Presenting Complaints

• Children are brought by parents because they can't sit still, are always moving, cannot wait for others, will not listen to what others say. Their concentration is poor and they are likely to be failing and getting into trouble at school.

Diagnostic Features

• There is severe difficulty in maintaining attention (short attention span, frequent changes of activity)
• There is abnormal physical restlessness, most evident in class or at meal times
• There is impulsiveness and the child cannot wait for a turn and acts without thinking
• There are often discipline problems, school failure, proneness to accidents
• The pattern occurs in all situations, home, school, play

Avoid premature diagnosis. High levels of physical activity are not necessarily abnormal.

Differential Diagnosis

Consider the presence of :

• a specific physical disorder (e.g. epilepsy, fetal alcohol syndrome, thyroid disease)
• emotional distress with anxiety or depression
• autism and social/language impairment and stereotyped behaviours are present.
• conduct disorder
• mild mental retardation or specific learning disability

Hyperkinetic behaviour can either cause or result from parent child problems. Assessment of family relationships may be important.