Children Who Have Attentional Disorders: Diagnosis and Evaluation

Abstract

Attentional disorders (ADs) are among the most common chronic biobehavioral problems encountered during childhood and adolescence. Children who have attention problems represent a very diverse, heterogeneous population who exhibit a broad spectrum of symptom severity and a wide range of associated diagnoses. ADs are approximately six times more frequent in boys than in girls. Symptoms persist into adulthood in 40% to 60% of individuals who were hyperactive as children. The prevalence of these disorders is estimated at 3% to 5% of the school-age population. In spite of this, ADs remain some of the least understood and most commonly reconceptualized constructs in pediatric practice. Labels for these problems have included minimal brain dysfunction (MBD), hyperkinesis, hyperactivity, attention deficit disorder (ADD), attention deficit disorder with hyperactivity (ADDH), and presently, attention deficit hyperactivity disorder (ADHD). In this review, AD often will be used as a generic term for these entities. Clinically, children who have AD exhibit core symptoms of inattention, impulsivity, and overactivity that are inappropriate for their developmental level and interfere with their optimal functioning. Difficulty with adhering to rules and instructions and excessive day-to-day variability in performing tasks or following directions also are thought by some investigators to be primary deficits in these disorders.