Symptom development in children by age and frequency
- 1. Symptom development of ADHD-HI (with hyperactivity) by age
- 2. Symptom frequency and symptom intensity in ADHD
- 3. Ethnic and cultural differences
1. Symptom development of ADHD-HI (with hyperactivity) by age
1.1. Infancy
One study was able to distinguish those with high genetic ADHD risk (older siblings or parents with ADHD) from those without genetic ADHD risk on the basis of behavior (primarily increased activity and impulsivity and more frequently reported behavioral and temperament problems) in children 1 month of age.1
- Restlessness, hypermotor activity
- Sleep
- Crying, screaming
- Food intake
- Cleanliness education often delayed2
- Language development often delayed2
- Stroking is not enjoyed4
- Often skin allergies4
1.2. Toddler age (1 - 3 years)
- Distractibility3
- Chaotic and destructive, little goal-oriented play behavior2
- Sleep problems
- Gross motor problems
- Game endurance shortens6
- Often changes employment
- Does not finish game
- Learning problems
- Can’t wait6
- Until the turn
- Sensitivity changes
- Highly sensitive or hyposensitive to external stimuli6
- Novelty Seeking
- ADHD-HI-specific
- ADHD-I specific
1.3. Preschool age (4 - 6 years)
1.3.1. ADHD-I in preschool age (without hyperactivity)
- Often anxious6
- Often unsafe6
- Learning Difficulties
- Gross motor skills
- Withdrawn social behavior
- Often loses and forgets things6
1.3.2. AHDS in preschool age (with hyperactivity)
- Motor hyperactivity
- Impulsivity
- Attention problems
- Aggression
- Often as a comorbidity
- Especially with uncertainty6
- Gross motor skills
- Social behavior
- Impatience
- Wets more often still a6
- More often during the day than at night
- Sleep
1.4. School time (6 to 15 years)
ADHD symptoms now become fully apparent.2
1.4.1. ADHD-I at school age (without hyperactivity)
- Emotional problems
- Attention and learning difficulties
- Gross and fine motor problems
- Social behavior
- Often loses and forgets things
- Somatization tendencies
1.4.2. ADHD-HI in school age (with hyperactivity)
- Social behavior
- Fitting in with the rest of the class very difficult2
- Aggression
- Hits frequently, is often hit by others2
- Risk behavior
- Attention problems become apparent for the first time
- Earliest at the age of 7 years
- Until the age of 14, 15
- Motor hyperactivity
- Gross motor skills
- Poor force dosage6
- Impulsivity
- High sensitivity
- Is often sensitive to noise itself9
- Attention problems
- Often only become apparent at a later age (school years)
- Can not listen for long6
- Forgets quickly6
- Loses a lot6
- Concentration span limited
- Frequently switches back and forth between tasks / activities6
- Often paints on the side
- Difficulty starting homework6
- Frequently interrupts homework6
- Good observation skills6
- Learning problems
- Makes mistakes again and again
- Does not learn from mistakes6
- Gross motor skills
- Emotional dysregulation
- Rejection Sensitivity
- Feels quickly treated unfairly6
- Rejection Sensitivity
- Social behavior
- Collects useless things6
- Sleep
- Often fall asleep late
1.5. Adolescence (from 15 years)
- Motor hyperactivity decreases2
- Inner and outer restlessness6
- Impulsivity and decreased attention remain2
- Orientation towards marginalized social groups2
- Risk of developing a propensity for addiction2
- Willingness to engage in high-risk behavior2
- Frequent accidents2
- Performance drop under stress6
- Organization problems6
- Low determination6
- Crackled handwriting6
1.6. Adulthood
- Hardly any motor hyperactivity, instead inner restlessness, being driven12
- Attention problems subside somewhat
- Emotional problems / affective comorbidities increase
- Depression
- Anxiety disorders
- Increased risk of addiction, disturbances in social behavior13
- Anxiety symptoms, alcohol problems14
- Criminal history 15
- Increased accident proneness16
- Worse professional position17
2. Symptom frequency and symptom intensity in ADHD
The diagnosis of ADHD is not made by having a specific type of symptom that is exclusive to ADHD (categorical), but by the set of symptoms that may originate from ADHD and their intensity (dimensional).1819
- In a collection of symptoms presented by Barkley20
- Non-affected persons on average 1 to 2 of the 18 symptoms often, i.e. about 5 %
- ADHD sufferers often have on average 12 of the 18 symptoms mentioned, i.e. about 66%.20
- In the online test we designed ourselves ⇒ ADHD online tests
have- Subjects not affected according to their own assessment, on average just under 8 out of 32 possible symptoms (25 %)
- Subjects with a confirmed ADHD diagnosis around 24 of the 32 possible symptoms (75 %)
- Hardly any affected person has all symptoms “often”, and it is hardly typifiable which symptoms occur together in clusters.
The symptoms must occur over a long period of time and in several areas of life. In most cases, they first become apparent before the age of 12. However, more and more cases of Late Onset ADHD are being recognized, in which there were no sufficiently severe symptoms in adolescence to warrant a diagnosis. This mainly affects women in their late 30s and older.
The fact that symptoms must persist for a longer period of time and in different areas of life serves to distinguish ADHD as a permanent disorder from symptoms of merely temporary (stress) exposure to stressors that exist for a limited period of time.
3. Ethnic and cultural differences
When adults diagnose ADHD in children, the different ethnic and cultural backgrounds should be taken into account.21
Miller, Iosif, Bell, Farquhar-Leicester, Hatch, Hill, Hill, Solis, Young, Ozonoff (2020): Can Familial Risk for ADHD Be Detected in the First Two Years of Life? J Clin Child Adolesc Psychol. 2020 Jan 17;1-13. doi: 10.1080/15374416.2019.1709196. PMID: 31951755. ↥
www.sonderpaedagogik-k.uni-wuerzburg.de/fileadmin/06040400/downloads/sopaed2_ws0304_ads-adhs.pdf ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥
Brandau (2004): Das ADHS-Puzzle; Systemisch-evolutionäre Aspekte, Unfallrisiko und klinische Perspektiven. Seite 39 ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥
Simchen (2015): Die vielen Gesichter des ADS, 4. Aufl., S. 11 ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥
Carpena, Munhoz, Xavier, Rohde, Santos, Del-Ponte, Barros, Matijasevich, Tovo-Rodrigues (2019): The Role of Sleep Duration and Sleep Problems During Childhood in the Development of ADHD in Adolescence: Findings From a Population-Based Birth Cohort. J Atten Disord. 2019 Oct 16:1087054719879500. doi: 10.1177/1087054719879500. ↥
Simchen (2015): 1.1. Viele fragen: “Woran erkenne ich ADS?” In: Die vielen Gesichter des ADS, 4. Aufl. ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥ ↥
Goh, Yang, Tsotsi, Qiu, Chong, Tan, Pei-Chi, Broekman, Rifkin-Graboi (2020): Mitigation of a Prospective Association Between Early Language Delay at Toddlerhood and ADHD Among Bilingual Preschoolers: Evidence from the GUSTO Cohort. J Abnorm Child Psychol. 2020 Jan 3. doi: 10.1007/s10802-019-00607-5. ↥
Gagne, Asherson, Saudino (2020): A Twin Study of Inhibitory Control at Age Two and ADHD Behavior Problems at Age Three. Behav Genet. 2020 Jul;50(4):289-300. doi: 10.1007/s10519-020-09997-5. PMID: 32162153. ↥
Simchen (2015): 1.1. Viele fragen: “Woran erkenne ich ADS?” In: Die vielen Gesichter des ADS, 4. Aufl. ↥ ↥
Simchen (2015): Die vielen Gesichter des ADS, 4. Aufl., S. 13 ↥ ↥ ↥ ↥
[Simchen (2015): 1.1. Viele fragen: “Woran erkenne ich ADS?” In: Die vielen Gesichter des ADS, 4. Aufl.](https://www.kohlhammer.de/wms/instances/KOB/appDE/E-Books/Die-vielen-Gesichter-des-ADS-978-3-17-026957-6 ↥
Barkley: Das große Handbuch für Erwachsene mit ADHS, 2010, Huber ↥
www.sonderpaedagogik-k.uni-wuerzburg.de/fileadmin/06040400/downloads/sopaed2_ws0304_ads-adhs.pdf unter Verweis auf New York-Studie 1985 -1991 ↥
www.sonderpaedagogik-k.uni-wuerzburg.de/fileadmin/06040400/downloads/sopaed2_ws0304_ads-adhs.pdf unter Verweis auf Shekim et al. 1990 ↥
www.sonderpaedagogik-k.uni-wuerzburg.de/fileadmin/06040400/downloads/sopaed2_ws0304_ads-adhs.pdf unter Verweis auf Iowa-Studie 1983 ↥
www.sonderpaedagogik-k.uni-wuerzburg.de/fileadmin/06040400/downloads/sopaed2_ws0304_ads-adhs.pdf unter Verweis auf Beck et al. 1996 ↥
www.sonderpaedagogik-k.uni-wuerzburg.de/fileadmin/06040400/downloads/sopaed2_ws0304_ads-adhs.pdf unter Verweis auf Warnke & Remschmidt 1990 ↥
Edel, Vollmoeller (2006): Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung bei Erwachsenen, Springer, Seite 52 ↥
so auch Barkley, Steinhausen, Krause und viele andere ↥
Barkley: Das große Handbuch für Erwachsene mit ADHS, 2010, Huber, Seite 46; n = 252 ↥ ↥
DuPaul (2020): Adult Ratings of Child ADHD Symptoms: Importance of Race, Role, and Context. J Abnorm Child Psychol. 2020 Jan 3. doi: 10.1007/s10802-019-00615-5. ↥