Inattention and hyperactivity/impulsivity are the key behaviors of ADHD. Some people with ADHD only have problems with one of the behaviors, while others have both inattention and hyperactivity-impulsivity. Most children have the combined type of ADHD. Individuals with problems with inattention may wander off task, lack persistence, have difficulty sustaining focus, and are disorganized; and these problems are not due to defiance or lack of comprehension.
Individuals with hyperactivity seem to move about constantly, including in situations in which it is not appropriate; or excessively fidget, tap, or talk. In adults, it may be extreme restlessness or wearing others out with constant activity. A person who is impulsive makes hasty decisions without first thinking about them and these decisions often lead to harmful consequences. It is normal to have some inattention, unfocused motor activity and impulsivity, but for people with ADHD, these behaviors are more severe, occur more often, and interfere with or reduce the quality of how they function socially, at school, or in a job.
Diagnosis of ADHD requires a comprehensive evaluation by a licensed clinician, such as a psychologist or psychiatrist with expertise in ADHD. For a person to receive a diagnosis of ADHD, the symptoms of inattention and/or hyperactivity-impulsivity must be chronic or long-lasting, impair the person’s functioning, and cause the person to fall behind normal development for his or her age. Most children with ADHD receive a diagnosis during the elementary school years.
For an adolescent or adult to receive a diagnosis of ADHD, the symptoms need to have been present prior to age 12. ADHD symptoms can appear as early as between the ages of 3 and 6 and can continue through adolescence and adulthood. Symptoms of ADHD can be mistaken for emotional or disciplinary problems or missed entirely in quiet, well-behaved children, leading to a delay in diagnosis. Adults with undiagnosed ADHD may have a history of poor academic performance, problems at work, or difficult or failed relationships.
ADHD symptoms can change over time as a person ages. In young children with ADHD, hyperactivity-impulsivity is the most predominant symptom. As a child reaches elementary school, the symptom of inattention may become more prominent and cause the child to struggle academically. In adolescence, hyperactivity seems to lessen and may show more often as feelings of restlessness or fidgeting, but inattention and impulsivity may remain. Many adolescents with ADHD also struggle with relationships and antisocial behaviors. Inattention, restlessness, and impulsivity tend to persist into adulthood.
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