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Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common childhood disorders,
occurring in approximately 3% to 5% of children. It is characterized by inattention, impulsivity, and
hyperactivity. Diagnostically, ADHD is divided into either the inattentive symptoms or the
hyperactivity-impulsivity constellation of symptoms. Inattention usually involves difficulty with auditory
attention, difficulty sustaining attention for prolonged periods of time, failure to listen, organizational
problems, distractibility, failure to follow through and complete activities, and forgetfulness.
Hyperactivity symptoms typically consist of excessive behavior, restlessness, squirming, difficulty
remaining seated, inappropriate noises, and difficulty waiting turns. Typically, unless caused by
accident or injury, these symptoms typically are present in younger children who are
developmentally identifiable between the ages of 3 and 7, although it is difficult to discern children
with ADHD from other children at much younger ages given their lack the of developmental
maturation. Typically, children with ADHD begin to stand out in kindergarten, first or second grade
when similar age peers are increasing their control over attention and concentration abilities,
impulsivity, and over activity/fidgety behavior. It is for this reason that teachers often first identify
ADHD symptoms when the demands of sitting in a structured class and focusing attention on
academic tasks becomes challenging or impossible for some children.
Children with ADHD often do poorly in school and they are more likely to have other difficulties, such
as speech and language impairments or learning disabilities. They have increased difficulties with
peer acceptance and social behavior, and they are more than likely over time to become anxious and
depressed as a result of the negative feedback which their environment delivers to them in response
to their behavior patterns. Additionally, children with ADHD often develop oppositional tendencies,
patterns of noncompliance, and sometimes develop aggressive and antisocial behavior.
Some professionals differentiate cognitive versus behavioral ADHD, given that some children with
ADHD primarily evidence symptoms in the areas of inattention which interfere with learning and
academic work, while other children with impulsivity and/or hyperactivity may develop other problems
such as peer difficulties, non-compliance with adults, and aggressive or anti-social behavior during
Given the sometimes extreme nature of the difficulties that children with ADHD encounter, there is
long-term potential for more serious problems developing. Research has clearly documented that
there is higher than average risk amongst ADHD children of developing substance abuse problems,
depression, alcoholism, legal difficulties, and longer term behavioral problems.
It is generally understood that the discontrol of behavior in ADHD results from subtle neuroanatomical
abnormalities (primarily in the frontal lobes) in children, often caused by either subtle trauma (i.e.
birth trauma, anoxia seizure, illness, head injury, lead ingestion) or genetic/familial transmission .
Other factors, such as the presence or absence of firm parental limit setting and structure in a child's
life may exacerbate or contribute to the level of discontrol the child with ADHD experiences. And
while significant psychological events in a child's life (i.e. environmental stressors such as family
deaths, parental divorce, or other psychologically traumatic circumstances) may contribute to
exacerbating Attention Deficit Hyperactivity Disorder symptoms, these factors are generally not
considered to cause such problems.
ATTENTION DEFICIT HYPERACTIVITY DISORDER