Attention deficit hyperactivity disorder (ADHD) is a developmental disorder that affects the behavior, attention, and learning of children. If it is unrecognized, these children can face excessive criticism, failure, and disappointment, while their parents struggle with what to do.
ADHD youngsters are easily distracted and have trouble concentrating. They may be impulsive and seem to act without thinking, touching objects that are off limits or running into the street to chase a ball without apparent regard for their own safety. In calm moments, they might know better. They may not cope well with frustration and can have dramatic mood swings. At school they may be fidgety and brimming with energy, finding it difficult to sit still, jumping out of their seat constantly, as if unable to control their perpetual motion. They often have difficulty with sequencing and organizational skills. Others who cannot concentrate may sit quietly, daydreaming and appearing "spaced out." Because of their behavior they may be rejected by other children and disliked by teachers; in the process, their report cards may be disappointing and their self-esteem may suffer, despite the fact that they are often as bright as their peers.
Over the years a variety of labels—minimal brain dysfunction, hyperkinetic/impulsive disorder, hyperkinesis, hyperactivity, and attention deficit disorder with or without hyperactivity—have been used to describe children with some or all of these behavioral problems. Now, most experts are using the term attention deficit hyperactivity disorder as a diagnosis for children whose behavior tends to be characteristically impulsive, inattentive, or a combination of both. Since all children have these traits some of the time, the diagnosis usually requires that the symptoms be present for at least six months by age seven, be evident in various situations, and be more intense than usually seen in other children of the same age and gender.
More than 6 percent of school-age children have ADHD. Boys outnumber girls. Researchers are examining multiple causes of the disorder, including heredity, brain chemistry, and social factors. Some researchers believe that children with ADHD have abnormally low levels and imbalances of certain neurotransmitters, the chemicals that convey messages between brain cells. Recent studies suggest that various parts of the brain may be functioning differently than in the majority of children.
Many ADHD children also have reading disabilities and other specific learning problems, which further interfere with their success at school. (Most children who have specific learning problems do not have ADHD.) Children with difficulties with language and memory have problems with schoolwork that are compounded when ADHD characteristics like distractibility and impulsiveness are present. A child with ADHD can affect his family in many ways. Normal family routines may be hard to maintain because the child's behavior has been so disorganized and unpredictable, often for a number of years. Parents may not be able to comfortably plan outings or other family events, not knowing what their child's behavior or activity level is likely to be. Children with ADHD frequently become "overexcited" and out of control in stimulating environments. They may also exhibit angry and resistant behavior toward their parents or have low self-esteem. This may be the result of the child's exasperation at failing to meet their parents' expectations or to manage day-to-day tasks due to ADHD symptoms.
School performance also suffers, and teachers complain to parents, who also must struggle with their child's difficulties with peers—conflicts, inappropriate behavior, and having few friends. The condition may produce enormous stress for families, who often search for physicians and others able to provide the care they need.