Lack of Attention vs. ADHD: How can parents tell the difference?

By Margo Anderson

In the past decade, the diagnosis of Attention Deficit Hyperactivity Disorder, or ADHD, has become more and more common. According to the Center for Disease Control, in 2011, 1 in 5 boys and 1 in 11 girls of high school age had been diagnosed with ADHD at some point in their lives. That’s a full 2 million more students than just eight years earlier. 

As stated by the CDC, while researchers do not know what causes ADHD, it is believed that it is a combination of genes and a number of environmental factors such as brain injury, exposures to substances like lead, alcohol, and tobacco during pregnancy, premature delivery, and low body weight. There is no research to support the theories that too much sugar, too much TV, or family chaos causes ADHD, though they may make it worse in those who already have it. 

Individuals with ADHD often have difficulty paying attention and tend to be hyperactive and impulsive. These challenges continue throughout adolescence and adulthood. As described by the National Institute of Mental Health, ADHD has three key features: inattention, hyperactivity, and impulsivity. Inattention includes being easily distracted, being forgetful, missing details, having trouble focusing on one thing, being bored after a few minutes, having trouble focusing on completing a task, not being able to listen, daydreaming, difficulty processing information, or struggling to follow instructions. Hyperactivity includes fidgeting, nonstop talking, dashing around, and difficulty doing quiet tasks. Impulsivity includes being impatient, making inappropriate comments or emotions, having a lack of regard for consequences, interrupting, and having difficulty waiting. An individual with ADHD may show symptoms that fall largely into one category or show symptoms within each category. 

In general, most symptoms of ADHD are apparent before age 7. But many of the signs and symptoms of ADHD could be considered normal behaviors for anyone at certain times, particularly for children that age. Therefore it can be difficult to distinguish between ADHD and typical development. 

The National Institute of Mental Health does offer some helpful distinctions between typical growth and ADHD. The signs and symptoms of ADHD generally last longer than 6 months and continue throughout the day. That is, all children get excited when they get to go out to their favorite restaurant or go to the park and all children get nervous when they have to get a shot or bored when they have to sit in class for hours at a time. A lack of attention or hyperactivity in certain circumstances is not out of the ordinary. But inattention or hyperactivity during other times too may be out of the ordinary. The signs and symptoms of ADHD are more severe than the behavior of others the same age. The Children’s Physician Network states that a normal attention span is roughly 3 to 5 minutes per year of age. So a 2 year old should be able to keep occupied for at least 6 minutes while a 5 year old should be able to keep occupied for at least 15 minutes.  It is also important to ensure that there are no other explanations for a behavior such as a seizure disorder, undetected hearing or vision problems, learning disabilities, medical issues that affect thought or behavior, anxiety or depression, or a significant or sudden life change. 

If it turns out that a child does have ADHD, there are several things a parent can do to help. ADHD can be treated with psychotherapy, special programs in school, and, if necessary, a variety of stimulant medications. Of course, it is always important to consult a physician before putting a child on any kind of medication.  A full neuropsychological evaluation to rule out other causes of attention deficits is also recommended. There are also a number of steps that parents can take at home. First, parents should be clear and consistent about the expectations and maintain firm discipline when a behavior is unacceptable. Discipline should not be physical and children should not be punished for doing things that they cannot help. It is also important to buffer the child against harsh criticism by other parents. A reward system should be in place for good behavior. Second, parents should provide an outlet for the child’s energy, such as an outdoor sport. It is also helpful to stretch the child’s attention span by reading a story or playing a game together. A structured routine can help a child with ADHD to maintain order. Finally, it is important for any parent to allow time for oneself without the children, as no parent can be their best when they are exhausted. There are also several parent education classes available across the country such as those found at www.chadd.org.

Lowe & Liebich Psychology Associates have psychologists and therapists who specialize in the assessment and treatment of ADHD.  If you would like your child to be evaluated or are interested in child or family therapy, please call us at 630-791-0118.