Please read the other 3 threads first. This one will cover Hyperactivity- Impulsivity. Once again, remember that there are other things that can look like this but not be ADHD. We can talk about that later in a comorbid features thread.

The assumption here is that you have done a thorough medical screening to rule out physical problems that might cause these symptoms, that you have checked for good prenatal care and have a working knowledge of the child's developmental milestones and perhaps most importantly, you have done a thorough screening of their family history for ADHD or similar porblems. Keep in mind that ADHD is considered to be a developmental disability.

Here are the symptoms for Hyperactivity-Impulsivity:

1) Often fidgets with hands or feet or squirms in seat.

What child doesn't do this? However, the ADHD child is literally "spilling over." This refers to having so much uncontrolled energy that they exhibit these behaviors everywhere and all he time; sometimes without even realizing it. Also, "spilling over" is another way of helping to modulate (keep in proper measure or proportion) the excess activity.

2) Often leaves seat in classroom or in other situations in which remaining seated is expected.

This is a telltale symptom for me because I think it really distinguishes the degree of hyperactivity. A child who can never stay seated at school, at the dinner table (regardless of what TV show might be on) or church, is certainly showing "high risk" ADHD behavior.

3) Often runs about or climbs excessively in situations in which it is inappropriate (adolescents or adults may have feelings of restlessness).

We're usually talking about big ticket items here like scaring your parents by running in front of cars, climbing up on the roof or in trees, riding your bike into the street without looking, doing reckelss behavior like bike jumps into the street, etc. I realize that those are extreme but that is the nature of this particular symptom. This brief listing is unofficial and is Not meant to be all inclusive.

Also, remember that the entire symptom list is weighted more for boys than girls and that the oldest subject in the sample population was only 16yrs old. This makes diagnosing adults more tricky for those that work with them.

One of the questions I now ask routinely here is whether the child has ever been hit by a car. You'd be amazed at how many "Yes's" I get.

4) Often has difficulty playing or engaging in leisure activities quietly.

Boys are almost always more noisy than girls, so this is again weighted more towards them, which is a problem obviously. It's also easy to become used to these kinds of behaviors and tune them out at home. I tend to stomp when I walk and close things like cabinets and doors harder than I imagined.

One of the things I look for here is making nonstop noises while playing. I also have to be careful of possible comorbid features(other problems that coexist with ADHD and happen simulataneously) that might cause this.

5) Is often "on the go" or acts as if being "driven by a motor"

The key feature here is to remember "Always and Everywhere." This gets tricky because of possible hyperfocusing that might cause the child to sit and play or do something they love to do.

I usually ask about them running thru the mall or the grocery strore "touching everything" or whether they always seem to run instead of walk, Things like that.

By the way, research has shown that only about 5% of ADHD kids have food allergies that Impact Their ADHD Behavior. The US Surgeon Generals Report does a good job of discussing that as do Kate Kelly & Peg Ramundo in their ADHD classic book You Mean Im Not Lazy Stupid Or Crazy?

6) Often talks excessively.

Not a fair question for teens. The key here is have they Always been that way since they were little.

7) Often blurts out answers tp questions before they are completed.

This is a little easier to spot. Please recognize that in looking at all 18 symptoms they are asking about " Often", as opposed to "Sometimes." Thats why checklists are so helpful.

8) Often has difficulty awaiting turn.

ADHD kids don't share well if at all. This is but one of the several factors that hurt them in making friends. I recently heard at a workshop that as many as 80% of ADHD kids (this does NOT include the Inattentive Type ) don't have any friends. This is a definite setup for later low self-esteem and possible depresion.

When you throw academic struggles in on top of that, then it's easy to see how depression might possibly occur in some of these kids. Im not saying that All of them become depressed here but they are certainly more "at risk" because of it.

9) Often interrupts or intrudes on others, such as butting into conversations or games.

This one is fairly easy to spot. As a trained behaviorist I end up literally counting how many times this happens to get a baseline and then look for it over time (provided you have the luxury of seeing them more than once). Here's where being ADHD can help me in my job...lol.

Thanks for taking the time to read this and I hope it helps you in better understanding some (but not all) of what Diagnosis entails.