Attention Deficit Hyperactivity Disorder (ADHD) is one of the most studied and prevalent mental disorders in childhood. Its core symptoms include inattention, hyperactivity and impulsivity. These manifestations are frequently associated with other problems and difficulties, such as learning disabilities and difficulties at school, disruptive behaviour disorders, autism and emotional/relational problems, such as anxiety and depression.
ADHD is generally recognised in childhood, but its symptoms persist into adolescence and adulthood in more than half cases. Despite the high prevalence (at 3-7% according to the Diagnostic and Statistical Manual of Mental Disorders, DSM-IV-TR, APA 2000) there is a certain reticence in diagnosing this disorder in the clinical practice, especially with regards to the Italian context.
Children with ADHD generally present the following characteristics:
1) Inattention: consists in the difficulty in paying attention and being concentrated in everyday activities. ADHD children are frequently distracted by external stimuli and are more likely to commit errors due to distractions. Teachers usually report that they cannot follow instructions and are always distracted. However, inattention is not present in every occasion: when highly stimulated and engaged in highly interesting activities, ADHD children can actually sustain attention and obtain good performances.
2) Hyperactivity: refers not only to the need of keeping high levels of activity, but also to the disorganisation and to the lack of purposes in what they are doing. They generally jump from an activity to another, are in constant motion and cannot stay still even for a short time. They mainly differ from other children in the inability to inhibit their motion in situations when this is required.
3) Impulsivity: represents the inability of thinking before acting, planning actions and foresee the consequences of actions. Children with ADHD find it particularly difficult to wait for their turn and to respect the rules at school or in peer interactions. They generally answer questions precipitously and interrupt people whilst they are speaking or doing something. For these reasons, impulsivity is often one of the main issues that make the relationships with family members, teachers and peers very difficult.
It is extremely important to discriminate children with mild problems of inattention and hyperactivity from those in which these symptoms are pronounced and are likely to cause great impairment with relatives, friends and at school. Early and careful identification of the disorder is therefore crucial in order to offer to ADHD children and their families an appropriate rehabilitation and treatment.
By Giorgia Michelini
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th edn. Text Revision ed.). Washington, DC, USA: American.