In addition to this physicians, psychiatrists and clinicians are often unfamiliar with the subtleties of adult presentations of a classically childhood disorder.
It is difficult to describe the characteristics of children with Attention-Deficit Hyperactivity Disorder (ADHD) as the attributes are not unusual, but many of the symptoms are present in all children and adults to some degree at some particular time. What characterizes ADHD in children is the intensity, the persistence, and the patterning of these symptoms. If we talk about the disorders the most prevalent are the learning disorders, associated with the areas of reading, spelling, or math. Studies have shown that somewhere between 20 to 30 percent of ADHD children have learning disorders.
Among the psychological disorders are those classified as Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD). Studies performed in clinics (where children are often referred by schools and social agencies) indicate that about 35 percent of ADHD children have ODD, and more than 25 percent have CD. Clinics are more likely to see severe cases of ADHD, however. One characteristic of the ADHD child that is always present is easy distractibility or shortness of attention span. This difficulty is not as obvious as hyperactivity but is of greater practical importance. The ADHD child does not possess the concentration capability. Young children, in comparison to adults, are relatively lacking in the ability to concentrate and follow through on long and tedious tasks.
It is important to note that distractibility need not be present at all times. Often when the child receives individual attention he can attend well for a while. The teacher may report that he 'does well with one-to-one attention.' (Wender, 2000, p. 41) A psychologist may note that the child can pay attention during testing. A pediatrician may observe that the child was not inattentive during the brief office examination.
Many ADHD children can listen attentively for at least a little while. If the examiner, child psychiatrist, paediatrician, or psychologist does not realize the potential variability of such behavior, he or she may incorrectly come to the conclusion that the child is perfectly fine and that the parents and teacher are overreacting.
In some ADHD children, the distractibility may be concealed by the ability to stick with a particular activity for an unusually long period of time. Usually it is an activity they choose themselves. Sometimes it is a socially useful one (e.g., reading), and sometimes it is not. The child may seem to "lock on" and be undetachable or unusually persistent. The activity may be performed repetitiously for a long period of time. Such paradoxical behavior in an ostensibly distractible child may confuse a parent, who will ask, "How can he be distractible when he plays with his computer games for hours on end" The highly unsatisfactory answer must be: "We do
not know, but this is indeed the case."
In many ADHD children some of the more troublesome symptoms gradually diminish and finally disappear around the time of puberty; in some children such improvements