Symptoms:
ADHD symptoms normally start in early childhood. According to the DSM-5, several symptoms must to be present before the age of 12. Many parents report excessive motor activity when their toddlers are around two years of age, but ADHD symptoms can be hard to separate from the normal active behaviour that is typical for kids under four years of age. When making a diagnosis, children should have six or more symptoms of the disorder present, with adolescents 17 or older and adults having at least five of the symptoms present. The DSM-5 lists three presentations of ADHD. These are predominantly being inattentive, hyperactive-impulsive, and combined. The symptoms for each are summarized below.
ADHD predominantly inattentive presentation
- Fails to pay close attention to detail or makes careless mistakes
- Has difficulty maintaining attention
- Appears not to listen
- Struggles to follow through with instructions
- Has difficulty with organization
- Avoids or dislikes tasks requiring sustained mental effort
- Loses things
- Is easily distracted
- Is forgetful in daily activities
ADHD predominantly hyperactive-impulsive presentation
- Fidgets with hands or feet, and squirms in chair
• Has difficulty staying seated
• Runs about or climbs excessively in children; extreme restlessness in adults
• Difficulty engaging in activities quietly
• Adults will often feel as if they are being driven by a motor
• Talks excessively
• Blurts out answers before questions have been completed
• Difficulty waiting or taking turns
• Interrupts or intrudes upon others
ADHD combined presentation
- The individual meets the criteria for both inattention and hyperactive-impulsive ADHD presentations.
These symptoms can change over time, so children may fit different presentations as they get older.
Confusing labels for ADHD
In 1994, the name of the disorder was changed, causing confusion for many people. All forms of attention deficit disorder are now officially called “Attention-Deficit/Hyperactivity Disorder,” regardless of whether the individual has symptoms of hyperactivity or not.
Even though these are the official labels, a lot of professionals and lay people still use both terms: ADD and ADHD. Some use those terms to designate the old subtypes; others use ADD just as a shorter way to refer to any presentation.
Severity of symptoms
As ADHD symptoms affect individuals to varying degrees, the DSM-5 now requires professionals diagnosing ADHD to include the severity of the disorder. How severe the disorder is can change during a person’s lifetime. Clinicians can designate the severity of ADHD as “mild,” “moderate” or “severe” under the criteria in the DSM-5.
Mild: Few symptoms beyond the required number for diagnosis are present, and symptoms result in minor impairment in social, school or work settings.
Moderate: Symptoms or functional impairment between “mild” and “severe” are present.
Severe: Many symptoms are present beyond the number needed to make a diagnosis; several symptoms are particularly severe; or symptoms result in marked impairment in social, school or work settings.
As individuals age, their symptoms may lessen, change, or take different forms. Adults who retain some of the symptoms of childhood ADHD, but not all, can be diagnosed as having ADHD in partial remission.