Children may be brought to the physician directly by parents or may be referred by their teachers. The presenting complaints may include over activity, disruptive behavior at home and classroom, academic underachievement, inattention and risky behavior. All over activity is not ADHD. Typically young children can be hyperactive. It is known that depressed parents may perceive normal activity in their children as hyperactivity. A good history and information from multiple informants like parents, teachers and observation across settings is essential to arrive at a conclusion .Getting information from various other sources is always desirable to improve the accuracy of diagnosis and avoid misdiagnosis/ over diagnosis/ under diagnosis .

Useful sources for information

  • Parents and care givers
  • School report (classroom behavior ,  teacher’s rating scales),
  • Report of  behaviour on social occasions,
  • Comments/criticism by relatives/friends,
  • Description of a typical day including instrumental activities of daily living,


The key elements included in a thorough assessment are –

  1. The presenting symptoms,
  2. Differential diagnosis,
  3. Medical and psychiatric history,
  4. Perinatal and developmental history,
  5. Personal-social history
  6. Family history,
  7. Child’s version of the problems and mental status examination.
  8. Medical evaluation – especially before starting treatment

Children with ADHD also may struggle with low self-esteem, troubled relationships and poor performance in school. Symptoms sometimes lessen with age. However, some people never completely outgrow their ADHD symptoms. But they can learn strategies to be successful.

1. Hyperactive/impulsive

This type occurs when a person has symptoms of hyperactivity and impulsivity but not inattention.
Children with this form of ADHD have tons of energy and are constantly moving in a way that causes problems. It’s diagnosed if a child under age 16 has 6 or more hyperactive/impulse symptoms for at least 6 months (5 or more for older teens). This form is more noticeable than the inattentive type.

Symptoms include:

•Blurting out answers before a question is finished
•Constantly interrupting others
•Trouble waiting his turn
•Talks too much
•Fidgeting, tapping, and squirming
•Gets up when it’s not appropriate (such as when the teacher is talking or in the middle of dinner)
•Running or climbing in inappropriate situations
•Unable to play quietly

2. Inattentive
3. Combined


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