Attention deficit hyperactivity disorder or ADHD is a hereditary chronic neurobiological disorder that can manifest itself at any age. The main symptoms are:

• Attention deficit
• Impulsivity
• Motor hyperactivity

ADHD (attention deficit hyperactivity disorder) is related to a malfunction in certain brain regions and effects on brain neurotransmitter levels, specifically norepinephrine and dopamine. Although the symptoms do not appear to be very serious, children with ADHD may suffer associated problems such as: decreased learning ability, poor school performance and failure, emotional problems such as depression, feeling of distrust, insecurity, behavioural and/or personality disorders, difficulties in family relationships, problems in their social relationships, etc.

This is why it is very important that early childhood ADHD is detected and the intervention started as soon as possible. Early intervention is one of the most determining factors of a good prognosis. Other factors that will influence the positive evolution of ADHD (attention deficit hyperactivity disorder) are:

• That the child’s parents and teachers are aware of the problem
• Using flexible but clear rules with these children
• Educational guidelines that take into account social reinforcement and the absence of physical punishment as a method to control behaviour
• Active teaching and flexibility in teaching methods
• Collaboration between the school and the family

Certain factors generally favour the negative evolution of the disorder, such as a family environment marked by stress, hostility and disagreements between parents, an overly permissive upbringing or, conversely, an upbringing where verbal and/or physical punishments are predominant. A low IQ and associated behavioural disorders (defiance, aggressions, etc.) are also negative factors for ADHD.

Some of the symptoms presented by children with ADHD also manifest themselves in the general population. What differentiates a child with ADHD from one who does not have the disorder is the frequency and intensity with which these symptoms appear and that they are maintained over time, interfering with the child’s school, family and/or social life.

Behavioural symptoms of ADHD

Off-task behaviour

A child with ADHD has many difficulties in correctly prioritising stimuli. This means that their attention is dispersed and altered when faced with any irrelevant stimulus. This greater difficulty in processing stimuli, and not laziness and reluctance, can make them demotivated by tasks (especially if they are repetitive). The most frequent off-task behaviours seen in a child with attention deficit hyperactivity disorder are:

• Not finishing tasks that have been started
• Making a lot of mistakes
• Not focusing on games
• It often seems they have not heard when spoken to directly
• Difficulty getting organised
• Avoiding tasks that require mental effort
• Often losing things they need (pencils, toys, books, clothes...)
• Being distracted by everything
• Careless in activities
• Forgetting everyday tasks such as doing homework, handing in homework, taking the right materials, etc.

Hyperactive behaviour

A child with attention deficit hyperactivity disorder (ADHD) has excessive uncontrolled motor activity without a specific purpose that goes beyond the normal limits for their age. This means they need to move more than would be considered normal for their age. In most cases, this motor restlessness reduces as the years go by, unlike a lack of attention and impulsivity, which are usually maintained over time. The most frequent hyperactive behaviours observed are:

• Continuously gets up from the chair
• Runs everywhere
• Finds it hard to do quiet play activities
• Is excitable
• Speaks excessively
• Constantly moves hands and feet

Impulsive behaviour

We can differentiate between cognitive impulsivity and behavioural impulsivity. The first refers to the impulsive cognitive style characterised by fast, inaccurate and poor processes of perception and analysis of information in complex tasks. The second, behavioural impulsivity, is linked to a lack of motor and emotional control, and causes the person to act without thinking about the subsequent consequences of their actions, driven by a desire for immediate gratification. This type of impulsivity is considered to be closely related to their degree of tolerance to frustration. In fact, it has been seen that children with ADHD show a low frustration threshold. Impulsive behaviour, along with a lack of risk awareness, make them more prone to accidents. The most frequent impulsive behaviours in a child with ADHD are:

• Difficulties waiting their turn
• Typically interrupting conversations or games

Cognitive symptoms of attention deficit hyperactivity disorder (ADHD)

These symptoms are related to cognitive disorders:

• Difficulty with controlled attention in new tasks that require effort, in relation to automatic tasks that are easy or familiar to them
• Difficulty in processing several stimuli simultaneously
• Difficulty in differentiating between relevant and irrelevant stimuli
• Difficulty in continuously maintaining attention
• Difficulty learning and remembering what they have learned as they process information superficially
• Sensitivity to variations in the context or working environment

Children with attention deficit hyperactivity disorder (ADHD) also present difficulties with organising information and learning difficulties (in reading comprehension and fluency, in calculating and solving mathematical problems, in writing and coordination, in following instructions and staying motivated).

• Low tolerance to frustration: the succession of frustrating situations combined with few successful experiences causes the child to develop a feeling of helplessness that makes him or her more intolerant of demanding situations
• Low self-esteem or seemingly inflated self-esteem
• Appearance of depressive feelings
• Childish behaviour, instability and frequent mood swings
• Seeks attention (often through disobedience or misconduct)
• Dependent on adult approval
• Difficulties in social relationships