Attention Deficit Disorder (ADD) affects 5% of children and 2.5% of adults in the United States, according to the American Psychiatric Association.
Although more commonly diagnosed in children, it is sometimes recognized later in life. There are treatments but no cure, so it persists into the teen years and through adulthood.
According to WebMD, there are three main symptoms of ADD.
- – Inattention
- – Hyperactivity
- – Impulsivity
These symptoms manifest themselves in different ways in children, teens, and adults. Girls and women may show different symptoms than boys and men. Recognizing the symptoms can help lead to a diagnosis and treatment for this perplexing disorder.
ADD Symptoms in Children
It can be difficult to recognize the symptoms of ADD in children, particularly if they are the first child in the family, or if they are very young. Children develop at different rates, and some children with ADD may simply appear to be reaching some developmental milestones later than their peers. Parents and physicians may interpret ADD symptoms as ‘typical kid behavior.’
Each of the three main symptoms of ADD can appear in various ways in children. A child does not have to exhibit all of these characteristics to receive a diagnosis of ADD, but they will need to show several of them.
Inattention in young children may be difficult to recognize as the ability to pay attention is a trait that develops in children at varying rates. If a child has difficulty attending, it may not be obvious until the child is in school. A child with ADD will have difficulty following directions, paying attention to detail and staying on topic. They may make careless mistakes. They may have difficulty staying organized, and forget appointments or scheduled activities.
Children with inattention are easily distracted. They may find it nearly impossible to pay attention to what is going on in their school classroom if, for example, there is something unusual going on outside the window. They may have difficulty focusing on things they are not interested in but may become hyper-focused on things that they find fascinating.
All children, particularly toddlers and preschoolers, seem to have boundless energy. That’s why it can be so difficult to identify those who have hyperactivity associated with ADD.
Children with hyperactivity will constantly run, jump, and climb, even when it is not appropriate. They will squirm and fidget when they have to sit for any length of time. Some parents describe their children with hyperactivity as being ‘driven by a motor,’ stating that it is nearly impossible at times to get them to stop moving.
The ability to control impulses is also age-related in children. Toddlers cannot control their impulses very well, and preschoolers are just learning to do so. By four or five years old, however, a child should be able to wait their turn and refrain from interrupting, although they may need to be reminded to do so.
A child with ADD who is impulsive, however, has much more trouble controlling their impulses. Even with repeated reminders, they may interrupt others and blurt out answers or comments while someone else is still talking. They may also talk incessantly without pausing to let the other person respond.
The Centers for Disease Control provides a checklist for ADD symptoms. This checklist is helpful for parents and teachers who may have concerns that a child has ADD. The questions are very specific, and it is carefully noted that not all of the symptoms need to be present for a diagnosis of ADD to be indicated.
One of the points made in the checklist is that ‘There is clear evidence that the symptoms interfere with, or reduce the quality of, social, school or work functioning.’ This is key to a true ADD diagnosis, since some young children can behave appropriately in at school, for example, but not at home, which may indicate a cause other than ADD.
Determining if a Child Has ADD
Since many of the symptoms of ADD are similar to typical ‘kid’ behavior, it can be challenging to determine whether your child has ADD or is just an active youngster. The Centers for Disease Control checklist can help parents to identify if a child has ADD.
The checklist is quite detailed, but it breaks down into the three categories discussed earlier. It asks about specific situations and traits associated with each of the categories.
- Inattention – difficulty staying on task; not listening when spoken to; failure to finish projects, activities or homework; trouble with organization; distractibility or forgetfulness. Inattention may be offset by exceptional focus on certain tasks or in certain areas, to the exclusion of other activities.
- Impulsivity – blurting out answers before the question has been finished, difficulty with taking turns, interrupting others, talking excessively.
- Hyperactivity – fidgeting or squirming when seated, getting up from a seat before the activity is over, running and climbing excessively, acting as if ‘driven by a motor.’ The hyperactive child is may be unable to stop moving even when the situation warrants it, or when they want to.
Some symptoms of ADD may not be obvious. In school, for example, a child may appear to be paying attention in class, but their mind may be elsewhere.
They may insist they do not understand a homework assignment or the material on a test, when the problem may be that they cannot organize themselves well enough to complete the assignment or sit still long enough to take the test.
If a parent is concerned that their child is displaying symptoms of ADD, it may be best to observe the child interacting with their peers. If it seems that the child is the one who is always being corrected or redirected, or cannot follow the directions that the other children can, it may be time to seek a professional opinion.
Other children may display one or two or the characteristics described in an ADD diagnosis, but a child who has ADD will display most of them.
Symptoms of ADD in Teens
Since ADD does not go away, children who are diagnosed will still have the disorder as teenagers. Sometimes, ADD is not diagnosed until the teen years, particularly in girls.
While the basic symptoms of inattention, hyperactivity, and impulsivity are the same in teens as they are in children, the consequences of these symptoms can be quite different, according to WebMD.
The combination of the changing teenage mind and body, the increased responsibilities of work and driving, and the temptations of drinking and drug use combine to make the teen years particularly challenging for those with ADD.
The hormonal changes of puberty and adolescence may make ADD symptoms worse. Medications that have worked for years may suddenly become ineffective. Teens who struggle with impulsivity may have always had challenges maintaining relationships, and those stakes may be higher in the teen years.
Driving is riskier for teens with ADD as they have trouble attending to the task at hand and may be easily distracted. WebMD says that teens with ADD may be two to four times more likely to have a car accident than other teens.
Studies have found that teens with ADD are more likely to abuse alcohol and drugs other than marijuana than other teens. Some common ADD medications have warnings about interactions with alcohol, making this an even greater concern for some. Teenagers with ADD may also be at greater risk of developing depression and eating disorders.
Parents who have a child who received an ADD diagnosis at a young age should be on the lookout for changes in the child’s mood or behavior during the teen years. Other parents may want to watch for signs of ADD, including low self-esteem and risk-taking behavior.
ADD Symptoms In Men
The symptoms of ADD may be more difficult to spot in adults that in children, according to WebMD. Although the disorder may manifest itself differently in adults than in children, the symptoms fall into the same three categories.
Adults with ADD often exhibit signs of inattention, which can interfere with their daily lives. They may have difficulty getting organized, so they may miss appointments, forget to pay bills and be late turning in projects at work.
Because of the attention required and the need to sit still, driving can be a challenge for adults with ADD. They often get more speeding tickets, have more traffic accidents and may lose their licenses more frequently than those without ADD.
Distractibility in adults with ADD often looks the same as it does in children, but the stakes are higher. Being distracted while at work or while driving can have serious consequences for adults.
Hyperactivity may not be as pronounced in the adult with ADD as it is in children. As adults, we tend to be more aware that jumping on the couch is typically not appropriate behavior. However, we all know that person who fiddles with their pen or taps their foot throughout meetings, looking more and more uncomfortable as the meeting wears on. This person is likely to have ADD.
Doing things without thinking them through and saying whatever pops into your head without considering how it might make someone else feel are hallmarks of ADD. These traits may lead to marital problems for those with ADD. They may also struggle to get with people at work, or have difficulty keeping a job.
Adults with ADD may take more risks than those without the disorder. Adults who display both hyperactivity and impulsivity may take part in extreme sports or other risky endeavors.
Identifying ADD in Adults
ADDitude Magazine) offers a test to help adults determine if they have ADD. It asks about each of the three broad areas of ADD symptoms, citing specific examples of when they might occur.
- Inattention – Do you have trouble seeing tasks or projects through to completion? Do you sometimes ‘zone out’ during long conversations, finding it difficult to concentrate on what is being said? Are you unable to reach your goals, despite your best efforts?
- Hyperactivity – Do you find yourself swinging your leg or tapping your pen, or working off nervous energy in some other way? Do you drive too fast, engage in extreme sports, or take risks in other ways?
- Impulsivity – Do you make decisions without thinking them through? Do you engage in any compulsive behaviors, like excessive drinking, gambling or shopping? Do you say or do things without thinking that make others angry?
The test also asks about self-perception, such as whether you think others see you the way you see yourself, or if you think you have lower self-esteem than others.
ADD Symptoms in Women
According to WebMD, the symptoms of ADD in women may be very different than those in men. Women with ADD often struggle at home, finding it difficult to complete tasks and get and stay organized. They may feel overwhelmed with all the demands placed on them by work and family.
Women tend to have more symptoms of inattentiveness, and fewer symptoms of hyperactivity and impulsivity. For this reason, and because ADD is more often diagnosed in boys, many women are not diagnosed until they are in college, or even later.
This may be because the symptoms of inattention are more subtle than the other symptoms of ADD. Girls often learn to disguise their symptoms during their school years, so they are not diagnosed until later.
According to ADDitude Magazine, women with ADD may feel overwhelmed in public or crowded places, finding it difficult to shut out distractions. They may feel as if their life is out of control, and that they are unable to meet the demands that are put on them.
Organizing the household can be very challenging for women with ADD. They may struggle with tasks like balancing the checkbook or maintaining the family calendar. They may feel as if they are covering up their shortcomings or trying to ‘pass’ as someone they are not.
Women with ADD may have difficulty maintaining relationships, which can lead to social isolation. They may be more susceptible to eating disorders, depression, and anxiety.
Because the treatments for these symptoms can be very different for those with ADD than for those without it, it’s important to determine if a woman has ADD. It could explain many other conditions, making it somewhat easier to treat them all at once.
Executive Function and ADD
Teenagers and adults with ADD struggle with executive function skills. These are the skills that help us to get and stay organized and to perform multi-step tasks in the correct order.
According to ADDitude Magazine , executive function skills appear around the time of puberty. Until this time, children cannot reliably plan and execute complex tasks, which is why an executive function deficit usually doesn’t show up until late adolescence or adulthood.
There are six steps in a complex task, and these make up the six areas of executive function. They are:
- – Analyze the problem or task.
- – Plan a way to solve or address the problem or task.
- – Organize the steps that need to be taken to complete the task or solve the problem.
- – Develop a timeline for completion.
- – Adjust the plan if necessary.
- – Complete the task or solve the problem on time.
Someone with an executive function disorder may have difficulty completing one or many of these steps. They may spend an inordinate amount of time on one of the early steps, like analyzing or planning, and then be unable to focus on the remaining steps in order to get the task completed.
Behavior modification is commonly used to overcome deficits in executive function, and it can be very effective. When faced with a complex task that seems overwhelming, it may help to break the task down into smaller segments and devise a way to complete the segments in the correct order.
Use of visual planners to map out the task are often helpful. Many people find that they have one time of day when they are more productive than at other times, so reserving those few hours for complex tasks may allow those with executive function deficits to be more efficient.
Many people who have an executive function disorder also have ADD, but some have only the executive function disorder. These people have no problem sitting still and tend not to be impulsive, but they have similar organizational challenges to those with ADD.
The medications that are typically prescribed for ADD, such as stimulants, may not work on executive function if it is not part of an ADD diagnosis.
If you recognize these symptoms of ADD in yourself, your child, or another loved one, seek professional help. Your primary care physician should be able to recommend a practitioner who is experienced in identifying and treating ADD.
With a combination of behavior modification and medication, those with ADD can significantly improve their quality of life.