is often forgetful in daily activities

GROUP B
___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________

often fidgets with hands or feet or squirms in seat often leaves seat in classroom or in other situations in which remaining seated is expected often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness) often has difficulty playing or engaging in leisure activities quietly is often on the go or often acts as if driven by a motor often talks excessively often blurts out answers before questions have been completed often has difficulty awaiting turn often interrupts or intrudes on others (e.g., butts into conversations or games)

Were at least some of these symptoms present before age 7? Does some impairment occur in at least two settings or environments (home, school, work, etc.)? Is there clear evidence of clinically significant impairment in social, academic, or occupational functioning?

ADHD Subtypes Attention Deficit/Hyperactivity Disorder, Combined Type: if checked six or more in BOTH Group A and Group B and answered yes to the above questions Attention Deficit/Hyperactivity Disorder, Predominately Inattentive Type: if checked six or more of Group A and less than six of group B and answered yes to the above questions Attention Deficit/Hyperactivity Disorder, Predominately Hyperactive-Impulsive Type: if checked six or more from Group B but less than six for Group A and answered yes to the above questions American Psychiatric Association. (1994). Attention Deficit/Hyperactivity Disorder. Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington DC: APA. 78-85.

Associated Features and Disorders Associated descriptive features and mental disorders Vary depending on age and developmental stage Low frustration tolerance, temper outbursts, bossiness, stubbornness, excessive and frequent insistence that requests be met, mood lability, demoralization, dysphoria, rejection by peers, and poor self-esteem. Academic achievement is often impaired and devalued, typically leading to conflict with the family and school authorities. Inadequate self-application to tasks that require sustained effort is often interpreted by others as indicating laziness, a poor sense of responsibility, and oppositional behavior. Family relationships are often characterized by resentment and antagonism, especially because of variability in the individuals symptomatic status often leads parents to believe that all the troublesome behavior is willful. (APA, 1994, pp. 80-81) may obtain less schooling than their peers and have poorer vocational achievement. Intellectual development, as assessed by individual IQ tests, appears to be somewhat lower in children with this disorder (APA, 1994, p. 81) may coexist with Oppositional Defiant Disorder, Conduct Disorder, Mood Disorders, Anxiety Disorders, Learning Disorders, and Communication Disorders, Tourettes Disorder may be a history of child abuse or neglect, multiple foster placements, neurotoxin exposure (e.g., lead poisoning), infections (e.g., encephalitis), drug exposure in utero, low birth weight, and Mental Retardation (APA, 1994, p. 81) Associated Laboratory Findings no established diagnostic laboratory tests tests that require effortful mental processing have been noted to be abnormalnot yet entirely clear what fundamental cognitive deficit is responsible for this (APA, 1994, p. 81) Associated physical examination findings and general medical conditions no specific physical features associatedalthough minor physical abnormalities (e.g., hypertelorism, highly arched palate, low-set ears) may occur at a higher rate than in the general population (APA, 1994, p. 81) may also be a higher rate of physical injury (APA, 1994, p. 81) Specific Culture, Age, and Gender Features known to occur in various cultures, with variations in reported prevalence among Western countries probably arising more from different diagnostic practices than from differences in clinical presentation. (APA, 1994, p. 81) Diagnosis difficult in young children (ages 4 or 5 years)--behavior is much more variablefew demands for sustained attention inquiring about a wide variety of behaviors is helpful for attaining full clinical picture move excessively and typically are difficult to contain. (APA, 1994, p. 81) symptoms become less conspicuous with age; By late childhood and early adolescence, signs of excessive gross motor activityare less common, and hyperactivity symptoms may be confined to fidgetiness or an inner feeling of jitteriness or restlessness. (APA, 1994, pp. 81-82) much more frequent in males than in females, with male-to-female ratios ranging from 4:1 to 9:1, depending on the setting (i.e., general population or clinics). (APA, 1994, p. 82) Prevalence School-age children: 3%-5%; adolescents and adults: limited data (APA, 1994, p. 82) Course excessive motor activitywhentoddlers Usuallyfirst diagnosed during elementary school years, when school adjustment is compromised.relatively stable through early adolescence In most individuals, symptoms attenuate during late adolescence and adulthood, although a minority experiencefullsymptoms into mid-adulthood. Other adults may retain only some of the

symptomsthese individuals should receive the diagnosis of Attention-Deficit/Hyperactivity Disorder, In Partial Remission (APA, 1994, p. 82 Familial Pattern more common in first-degree biological relatives.Studies also suggest that there is a higher prevalence of Mood and Anxiety Disorders, Learning Disorders, Substance-Related Disorders, and Antisocial Personality Disorder in family members of individuals with Attention-Deficit/Hyperactivity Disorder. (APA, 1994, p. 82) References American Psychiatric Association. (1994). Attention-Deficit/Hyperactivity Disorder. Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington DC: APA. 78-85.