Parenting advice to help you know the signs of ADHD, the difference between ADHD and ADD, what to expect age by age, and when to seek help for your child.
A government survey released this weeks finds that one in ten children in the United States have ADHD (or attention deficit hyperactivity disorder). That number is a sizable increase from just a few years earlier. Studies in the past found that less than 8 percent of kids had been diagnosed with ADHD.
Most researchers attribute the rise to growing awareness and better screening of children. Other theories include: too much sugar in our children’s diets, poor diets, sleep deprivation, fast-paced images of television or computer screens in younger-aged children, food additives, overscheduled lives, and stress (to name a few). And then another reason: misdiagnosis or over-diagnosis.
There is a difference between ADD and ADHD (I know…I know… labels and abbreviations, but it’s critical to be aware of those labels). And there is also a difference is what ADHD looks like age by age. And if your child does have a serious attention deficit you will want to get help for your child–and the sooner the better. I taught special education for years and watched countless children suffer from low self-esteem and school failure because they didn’t get the right help soon enough.
Here are those differences between ADD and ADHD, and a quick crash course about those labels, as well as what to expect age by age with kids and attention deficits. If you do suspect your child has ADHD you get the right diagnosis.
When to Seek Help
Many kids have trouble paying attention, but far fewer have an actual diagnosable problem such as Attention Deficit Disorder (ADD). Of course, you should work with the teacher to find ways to handle his attention problems so he can succeed in school. But use these three factors to help you decide if your child’s behavior really warrants a label:
1. The attention difficulty is clearly noticeably–even extreme–when your child’s behavior is compared to other kids the same age and gender.
2. The attention problem has lasted at least six months and is evident in at least two settings different (such as home and school and not just at school).
3. Your child’s inability to pay attention significantly interferes with his ability to function and thrive in life and is not something your child can control.
If “yes” is your answer to each of those three factors then your child is clearly struggling and will be at risk of everything from low self-esteem, school failure, friendship troubles to even drug abuse. It is time to pick up the phone and seek the advice of a trained expert for an evaluation.
The Difference Between ADD and ADHD
The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV-TR) is the official manual published by the American Psychiatric Association that lists all recognized mental and behavioral disorders. Doctors in the U.S. currently recognize three types of attention-deficits:
- “Predominantly inattentive type:” (Attention Deficit Disorder or A.D.D.) The child has difficulty paying attention, doesn’t seem to listen, is easily distracted and forgetful but has no signs of hyperactivity.
- “Predominantly hyperactive/impulsive type”: (Attention-Deficit Hyperactivity Disorder or A.D.H.D.) The child fidgets or squirms in his seat, leaves seat when expected to remain seated, talks excessively, has trouble waiting, appears in perpetual motion, interrupts or intrudes on others; blurts out answers before questions are complete.
- “Combined type” (A.D.D./A.D.H.D.) The child displays both inattentive and hyperactive and impulsive behaviors.
To be diagnosed with any of the classifications, the child must display at least six problem behaviors before seven years of age. Those behaviors must also significantly interfere with the child’s ability to achieve academically or socially and are not consistent with normal child development. If you suspect your child has an attention disorder such as ADD or ADHD, seek an evaluation only of a physician, child neurologist, psychiatrist, psychologist or pediatric specialist credentialed in child behavior and development.
What to Expect Age by Age
Preschool: Typical behaviors—such as not listening, difficulty settling down and uninterested in paper tasks can easily be confused with true attention deficits but are common with preschoolers. Doctors generally won’t diagnose ADD because most preschoolers can be forgetful, lose their belongings and be easily distracted to some degree and are unable (especially boys) to sustain attention for long periods.So don’t jump to conclusions that your child has a disorder. Pay attention instead to extreme behavior patterns: your child is noticeably more distracted than other kids; constantly in trouble with friends;repeatedly must be asked to listen.
School Age: More severe symptoms may surface in first and second grade when a child is unable to follow directions and complete only small quantities of work. Milder attention problems may not surface until third or fourth grade when kids are expected to function more independently. Symptoms are most likely to be seen at school where the child has greater difficulty completing class work and at home where homework can take several hours to finish. About three to five percent of school-age kids are diagnosed with ADD/ADHD especially boys (by a five to one ratio) who tend to have more difficulty focusing.
Preteens: Schoolwork and grades can suffer and self-esteem can plummet as work load and academic pressures increases. Stress, peer pressure, bullying, over extended schedules and lack of sleep peaks and can contribute to concentration difficulties as well. Tweens diagnosed with ADD/ADHD prone to have more problem including shoplifting, substance abuse and delinquent and risky behavior that could cause physical injury (especially boys). Seventy to 80 percent of preteens diagnosed with clinical attention deficits still have symptoms as teens and adults.
If you suspect your child has a serious attention deficit, please get help! Then don’t stop until you receive the advice and support your child needs to succeed.
For tips on stretching children’s attention spans, understanding ADD and ADHD refer to the chapters in The Big Book of Parenting Solutions: 101 Answers to Your Everyday Challenges and Wildest Worries. Portions of this blog were adapting from that book so please respect the copyright. For more parenting solutions and late-breaking parenting news refer to my blog and website or follow me on twitter @MicheleBorba.
Resources used for this blog
Diagnostic and Statistical Manual of Mental Disorders: Criteria for Attention-Deficit/Hyperactivity Disorder, 4th Edition, American Psychiatric Association, 1994.
Some of the behaviors started before age seven: Susan Ashley, The ADD & ADHD Answer Book: The Top 275 Questions Parents Ask, Naperville, IL: Sourcebooks, Inc., 2005, p. 5
AAP book Attention Deficit Hyperactivity Disorder pp. 270.
Surfacing in first and second grade; third and fourth grade: Susan Ashley, The ADD & ADHD Answer Book: The Top 275 Questions Parents Ask, by Naperville, IL: 2005, p. 26.
Increased risk for engaging in delinquent and antisocial behavior: K. R. Stern, “A Treatment Study of Children With Attention Deficit Hyperactivity Disorder,” #20; Washington, DC: U.S. Department of Justice, May 2001.
70 to 80 percent of children diagnosed with ADHD still have symptoms as teens and adults: K. Painter, “Lofty Hopes for ADHD,” USA Today, Sept 17, 2007.