• Inattention
• Impulsivity
• Hyperactivity

There are times when parents feel that there is no problem at home due to child because either the ADHD child is their only child and have no other child to compare with, or they have found out ways and means to handle their child’s behavior.

The presence of these symptoms is not enough to diagnose ADHD. In addition, their duration and frequency is also taken into consideration before concluding that the patient has ADHD. Listed below are the conditions that must exist and are necessary for the diagnosis of ADHD. The symptoms

• The symptoms must have been exhibited for six months at its minimum.
• The symptoms must be quite intense than expected according to the child’s age and intelligence (must be more than a busy tot)
• The symptoms have a negatively affect on at least two places, for instance, at home or school.
• The symptoms have been developed before the child is seven.
• The symptoms are not due to other medical conditions such as anxiety, depression, conduct disorder, or autism that overlap the symptoms of ADHD.

Inattention

Inattention refers to lack of concentration and low span of attention that makes it difficult to perform or achieve something. Listed below are the ADHD symptoms placed under this category.

• Paying poor attention to explanations
• Making careless mistakes in homework and daily activities
• Feeling difficult to maintain attention
• Seeming not listening while speaking on a one-to-one basis
• Failing to follow instructions
• Failing to complete an assigned task
• Feeling difficult in organizing tasks and activities
• Disliking tasks wherein sustained mental focus is necessary
• Forgetting things required for tasks or activities
• Getting distracted easily
• Forgetting things while performing a task or activity

Impact on Social Relationships and Self-esteem

The child might make silly mistakes, forget the game rules, answers meaninglessly, and forget what to do next when being in a group with other children. So, other children would ignore such an ADHD child, would never want him/her in their team, and would bully him/her on the ground or in park. Due to this, the child starts feeling that he/she is useless, which in turn, lowers his/her self-esteem. As a result, he/she need lots of support and assurance for boosting self-confidence.

Impact on Parents

Your child might misplace things, forgets things, does not answer, spoil the task; which all can be frustrating. Initially, you yell at your child and even give her negative comments. Afterwards, you end up feeling guilty, as you realize when you cool down that it was not the fault of your child. This is because it was not intentionally done.

Impact on Education

Your child would feel it difficult to remember concepts, principles, and rules. He/She would also feel difficult to write, present properly, confused by different teachers in different lectures, or do two tasks simultaneously. Due to inattention, it is further tough for him/her to organize things and do homework.

Due to the above problems, your child cannot perform up to its fullest and would acquire low marks or grades, might even fail in exams, and might not even like to go to school or spend very less time there.

Impulsivity

Impulsivity refers to the state of being restless and hotheaded. Listed below are the ADHD symptoms placed under this category.

• Bursting out the answers, not even waiting for the question to complete
• Failing to await his/her turn when in group or play
• Interrupts others or interfere with others

Impact on Social Relationships and Self-esteem

If your child is highly impulsive, then he/she might speak without any prior thinking and interfere in the games of others. In addition, the child tends to change moods so frequently that others cannot make out what he/she will do next and burst out if frustrated.

Such behaviors will make her socially inept and therefore, he/she might start to feel rejected. Not only this, others will further take advantage of your child’s aggravated state and ignite him/her by bullying and pushing. This will further make your child aggressive. Repetition of such instances obviously results in low self-esteem of your child.

The worst part of this is that your child can be easily inclined towards alcohol, drugs, and other such addictive substances. This is because your child cannot think before acting and until the time he/she understands, it is already too late.

To overcome all these situations, the only need is of constant monitoring, counseling, and true unconditional love towards your child.

Impact on Parents

Your child tends to speak in such a manner that it might hurt or embarrass you. The fact that he/she is unable to wait for anything will lead into frequent interruption such that it might become intolerable for you. This can strain your relationship.

Calm, steadiness, patience, and true unconditional love are the sweet medicines for your child.

Impact on Education

One common behavior with regards to impulsivity is that your child interrupts frequently when the teacher teaches and tends to burst out with the answers. This applies brakes to his/her knowledge and understanding that results in low marks in tests. This will make her go down the progress line, which can further motivate her to burst with the answers even more.

Hyperactive

Listed below are the ADHD symptoms placed under this category.

• Fidgeting with hands or feet
• Fidgeting on the seat
• Leaving the seat frequently in the classroom
• Runs about excessively
• Feels difficult to playing quietly
• Talks too much

Impact on Social Relationships and Self-esteem

• Goes on and on about a topic
• Takes over a conversation
• Acts silly in a group in desire to obtain attention
• Damages other children’s belongings without any reason
• Hurts other children
• Lacks motor skills (for example, cannot throw a ball)

Following are the effects of the above behaviors.

• Makes him/her bossy, silly, clumsy, and rough to others
• Makes him/her appear the reason due to which the team will loss the game
• Becomes an entity of rejection and ignorance by others
• Reduces self-esteem of the child
• Forces him/her to bully to avoid being bullied

Impact on Parents

It might be wearing for you to keep looking after your child for his/her safety. Further, you might worry that it is my mistake due to which my child’s behavior is not as that of the other children.

If your child hurts you or damage some items, you might be just frustrated and yell at him like anything. Everything is likely to worsen your relationship with the child.

Impact on Education

Due to fidgeting, your child can miss new things and can become impatient to behave with teachers. This would result in stagnant knowledge that can affect the overall growth and development.

A specialist will obtain the necessary information from the child’ parents and school reports.

Questions to the Parents

A specialist will ask certain questions regarding your child. Listed below are the topics on which parents will be questioned.

• Child’s medical past, including even mental health problems
• Family history of ADHD and mental health problems
• Child’s development and temperament
• About ADHD symptoms and the time when you started observing them in your child
• Other problems that the child might have
• Relationship with your child (also of your partner)
• Parenting problems, if any

In rare cases, parents will need to examine their child’s behavior through a rating scale. This scale is similar to a questionnaire to detect the severity of symptoms.

Information from the Child’s School

After obtaining information from the parents, the specialist will need information from your child’s school teachers. The information will be collected about:

• Class behavior
• Academic achievements
• Relationships with other students
• Reaction to discipline and authority

Similar to parents, the teachers might be asked to use the rating scales to evaluate the behavior of your child.

Going Ahead with the Assessment

The specialist might need to assess your child to seek whether he/she is suffering from a physical disease that is the cause of the symptoms or making them severe. The other purpose of the assessment is to examine the mental state and find out the minute details required for identifying effective, but suitable medication. Gathering such details also aids the specialist to identify the need of other assessment, for instance, by a speech therapist or hearing expert.

Another type of mental examination might be conducted wherein the child’s mental abilities are assessed. This type of assessment is known as ‘psychometric’ assessment and measures certain mental abilities such as IQ, speech, and reading ability. More tests can also be conducted that measure attention, impulsiveness, depression, autism, learning disability, and dyspraxia (affects co-ordination). These tests are required because they can tend to hide the presence of ADHD symptoms in your child.

Rules for Diagnosing

During the process of diagnosis, the medical experts need to follow two unique sets of criteria. These are ICD-10 and DSM-IV-TR. However, there is no direct method of indicating that a person has ADHD. Therefore, although the two criteria are required for the diagnosis, the specialist must give his/her medical opinion.

ICD-10

ICD-10 refers to a collection of criteria laid down by the World Health Organisation (WHO) for diagnosing hyperkinetic disorder (ADHD is much more than this).

DSM-IV

The American Psychiatric Association has laid down the DSM-IV-TR criteria to diagnose different types of ADHD, such as hyperkinetic disorder (a severe one).

ICD-10 versus DSM-IV

Table 1.1 lists the differences between ICD-10 and DSM-IV

Fewer children who exhibit severe symptoms are diagnosed with ICD-10. This would indicate that these children who are diagnosed as having ADHD are not provided with the treatment. While, some experts are of the opinion that a broad range of people are diagnosed with DSM-IV.

Age of Diagnosis

It is quite difficult to diagnose ADHD in pre-school children, because they are commonly active, which cannot be counted as abnormal behavior.

Children at primary school are suitable for the diagnosis of ADHD. The diagnosis is done between the age periods of 5-11 years. During this period, the symptoms of ADHD are apparent and clear, as the rules and routine of a school make the symptoms come out very easily, which can be noticed immediately.

If a young child exhibits extreme hyperactiveness, this can be a green signal of a medical condition already persisting and negatively affect his/her development, for example, autism.

But remember, even teenagers and adults can have ADHD that needs diagnosis.

After Diagnosis

The first step after diagnosing a person as having ADHD is to devise a treatment plan. This might include medicines to be given, educational methods, behavioral therapy, and psychotherapy.

After assessing your child, the specialist will work with you, your child, and his/her teachers prior to initiating the treatment. During this period, he/she might give a score for different characteristics of your child’s behavior. This rating/assessment acts as a base or a parameter based on which the specialist can determine how much your child has improved in the near future due to the treatment. Actually, for each characteristic of the behavior, a target is specified by the specialist for you child. To measure the effectives of the treatment, the child is again scored on each aspect and this is compared with the figure/grade your child had scored before the treatment. For instance, you might be asked how many times your child beats his/her younger sister.

During the treatment, your child will be monitored regularly to:

• Measure the effectiveness of the treatment for the important symptoms
• Identify how much dose of a medicine is suitable
• Detect any side-effects of the medicines given
• Determine how well your child is integrating emotionally, educationally, and socially