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Symptoms and Diagnosis of ADHD

Updated: Nov 6, 2023


A girl child with ADHD being evaluated by a speech therapist

If we wish to move to a framework of friendly neurodiversity, the term “socially awkward” must be removed. We are all different flavors of human. There is no one “standard” way to be.


Masking refers to an unconscious or conscious effort to hide and cover one’s own self from the world, as an attempt to accommodate others and coexist. Girls and women have been taught from an early age to “blend in".


Sensitivity implies a certain heightened reaction to external stimuli like, experiences, noise, chatter, others’ emotional expression, sound, light, or other environmental changes.


Sensitivity and high empathy are common experiences for many women, but some women experience these qualities to greater extent, in conditions like Asperger’s, ADHD, HSP(highly sensitive person), and other traits.


In a research, it was found that when Highly Sensitive Person's try to mimic others in what they perceive as “normal” —such as tolerating bright lights and loud music—they become exhausted, burned out, depressed, or develop symptoms such as headaches and fatigue.


Common behavioral practices seen in them:-

  • Being confused by the rules of accurate eye contact, tone of voice, proximity of body,body stance, and posture in conversation,

  • Becoming exhausted by conversations,

  • Preparing mentally for outings, excursions, meetings, and appointments, often days before a scheduled event,

  • Continually questioning the actions and behaviors of themselves and others,

  • Training themselves in social interactions through reading and studying other people

  • Having huge compassion for suffering (sometimes for inanimate objects),

  • Practicing/rehearsing what to say to another person before entering a room.


Stimming refers to movements—such as flapping the hands or tapping the fingers—in order to help relieve the anxiety that comes with overstimulation.


With ADHD the sensitivity is a bit different, high stimulation can be both exciting and confusing for people with ADHD, as they can get overwhelmed and overstimulated easily without realizing. Along with sensory regulation, emotional regulation becomes difficult, which can lead to sensory overload or “meltdowns,” common in ADHD, as with the autism.


Remember, despite what the words “attention deficit” imply, ADHD is not a deficit of attention, but rather a challenge of regulating it at will or on demand. Individuals with ADHD often have too much attention—just not at the “socially acceptable” times.


Types of ADHD

There are three sub-types of ADHD, which are:

  • Predominantly Hyperactive-Impulsive: increased symptoms of hyperactivity and impulsivity as compared to those of inattention, learning in the classroom is quithe difficult for these children as they disrupt the normal environment with their hyperactive and impulsive actions. There must be at least 6 symptoms of hyperactivity and impulsivity to categorize children in this subtype.

  • Predominantly Inattentive: more signs of inattention as compared to those of impulsivity and hyperactivity. Such children do not usually act out and may sit quietly doing their work. However, they have problems in getting along with other children, their ADHD may be overlooked due to their quiet nature. the symptoms of hyperactivity may be present but they do not predominate. This means at least 6 or more symptoms in the inattention behavior category and fewer than six in other two categories.

Girls are usually more often diagnosed with predominantly inattentive sub type.
  • Combined Hyperactive-Impulsive and Inattentive: They don’t show signs predominantly of one kind of behavior. Diagnosing someone with the combination type ADHD means they should exhibit at least 6 symptoms of each kind of behavior, that is, inattentive, hyperactive, and impulsive.

Most children have combination type ADHD according to the National Institute of Mental Health.

Symptoms of inattention may include a number of behaviors

The child may:

  • Be easily distracted

  • Miss detail or forget things

  • Switch from one activity to another frequently

  • Face difficulty in focusing on one task

  • Face difficulty in learning something new

  • Be easily bored in a few minutes with one task, unless doing something enjoyable

  • Not seem to listen when spoken to

  • Day dream

  • Be easily confused

  • Struggle with following instructions


Symptoms of hyperactivity may include behaviors such as:

  • Talking non-stop

  • Fidgeting in their seats

  • Playing with or touching everything and anything in sight

  • Constantly in motion

  • Trouble sitting still in school, during dinner or story time

  • Difficulty in doing quiet tasks


Symptoms of impulsivity may include behaviors such as:

  • Being very impatient

  • Showing emotions without restraint

  • Acting without regard for consequence

  • Blurting out comments that may be inappropriate

  • Difficulty in waiting for their turn in games or anything else

  • Interrupting other’s activities or conversation often


ADHD can significantly impact one's daily life, including school, work, and personal relationships. Early diagnosis is crucial for effective management and improved outcomes. I cannot emphasize enough on the importance of timely diagnosis of ADHD.


Techniques for Diagnosis of ADHD


1. Clinical Assessment:

It is often the first step in diagnosing ADHD. This involves a comprehensive evaluation by a healthcare professional, typically a psychiatrist or pediatrician. They will take a thorough medical and psychiatric history, along with discussions with parents, teachers, or caregivers to gather information about the individual's behavior and symptoms.


2. Diagnostic Criteria:

Diagnostic and Statistical Manual of Mental Disorders (DSM-5) outlined a specific criteria from r the diagnosis of ADHD. To be diagnosed with ADHD, an individual must exhibit symptoms of inattention, hyperactivity, and impulsivity (mentioned above) that are persistent and impair their daily functioning. The symptoms should be present for at least six months and occur in multiple settings.


3. Rating Scales:

Rating scales, such as the ADHD Rating Scale-5, can be valuable tools in assessing the ADHD symptoms. These scales help quantify the severity of symptoms and can assist in making a more accurate diagnosis.


4. Neuropsychological Testing:

Neuropsychological testing involves a series of cognitive and behavioral assessments to evaluate various aspects of a person's functioning, including attention, memory, and executive functions. These tests can help identify specific cognitive deficits associated with ADHD.


5. Ruling Out Other Conditions:

It's essential to rule out other conditions that may mimic ADHD symptoms, such as anxiety, depression, or learning disabilities. It helps reach an accurate diagnosis and plan appropriate treatment.


Importance of timely intervention in ADHD


  • Children and adults with ADHD can benefit from various treatment options, including behavioral therapy, medication, and psychoeducation.

  • A proper diagnosis can lead to accommodations and support in educational and workplace settings, helping individuals reach their full potential.

  • Individuals with ADHD often face difficulties in maintaining personal relationships, timely diagnosis and treatment can lead to improved interpersonal relationships and better family dynamics.

  • Living undiagnosed with ADHD can lead to frustration, low self-esteem, and emotional distress. Diagnosis and treatment can help individuals manage their symptoms and improve their emotional well-being.

  • Due to the constant stress faced by the individuals with ADHD, they can resort to substance abuse, academic underachievement, and mental health disorders.



References:

1. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5).







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