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ADHD in Children

Typical Features of Affected Children

Section titled “Typical Features of Affected Children”
  • Low self-esteem
  • Hot-tempered
  • Anxious, involved in fights
  • Sad, depressed
  • Temper tantrums
  • Anxious about things
  • Bossy
  • Feelings of guilt and remorse
  • Teased other children
  • No enjoyment of anything
  • Disobedient, rebellious
  • Easily irritated
  • Loss of self-control
  • Always followed others
  • Tendency to be unreasonable
  • Inattentive
  • Difficulties with authority
  • Shy, angry
  • Restless
  • Difficulty seeing others’ point of view
  • School difficulties/learning problems
  • Impairments in social adaptation

What Is NOT a Cause

Section titled “What Is NOT a Cause”

Parenting Recommendations

Section titled “Parenting Recommendations”

General parenting guidelines should be particularly observed with affected children. The approach of parents, educators/teachers, or other important caregivers should be characterized by:

  • Positive attention for appropriate behavior
  • Appropriate instructions and limit-setting in a clear manner
  • Appropriate negative consequences for conspicuous behavior

Diagnostic Indicators by Age

Section titled “Diagnostic Indicators by Age”

Pregnancy

Section titled “Pregnancy”
  • Risk factors, stress
  • Unusually strong fetal movements

Infancy

Section titled “Infancy”
  • Increased restlessness, heightened irritability
  • Excessively crying babies
  • Severe sleep disturbances
  • Feeding difficulties

Toddler Age

Section titled “Toddler Age”
  • Motor restlessness from walking age
  • “Since he started walking, he walks away”

Kindergarten Age

Section titled “Kindergarten Age”
  • Play difficulties: Impulsivity, lack of persistence
  • Frequent switching of activities
  • Massive problems with rule-based games and group activities
  • Aggressive behavior

Preschool Age

Section titled “Preschool Age”
  • Lack of social competencies
  • Full picture of ADHD

Parent Rating Scale (Ages 6-10)

Section titled “Parent Rating Scale (Ages 6-10)”

Based on the Parents’ Rating Scale (Wender PH, 1995, “Attention-deficit hyperactivity disorder in adults”, Oxford University Press)

Instructions: Rate the extent to which your daughter/son displayed the following behaviors between the ages of 6 and 10.

Rating:

  • 0 = not at all
  • 1 = somewhat
  • 2 = clearly
  • 3 = very much

ADHD probable with a total score of 12 or above

Rating Items

Section titled “Rating Items”
  1. Restless - overactive
  2. Excitable, impulsive
  3. Disturbed other children
  4. Did not finish things started
  5. Constantly fidgeting
  6. Inattentive, easily distracted
  7. Expectations had to be met immediately, easily frustrated
  8. Cried often and easily
  9. Rapid and extreme mood changes
  10. Temper outbursts, explosive, unpredictable behavior

Further Information

Section titled “Further Information”

If ADHD is suspected, a specialist medical evaluation should always take place. Diagnosis requires:

  • Detailed medical history (including childhood)
  • Interviewing caregivers
  • Standardized questionnaires
  • Ruling out other disorders
  • Possibly neuropsychological testing

Possible Consequences in Children

Section titled “Possible Consequences in Children”

Children with ADHD may experience:

  • Poor school performance and grades
  • Worse career prospects
  • Difficulty making contacts
  • Increased accidents
  • Legal infractions
  • Anxiety disorders and emotional difficulties
  • Increased arguments with parents

A significant proportion of hyperkinetic children also have considerable psychological problems in adulthood, including addiction, depression, and personality disorders.

ADHD and Giftedness

Section titled “ADHD and Giftedness”

Intelligent and especially gifted children with ADHD are, according to one view, often more severely affected than normally gifted ADHD children.

Why?

Section titled “Why?”
  • Thanks to their intelligence, they can adapt for a longer period
  • When they eventually fail, the impact is all the more severe
  • Life crises and depression can result

Risk Factors in Childhood

Section titled “Risk Factors in Childhood”

After: U.T. Egle, S.O. Hoffmann, M. Steffens - “Psychosocial risk and protective factors in childhood and adolescence”

The following factors increase the risk of psychological disorders:

  • Low socioeconomic status
  • Maternal employment in the first year of life
  • Poor parental education
  • Large families with very limited living space
  • Contact with “social control” institutions
  • Criminality or dissociality of a parent
  • Chronic family disharmony
  • Insecure attachment behavior after the 12th/18th month of life
  • Psychological disorders of the mother or father
  • Severe physical illness of parents
  • Single mother
  • Authoritarian paternal behavior
  • Loss of the mother
  • Frequently changing early relationships
  • Sexual and/or physical abuse
  • Poor contacts with peers
  • Age gap to the next sibling under 18 months

Protective Factors in Childhood

Section titled “Protective Factors in Childhood”

The following factors can have a protective effect:

  • Lasting, good relationship with at least one primary caregiver
  • Extended family with compensatory parental relationships
  • Relief of the mother’s burden
  • Good substitute environment after early loss of mother
  • Above-average intelligence
  • Robust, active, and sociable temperament
  • Secure attachment behavior
  • Social support (e.g., youth groups, school, church)
  • Reliably supportive caregivers in adulthood
  • Later formation of difficult-to-dissolve bonds
  • Lower overall risk burden