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Is It ADHD, Or Is My Child Just A Bundle Of Energy?

Tribune photo by VICTOR JUNCO

ADHD, sometimes referred to as attention deficit disorder, is one of the most common neurobehavioral disorders of childhood.

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By BERNEY WILKINSON, PhD Tribune correspondent

The Tampa Tribune

Published: June 27, 2008

Attention deficit hyperactivity disorder, sometimes referred to as attention deficit disorder, is one of the most common neurobehavioral disorders of childhood. Data from the Centers for Disease Control and Prevention suggest that in 2003 nearly 8 percent of children and adolescents between the ages of 4 and 17 were diagnosed with ADHD. That translates into more than 4.4 million kids. While this is quite a large number, many more children and adolescents evaluated each year do not meet the diagnostic criteria for ADHD.

This raises a question: How can you tell the difference between hyperactivity and ADHD? Is your 8-year-old son showing signs of ADHD, or is he just a rambunctious boy with lots of energy? Let's walk through three important components (aside from the specific diagnostic criteria) that can help differentiate the two.

First, consider the developmental appropriateness of the behavior - that is, how similar is your child's behavior compared with what would be expected at his or her age? Until the ages of 5 or 6, many kids have an abundance of energy. In fact, in the typical kindergarten classroom, teachers incorporate many activities to keep kids moving and changing tasks. In general, it is normal for children, at one time or another, to have trouble focusing and behaving. However, by age 8, overactive behavior - such things as excessive fidgeting, difficulty remaining seated and taking turns, excessive talking and interrupting others - is likely to be developmentally inappropriate.

Second, examine where the behavioral problems occur. Is the child overactive at home, but well-behaved at school, church, and in other social settings? Does he or she get into trouble at school, without being disruptive at home? This is an important diagnostic consideration because ADHD is a disorder that affects a child's behavior in various settings. If a child's problem behavior is limited to one environment, it is likely an issue with the behavioral management strategies used in that setting rather than a disorder.

Finally, evaluate whether the behavior interferes with the child's ability to function in everyday life. If a child is overactive, it doesn't mean there's a problem. In children with ADHD, this overactive behavior prevents the child from meeting the expectations of their home, school and other environments. For example, while they can attend to video games and TV for hours on end, kids with ADHD often resist or procrastinate when given chores or tasks that require concentration and focus, such as homework.

A diagnosis of ADHD is a several-step process, requiring more comprehensive evaluation than just these three variables. Other conditions, like anxiety, depression and certain learning disabilities, can present similar symptoms. If an overactive child meets these three criteria, I would encourage parents to take the child for a full evaluation by a licensed mental health provider, including a child psychiatrist or a psychologist.

For information, check out the National Resource Center on AD/HD's Web site sponsored by the CDC at www.help4adhd.org. The center is a program of Children and Adults with Attention Deficit Hyperactivity Disorder.

Berney Wilkinson is a clinical psychologist and assistant professor of psychiatry at USF Health's Silver Child Development Center.

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