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ADHD Levels

By Rachel Elizabeth ; Updated August 14, 2017

Attention-deficit/hyperactivity disorder (ADHD) is a childhood disorder with difficulties in sustaining attention and controlling hyperactivity and impulsivity. According to the Centers for Disease Control and Prevention, 7 percent of children between the ages of 5 and 17 have a diagnosis of ADHD. There are three different levels or types of ADHD: predominantly inattentive, predominantly hyperactive/impulsive and combined type.

Predominantly Inattentive Type

According to the “Diagnostic and Statistical Manual of Mental Disorders,” 4th edition, text revision (DSM-IV-TR), children with the inattentive type of ADHD mainly demonstrate the following symptoms: 1. A lack of attention to detail and careless mistakes in their work. 2. Failure to listen when others are speaking to them. 3. Difficulty following instructions and finishing tasks. 4. Trouble sustaining attention on an activity. 5. Avoidance or dislike of activities that require concentration and effort, such as schoolwork. 6. Difficulty staying organized. 7. Becoming easily distracted by noise or events separate from their task. 8. Tendency to forget important items or routines, such as homework or brushing their teeth. 9. Often loses items, including toys, pencils, homework, etc. While they may also have some symptoms of hyperactivity and impulsivity, these symptoms are of lesser concern. As described by Robert Weis in “Introduction to Abnormal Child and Adolescent Psychology,” children with the inattentive type may be overlooked and diagnosed later because their behavior is not disruptive. They may appear forgetful and distracted, seeming unable to focus in class. Other children with this type may seem disoriented or daydreaming, unable to keep their attention on a task.

Predominantly Hyperactive/Impulsive Type

As described in the “Diagnostic and Statistical Manual of Mental Disorders,” 4th edition, text revision (DSM-IV-TR), children with the hyperactive/impulsive type mainly display the following symptoms: 1. Fidgeting or squirming in their chair. 2. Running or climbing constantly, at inappropriate times. 3. Leaving their seat during class or at home. 4. Seeming constantly on the move, with lots of energy. 5. Talking constantly. 6. Difficulty playing quietly. 7. Struggling to wait for their turn in games and activities. 8. Interrupting others or interfering with others’ activities. 9. Blurting out answers before the other person has finished speaking.

These children may also display symptoms of inattention, but these are not pervasive enough to warrant the diagnosis of the other type. According to Weis, younger children are more likely to be diagnosed with this type. It is thought that these children may later meet criteria for the combined type, but their symptoms of disruptive behavior are apparent earlier.

Combined Type

Children who meet the criteria for the combined type of ADHD demonstrate symptoms of inattention, hyperactivity and impulsivity. Essentially, they meet criteria for both of the previously mentioned types. As described by Weis, children with the combined type seem to be the most severely affected. They are perceived as distracted, constantly moving, impulsive, disruptive and disorganized. They struggle to inhibit their behaviors. The combination of problems in inattention and hyperactive and impulsive behavior leads to significant difficulties for these children. The majority of children with a diagnosis of ADHD have the combined type.

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