SOME OF THE FEATURES OF ADHD/ADD IN CHILDREN

Hyperactivity This is the feature most commonly associated with ADHD. However, many children with ADHD have no increased activity and some even have decreased motor activity. This feature will display itself in early childhood when the child is usually ahead of others in his mobility. He will move quickly and impulsively, constantly touch things or people and disregard instructions. The overactive child will have difficulty in cooperating in group activities and prefers to do his own thing.
At the age of about 12, the overactivity usually improves significantly and may even turn into under activity and an individual who rarely gets anything done. However, many ADHD children will grow into adults who undertake lots of different activities.

Impulsiveness This is often associated with hyperactivity and leads the child to act before he thinks. When they are young, impulsive children have no concept of danger and are at risk to themselves and others, leading to a large proportion of childhood accidents. Less extreme forms of impulsiveness can cause disorganisation and poor planning leading to children who never have the right equipment, who are always late or are in the wrong place. Impulsiveness in exams is a problem as the child often does not read the question properly. As the child grows up he often makes incorrect deductions and value judgements as a result of his haste.
Along with impulsiveness, ADHD children often display symptoms of impatience and intolerance. They experience great difficulty in waiting for anything & expect parents to agree to their demands immediately. A refusal is likely to lead to a temper tantrum. Frustration of their desires can lead to insistence, nagging and wearing down of the parent.

Attention Attention is the awareness that the child has for his surroundings and the alertness he has for changes to them. Children with attention span problems tend to be very easily distracted. In the classroom, they respond to all sorts of stimuli that others may not even notice. They are often restless or fidgety and frequently disturb other children. At home, they will change from one play activity to another and will be constantly on the move, unable to settle, even when watching television.

Concentration Concentration is the ability of the child to focus on one particular feature of his environment and direct his attention and thought processes solely to that feature. Children who cannot concentrate are usually day-dreamers who will focus on something of more interest to themselves, such as a forthcoming activity. They tend to be procrastinators who will generally put off until tomorrow what should be done today. They often have problems starting work assignments and also completing them. They are not as easily identified in the classroom setting because they are not disruptive, but simply ‘tune out’ and entertain themselves. At home, they often don’t appear to hear their parents because their thoughts are elsewhere. It is very often girls who display this feature, but it does also affect some boys.

Coordination Children with ADHD frequently have difficulty with coordination. Many have problems with fine motor coordination which affects their handwriting and doing fiddly tasks such as tying shoelaces. Gross motor skills are less often affected but can cause difficulties with learning usual childhood activities such as riding a bike, running or skateboarding. Hand-eye coordination can cause difficulties in copying from the blackboard and with ball sports and general clumsiness. Occupational Therapy should be provided for younger children with this problem.

Speech ADHD children may have some sort of speech or language dysfunction. This can include the delayed onset of speech, articulation difficulties or problems with sentence structure or the sequencing of sounds. There are often problems with poor written expression leading to difficulties in English.

Short-term memory Short-term memory is the part of the memory that retains new information and holds it for a period of time, anything up to a couple of months. If the brain receives the same information again within that period, it is reinforced and will be moved to long-term memory where it will be retained for a couple of years. When information is recalled, it is taken out of long-term memory and held in short-term while it is processed. Short-term memory is crucial to a child’s ability to learn; otherwise much of his learning will be forgotten. ADHD children almost invariably have a short-term memory deficit and this significantly affects their learning ability.
The difficulties seem to be mainly in the auditory sector so that they have more difficulty retaining spoken information than visual information, which is often retained really well. If they are given instructions they will often confuse the order, or forget part of them.
This can also have an effect on written and verbal expression. The child may lose some of his ideas whilst trying to formulate a sentence. The effect is often worse with written expression because of the difficulty of retaining information, recalling it mentally and then writing it down.

Inflexibility ADHD children often display an inflexible or dogmatic nature and things are usually either black or white, with no shades in-between. Once they have made a decision or taken a particular attitude, they find it very difficult to change it, even if the circumstances have changed. A change in the plans for the day, which may result from circumstances outside the control of the parents’, can result in a tantrum which is quite disproportionate to the actual event.
These children seem to have a lower frustration threshold than other children and are more easily upset than others. Their problems with adjustment to changes seem to also lead to great problems in handling choice. Offered a choice of sweets, after much deliberation, the child will choose one, only to demand a different one when he is actually given the original choice. This may appear to be a disciplinary problem but in a child with ADHD, it is part of the child’s poor ability to make a decision and stick with it.

Self-esteem This is a major problem for anyone with ADHD. As a child grows, developments in the brain allow him to develop an awareness of himself, and the value of himself, in relation to his environment and to other children of his own age in particular. Because of the dysfunction in the central part of the brain in ADHD, these children do not develop an appropriate self-concept that is found in other children.
This lack of self-esteem leads to awkwardness and unease when mixing with their peers, particularly in a group situation. It is usually easier to deal with only one or two friends at a time. This means that it is often difficult to build up a circle of friends in the normal way and this is exacerbated as the child grows older and reaches adolescence. By this stage their self-confidence may be virtually non-existent and they feel quite inadequate socially.
In order to gain acceptance by their peer group, they need to find ways of making themselves attractive to them. This means that they are much more easily influenced and led astray by other children, who are quick to recognise when they are dealing with someone who is inherently weaker than themselves and exploit this. The ADHD child is often ‘set up’ by others because of his desire to gain acceptance and because of his relative naivety and impulsiveness. They are much more likely to end up in trouble than their peers.

Social Immaturity Children with ADHD tend to be significantly more immature in their behaviour and social interaction. This is the case both at home and at school, but will be particularly obvious at school where they often act the class clown to gain the approval of their peers. They also seem to experience emotions differently or inappropriately, displaying an emotional immaturity.

Sleep Sleep disorders are fairly common in a child with ADHD. The most common one is difficulty in falling asleep at night which leads to the child resisting going to bed at night. Others wake several times during the night. Deep sleepers tend to have a restless sleep pattern, tossing and turning, talking in their sleep or even sleep-walking. This means that their sleep is not restful and they still feel tired when they wake in the morning. They can also suffer from night terrors.
There is a higher incidence of bed-wetting in children with ADHD than in the general population. This is probably due to the late maturation of the frontal part of the brain which controls bladder movement.

Appetite There are frequently problems with eating which often arise from taste or texture sensitivities and lead to strong likes and dislikes. There may also be associated gastrointestinal problems.