Top Five Attention Deficit/Hyperactivity Disorder (ADHD) Traits

1. Hyperactivity

Hyperactivity is when a child has excessive activity and movement. Toys and activities may not maintain your child’s interest for very long. Hyperactive kids can be exhausting. As a parent, you may think, “We have already been swimming and to the park, and my child is still wanting to go play soccer? I’m beat!” Perhaps they talk excessively, move constantly, and never sit still. For hyperactivity interventions see: Hyperactivity Course

2. Inattention

Inattention is when a child can not stay focused on a task or activity due to other distractions in the environment. If inattention is a concern, you may notice your child bounces from one activity to another, is easily drawn in by the noise of a car going by, or a bird chirping overhead. For inattention interventions see: Attention Course.

3. Distractibility

Internal distractibility is when kids get really focused on the ideas in their heads. For example, your child may get really interested in writing a story about horses and completely miss what the teacher is saying. External distractibility is when kids get easily pulled off task by sounds in the hallway or something else interesting going on in the room. Both types of distractibility are common in ADHD. 

4. Impulsivity

Impulsivity is when a child is unable to hold back on taking specific actions, even in the face of danger or negative consequences. Impulse control is the brain’s stop sign. An impulsive child has trouble thinking before acting. For impulsivity interventions see: Impulsivity Course

5. Disinhibition

Disinhibition is when a child is quick to act or overreact to situations. They have a lot of trouble limiting and filtering out their reactions. People might say that this child goes from “0-60 in 3 seconds flat” or “flies off the handle at the drop of a hat.” Kids with this issue are often quite emotional and are prone to meltdowns. For interventions regarding these emotional reactions see: Emotional Regulation Course

Individuals with ADHD might have challenges with schoolwork, homework, and interacting with others. It is considered the most common disorder of childhood.

Behavior problems associated with ADHD present significant challenges to schools and parents. For example, not handing homework in, having incomplete work, and missing directions are common teacher and parent complaints of children with ADHD. These challenges often continue into adulthood, with many adults with ADHD experiencing challenges with attention at work.

How ADHD is diagnosed in children

At least one of the two areas of symptoms (inattention and/or hyperactivity/impulsivity) must be present and causing challenges in multiple environments (home, school, extracurriculars, etc.) to be considered for a diagnosis of ADHD. 

If symptoms are present for inattention only, the individual is diagnosed with Inattentive presentation. If symptoms are present for hyperactivity/impulsivity only, the individual is diagnosed with the Hyperactive/impulsive presentation. If both sets of symptoms are present, the individual is diagnosed with the Combined presentation.

Clinical indicators of Inattention: makes careless mistakes, difficulty sustaining attention, not seeming to listen to directions or has trouble following instructions, losing focus easily and becoming distracted, disorganized, forgetful, losing important items, poor time management, avoiding tasks that require a lot of focus and attention

Clinical indicators of Hyperactivity/impulsivity: fidgeting, squirming, is often out of their seat, moving while in line, speaking out of turn, interrupting, running, and climbing when not appropriate, appearing to be sensory seeking.

Although the above symptoms of hyperactivity, impulsivity, and inattention are the primary terms used for diagnosis, experts like Russell Barkley believe that one important term has been left out of this list. That term is: disinhibition. If a child has a tendency to instantly react or overreact, without thinking about the consequences of their actions, they are disinhibited. 

Disinhibition is a significant…

…and most experts say the most significant

…sign of ADHD.

Intervention for ADHD

MANY, maybe even most, interventions for ADHD are not very effective. Unfortunately, parents are often shuffled around from to professional to professional without getting the clear guidance they need to help their kids. 

THE WAIT IS OVER. YOU ARE HERE.

Research from the nation’s foremost experts like Dr. Russell Barkley has shown that parent compassion and parent training is the most essential intervention for ADHD. Many of the therapies that cost thousands of dollars don’t actually work. However, parent training and direct intervention does work.  

When parents have a clear understanding of the symptoms and needs of their kids, things start to change.

These changes can be quick and can make a drastic difference. 

Now that you have started learning, you can decide on a few symptoms to target based on what you learned. For example, we host an Impulsivity in Childhood intervention course, a Hyperactivity in Childhood intervention course, and an Inattention in Childhood intervention course. Now that you have begun the journey, things can start to improve. 

Research on ADHD Interventions

Although many interventions are available, only a few have been validated with enough research to be named Tier 1 “Best Support” by the American Academy of Pediatrics. 

Those interventions include the following options: Medication, Behavior Therapy, Parent Management Training, Biofeedback, and Self-verbalization. A combination of these therapies has been known to help many children and adults with ADHD. 

For many children, intervention becomes the difference between success and failure in school. 

The ability or inability to stay on task and to hold back impulses is not unique to school; in fact, it often carries over into social settings.

Interventions can help many children increase their self-esteem and have greater success with peer relationships. 

Tests for ADHD

The Test of Variables of Attention (TOVA): This test is an individually administered computerized test of attention and impulse control that is used to diagnosis and monitor interventions for ADHD. The TOVA is appropriate for individuals from age 4 to 80+ years. TOVA can be administered in two formats, visual and auditory. Both formats measure the person’s ability to sustain their attention and to inhibit their impulses in the absence of immediate reinforcement.The TOVA is an objective, neurophysiological measure of attention. 

Conners’ Continuous Performance Test (CPT): This measure is shorter and may be more practical for a young child unable to complete the TOVA. 

NEPSY-II: This measure contains subtests to measure Attention and Executive Function. It is individually administered with both oral and visual subtests. The NEPSY looks at motor persistence, the ability to hold back impulsive responding, cognitive flexibility, and the ability to start tasks and to self-monitor behavior. 

Others that may be used: A number of rating scales can screen for symptoms of ADHD, including BASC-3, BRIEF, as well as the Conners’ 3 rating scales. Looking across measures at various symptoms, the clinician will determine whether or not your child’s symptoms are significant and what the explanation may be for those symptoms.

Where to go for help for kids with ADHD

YOU are your child’s best asset and resource. The time you take learning about how to understand your child and support their needs at home is worth more than any therapy. In addition, the following resources are potentially helpful as well. 

Cadey Courses. Taught by child psychologists Dr. Anna Kroncke and Dr. Marcy Willard, Cadey Courses provide step-by-step guidance for parenting a child with ADHD or related symptoms. These courses can be appropriate for parents of children aged 5-18. Curriculum may include topics like impulsivity, hyperactivity, focused attention, and an ADHD symptoms assessment course.

A referral for a comprehensive neuropsychological evaluation is most appropriate when concerns are suspected about ADHD. This type of assessment includes the evaluation of attention, cognitive ability, adaptive skills, executive functioning skills, academic profile, social skills, and sensory processing. Other areas may be evaluated as concerns arise. 

Taking a comprehensive neuropsychological report to the following professionals will help them to get an understanding of your child and their specific needs. Next, it’s important to consider how these therapies fit together and how different skills are being built and addressed to best support your child. 

Psychiatrist. It is estimated that at least 85% of children diagnosed with ADHD are treated with stimulant medication. For most children and adults with ADHD, stimulant medication reduces some of the core behavioral characteristics associated with disorder, including hyperactivity, impulsivity, and distractibility. 

Behavior Therapy/ Parent Training. Behavioral therapy develops a set of skills in children and parents to increase attentive, desired behaviors and/or to decrease impulsive problem behaviors. 

Parent Consult. Parent consultation can follow behavioral therapy or the Family Systems model and can provide guidance to families on strategies to use, systems to set up, and principles of reinforcement. Consultation can also focus on the parent’s experience and emotional well-being. 

School Services. School-based supports like an IEP or a Section 504 plan can help your child receive accommodations and modifications that they may require to access learning in the classroom setting. 

Outcomes

Although ADHD presents a myriad of challenges to children and families, interventions tend to be successful at treating many of the challenges associated with the disorder. 

Indeed, for many children, medication and organizational support allow them to be successful in school and beyond. Early intervention can help individuals develop strategies and systems to manage their inattentive symptoms and curb their impulsivity. Such supports allow for gainful employment and interpersonal success as an adult.