Attention-Deficit/Hyperactivity Disorder (ADHD)

Attention-Deficit/Hyperactivity Disorder (ADHD)

Definition

• Neurodevelopmental disorder characterized by a persistent pattern of inattention and/or hyperactivity-impulsivity.

History of ADHD

• 1968 - DSM-II: Introduced the term Hyperkinetic Reaction of Childhood.
• 1980 - DSM-III: Renamed to Attention Deficit Disorder (ADD).
• 1987 - DSM-III-R: Expanded to Attention Deficit/Hyperactivity Disorder (AD/HD).
• 1994/2000 - DSM-IV: Standardized to ADHD with subtypes including
  • ADHD-PI (Predominantly Inattentive)
  • ADHD-PH (Predominantly Hyperactive-Impulsive)
  • ADHD-C (Combined Presentation)
• 2013 - DSM-5: Updated to Attention-Deficit/Hyperactivity Disorder (ADHD) with added specifiers indicating current presentation and severity.

Specifiers of ADHD

1. Predominantly Inattentive Presentation

• Fails to give close attention
• Difficulty sustaining attention
• Appears not to listen when spoken to
• Fails to follow through on tasks
• Difficulty organizing tasks and activities
• Avoids or dislikes tasks that require sustained mental effort
• Frequently loses items necessary for tasks
• Easily distracted by external stimuli
• Forgetful in daily activities

2. Predominantly Hyperactive-Impulsive Presentation

• Fidgets, taps hands or feet, squirms
• Problems remaining seated in situations where it’s expected
• Frequently runs about or climbs in inappropriate situations
• Inability to engage in activities quietly
• Appears driven by a motor
• Talks excessively
• Blurts out answers before questions have been completed
• Difficulty waiting for their turn
• Interrupts or intrudes on others’ conversations or games

Severity Levels

• Mild: Few symptoms, minor impairment.
• Moderate: More symptoms than mild, moderate impairment.
• Severe: Many symptoms, significant impairment.
• Severity is determined based on the total number of symptoms and their impact on functioning.

Symptom Presentation

• Symptoms must persist for at least 6 months.
• Several symptoms must be evident before age 12.
• Symptoms should be present in two or more settings (e.g., home, school).
• Must significantly interfere with social, academic, or occupational functioning.