The Clinical Characteristics of ADD/ADHD Vary with Age.

It is my experience that all children with ADD/ADHD brain chemistry grow up and become adults with ADD/ADHD brain chemistry. Because adults are more socialized than children, and because some ADD/ADHD behaviors such as hyperactivity are less intense in adulthood, the clinical presentation of ADD/ADHD is more subtle as individuals mature.

CLINICAL PRESENTATION OF ADD/ADHD IN CHILDREN:

• Hyperactivity, fidgetiness and/or squirming.
• Impulsivity (difficulty staying focused on an immediate task because other thoughts often intrude and race through the mind.
• Inattention for "boring" or "unexciting" mental activity, very obvious with respect to school work but not limited to formal learning experiences.
• Waking slowly or, especially in young children, being disorganized and/or grumpy in the morning unless anticipating high excitement activity.
• Falling asleep slowly and with great difficulty at night.
• Spatial dyslexia (for example, writing mirror-image reversals of letters, difficulty with left-right discrimination, and difficulty properly sequencing letters, words or numbers).
• Episodic explosiveness (also referred to as emotional outbursts or temper tantrums in the very young) manifest as verbal violence and/or hitting, biting, kicking and the like.
• Bedwetting due to primary nocturnal enuresis.
• Unexplained and unreasonable emotional negativity.

CLINICAL PRESENTATION OF ADD/ADHD IN TEENAGERS:

• Fidgetiness, squirming, and in some gross hyperactivity.
• Impulsivity, that is, easily distracted because of racing thoughts.
• Inattention for "boring" or "unexciting" activities, especially but not limited to school work.
• Waking slowly most mornings.
• Falling asleep with difficulty at night, often dealt with by not trying to sleep until overwhelmingly tired.
• Spatial dyslexia and sometimes Verbal dyslexia (garbling and/or reversing the order of words while speaking).
• Episodic explosiveness also called emotional outbursts which involve hitting others, breaking inanimate objects, kicking or punching holes in walls or doors, and screaming uncontrollably often while using unseemly language.
• Bedwetting is not likly but may have continued from childhood.
• Unexplained emotional negativity, sometimes severe enough to be called depression, with or without actual suicide attempts.
• Unexplained irritability or easy frustration over minor issues or matters, often described as "things bug me."

CLINICAL PRESENTATION OF ADD/ADHD IN ADULTS:

• Fidgetiness and squirming, rarely gross hyperactivity, and often manifest as rhythmic leg-shaking, hand tapping, and body restlessness.
• Impulsivity, that is, disorganization due to a multitude of thoughts constantly racing through the mind.
• Inattention for "boring" activities such as reading economic reports, putting together tax information, finishing half-finished room repairs, and the like.
• Waking slowly and with difficulty in the morning unless unusually challenged.
• Falling asleep with difficulty until overwhelmingly tired.
• Spatial and/or verbal dyslexia.
• Episodic explosiveness or emotional outbursts which may include spousal and child abuse, self-mutilation, screaming, or hitting others.
• Bedwetting is uncommon but can be a problem for adults.
• Unexplained severe and persistent emotional negativity (even depression) without obvious cause.
• Unexplained, commonly present irritability which strikingly is provoked by only minor unpleasantness.