ADHD is one of the most commonly diagnosed disorders in children. Yet, in some kids its symptoms can be easily overlooked and/or erroneously dismissed. Find out exactly what are the ADHD symptoms in kids that you should look for. Know when it’s time for a professional assessment.
Are you wondering what a kid with ADHD looks like? It’s not necessarily the stereotype of a naughty child who can’t sit down that you might have in your head. You may be surprised to learn that it can cover a wide range of behaviors and personalities. Including kids who, superficially, seem like well behaved angels. Let’s take a closer look.
I have two kids with markedly different personalities. My youngest child is loud. Very loud. You can never miss his presence in a room. In photos, he likes to spread his arms and legs as wide as possible, as if he is about to give the whole world a hug. And he has this huge grin that jumps off the page.
While my oldest child, in contrast, is generally quite reserved. He rarely calls attention to himself. In photos, he’s often looking away from the camera, and sometimes looks quite solemn.
Both of these kids have been diagnosed with ADHD. Indeed, they have both been diagnosed with precisely the same presentation of ADHD.
ADHD Symptoms In Kids: The Overview
There’s an official handbook used by healthcare professionals to the diagnosis different types of mental conditions known as the DSM-5. And, the DSM-5 sets out the established criteria for diagnosing ADHD in kids. An ADHD diagnosis requires that a child show a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with his or her regular functioning in daily life across different settings.
The DSM-5 sets out three different types of ADHD:
- Combined (meaning both inattentive and hyperactive-impulsive)
The DSM-5 sets out a list of specific symptoms for each type of ADHD. To meet the criteria for an ADHD diagnosis, kids under the age of 17 must exhibit 6 out of 9 symptoms (for either or both categories). And, the symptoms must have been present for at least 6 months and be seen across more than one setting – so not just home or not just school.
These behaviors/factors count as symptoms if you basically observe them all the time. (Also check out our post on the ADHD facts of parenting an ADHD child.)
ADHD Symptoms In Kids: The Inattentive Presentation
Official DSM-5 Inattentive Criteria:
A child who often
- fails to pay close attention to details; makes careless mistakes.
- has difficulty paying attention to tasks and activities.
- doesn’t seem to listen when spoken to directly.
- doesn’t follow instructions and fails to complete tasks (e.g., loses focus or gets sidetracked when doing homework, chores, etc.).
- has difficulty organizing tasks and activities.
- avoids tasks that require sustained mental effort over an extended period of time.
- loses important items necessary for tasks or activities (e.g., school materials, pencils, keys, papers, glasses).
- gets easily distracted.
- is forgetful.
So, what might this look like in action?
A child who gets bored easily and often can’t manage to entertain himself.
Someone for whom homework sessions can seem tortuous (for all parties involved). Can’t work independently. Needs someone right there with him to stay on task. When you review the homework he’s done, it’s often filled with small errors from not paying attention to detail. Adding when he should have subtracted. Wrong punctuation, capitalization or spelling. Problems or instructions that seem to have been inexplicably skipped or missed.
And, when told to check his own work, he may review it but doesn’t see the errors.
Or, it could be a child who often forgets simple instructions in a short period of time. So, for instance, she goes upstairs to clean her room or put away clothes, but she forgets before she gets there. And you subsequently find her in her room doing something else entirely. And, your original instructions have not been followed.
Likewise, it might be a child who often seems spaced out and not paying attention to the task at hand. In group pictures, he often seems to be looking off in the wrong direction.
ADHD Symptoms In Kids: The Hyperactive-Impulsive Presentation
Official DSM-5 Hyperactive-Impulsive Symptoms:
A child who often
- fidgets with or taps hands or feet, or squirms in seat.
- leaves seat in situations when remaining seated is expected.
- runs about or climbs in situations where it is not appropriate (adolescents or adults may be limited to feeling restless).
- unable to play or take part in leisure activities quietly.
- Is often “on the go” acting as if “driven by a motor”.
- talks excessively.
- blurts out an answer before a question has been completed.
- has trouble waiting his/her turn.
- interrupts or intrudes on others (e.g., butts into conversations or games).
So what might this look like in action?
A child who cannot reliably respect personal space. He can’t seem to keep his hands and feet inside his personal bubble.
Or, perhaps a child who repeatedly breaks rules even though he knows the rules, knows the consequences, and cares about the consequences. A child who commits clear infractions and apologizes instantly. The apology seems sincere, yet the same thing keeps happening.
Similarly, it could be a child who seems to have an automatic physical response to unwanted situations. Hits, grabs, throws without time to think.
It could also be a child who’s extremely accident prone, even with specific warnings and cautions.
Or, it could also be a kid who seems to have boundless and relentless high energy levels. A child who constantly moves his body. An extreme fidgeter who always needs something to occupy his hands.
ADHD Combined Presentation
A child with a “combined” presentation of ADHD shows symptoms that fall within both of the above categories. The “combined” type of ADHD is the one most commonly diagnosed.
As it happens, both of my kids have been diagnosed with a “combined” presentation of ADHD. Which is one of the reasons I wonder how helpful this particular characterization actually is. Although both of my kids purportedly have a “combined” type, you have to stretch to see any similarities between them. The big kid clearly falls deeply in the “inattentive” box. If I were to assign a number, I would say he’s 90% inattentive and 10% hyperactive-impulsive. And the hyperactive-impulsive side is primarily just lots of fidgeting. Not jumping out of his seat fidgeting, but constantly having to do something with his arms and hands.
As for his little brother, I would say that he’s at least 98% hyperactive-impulsive. He easily hits all nine of those DSM-5 symptoms on a regular basis. And, as for signs of inattentiveness? The primary sign I observe there is that he may fail to complete an assigned task if left unsupervised. Meaning he has a tendency to get easily distracted without ongoing reminders.
But, experts says that ADHD symptoms can change over time, so his scope of inattentive characteristics may become more obvious as he gets older and moves farther along in school.
When ADHD Flies Incognito
If your kid seems to show a meaningful number of these symptoms, you should seek out a professional evaluation. But, don’t looks at these lists and think, well my kid only has 5 so I shouldn’t be concerned. Only a trained professional can accurately interpret and apply diagnostic criteria and make appropriate conclusions.
Some ADHD symptoms in kids can be disguised.
Keep in mind that you might be missing something or misinterpreting important nuances. Also, there are several conditions which share symptoms with ADHD and they can often hide or camouflage the ADHD. So, in getting your child evaluated, you may discover that he or she doesn’t have ADHD, but does have some other issues that need to be addressed.
Some examples of conditions that have symptoms similar to ADHD:
- Certain learning disabilities
- Anxiety disorders
- Auditory processing disorders
- Sensory processing issues
Some ADHD symptoms in kids can be easily overlooked.
Symptoms found on the list of criteria for “inattentive” ADHD can easily be overlooked, and are ones most likely to be dismissed. At first look, many of these symptoms seem like ones that can be overcome with more motivation and effort and so they get dismissed as signs of a potentially deeper issue.
And, it may also be easier to discount inattentive ADHD symptoms because of the issue of hyperfocus. Because of the phenomenon of hyperfocus that’s often seen in people with ADHD, a child can focus intently for extended periods of time on things that he finds particularly interesting or stimulating. For instance, a particular video game. When this happens, it starts to look like the lack of focus in other areas that he doesn’t really care about is more of choice. But neither the hyperfocus or lack of focus are actual choices.
When You Should Seek An Assessment
A diagnosis for ADHD requires more than reviewing a list of symptoms. So, if your child shows several of the recognized ADHD symptoms in kids, that’s just the start of the inquiry. The symptoms must occur on a regular basis at both home and school, or home and some other setting. They must have been present for at least six months or longer. And, the symptoms must create real problems with your child’s daily functioning.
If these factors ring true, you should follow up with a trained professional for an assessment.