Sounds like it. Especially since you know it runs in the family. I have it and it didn’t get bad until later in HS. Midlife has made it intolerable. I think the diagnostic criteria has not kept up with advances in understanding how ADHD presents in women and girls. Not that this knowledge requires much, just gives you a boost to keep helping her understand herself and keep her exercising a lot.

"I have it myself" --

ADHD is the most heritable neurodevelopment disorder. Twin studies suggest 74-88% heritability.

https://pmc.ncbi.nlm.nih.gov/articles/PMC7046577/

So, yes, your daughter probably has ADHD.

ADHD is less commonly diagnosed in girls because, culturally, girls are taught to be rule-followers, so there is less "running around" or physical acting out.

In our family, the "movement" is inside the brain -- constantly thinking about stuff, and talking (interrupting is a problem for all of us - I thought this was normal until I reached the "outside world").

Also, for many people with ADHD, particularly those that are strong, fluent readers, reading can serve as a form of hyper focus and immersion that is really pleasurable, IME, because it stimulates the brain.

The difficulty of doing things that are unpleasant or boring is a key marker of ADHD. ADHD is not a problem of NOT being able to concentrate, it is a problem of NOT being able to direct your concentration in appropriate ways. The "task positive network" in the ADHD brain has more competition from the "Default Mode Network" in the brain and thus we are more easily disrupted from or avoid boring, routine tasks.

It's dx mainly through parent and teacher questionnaires. Her teacher says it's not bad enough to warrant pursuing a dx, and you're not sure either. I would wait. You can read books like Smart but Scattered and try to implement some of the strategies. I wouldn't pay 4 k and pull her out of school for 2 days for a neuropsych given what you've shared. When we filled out the parent questionnaire, we were like wheres the column for all the d@mn time and his teacher had been complaining about him.

Stimulants are the main medication for ADHD, and they can help a lot but also have non-trival side effects like appetite suppression and trouble sleeping. There are other medications like Strattera and guanfacine.

Is it true that many common ADHD medications are kinds of stimulants?

Anonymous wrote:

Anonymous wrote:It sounds like there are effects both at school and at home so I would definitely explore. Start with your pediatrician.

I can't imagine a pediatrician will diagnose if it's not an obvious case meeting all the standard criteria, would they?

The pediatrician would likely refer to someone for a more comprehensive assessment, psychiatrist, psycho-ed or neuropsych.

Anonymous wrote:It sounds like there are effects both at school and at home so I would definitely explore. Start with your pediatrician.

I can't imagine a pediatrician will diagnose if it's not an obvious case meeting all the standard criteria, would they?

Sounds like an older version of my daughter. We went to KKI thinking it might be anxiety but teacher recognized it as adhd. She didn't seem inattentive to me at all but thats because she is usually choosing the activities when she is at home. When others choose and she is disinterested/challenged then the inattentive behaviors come out in full force

Anonymous wrote:Go to a doctor and not a message board. Get trained and qualified help for your child.

DP here. I agree with seeing a professional, but also, over the many years I have been raising a DC with SNs, the people on this message board have often been more helpful than doctors in teasing out what direction to go next.

This sounds like my son, diagnosed with ADHD, but I question whether there is more, especially with the mood disregulation and frustration intolerances.

It sounds like there are effects both at school and at home so I would definitely explore. Start with your pediatrician.

Anonymous wrote:What does her teacher say (or notice)?

Nvm...it was buried in your post

What does her teacher say (or notice)?

Go to a doctor and not a message board. Get trained and qualified help for your child.

Whoops, link with percentiles here: https://www.sanfordhealthplan.com/-/media/files/documents/providers/clinical-resources/cms-quality-child_adhd_rating_scale_screener.pdf

So my 10 year old does not meet the standard DSM criteria for ADHD... there's only like 4-6 of them that I'd say she does "often" (split across the two subcategories, although mostly hyperactive/impulsive: interrupts, blurts out, fidgets, makes careless mistakes, and maybe also "difficulty awaiting turn" and "avoids mental effort" but I'm less clear on how far outside the normal range she is on those), although a few others she does "sometimes." I found this helpful link with percentiles and it shows her as somewhere between the 85th-93rd percentile of girls age 8-10 for the hyperactive/impulsive symptoms (depending on how conservative I am with the sometimes vs often vs very often.) But I don't see any way she could get to 6 or even 5 of the hyperactive/impulsive symptoms because she's not constantly in motion (she definitely fidgets a lot, but isn't inappropriately leaving her seat or climbing things, or "on the go" all the time), she's fine playing or reading quietly for long stretches when she's in the mood or is just grumpy with the rest of us, and she's extroverted/chatty but I don't think it's to the extent they mean when they say "talks excessively." And she's even further from 6 inattentive symptoms.

However, she does also have a number of other characteristics I associate with ADHD (I have it myself and have read a lot about it as well) despite not being on the official list-- things like emotional dysregulation, low frustration tolerance, strong emotional reactions/difficulty adjusting when things don't go the way she had imagined they would (being found in hide and seek, us not appreciating a joke, etc), hyperfocus, impatience and difficulty tolerating curiosity/the unknown (i.e. not opening a package immediately, a conversation she's not part of), agitation and/or "tuning out" when bored by something, jumping to conclusions, justice sensitivity/strong focus on fairness, sensory sensitivities (clothes must feel a certain way, sensitivity to smells), etc.  

She does not have nearly as much trouble with disorganization, distraction, forgetfulness, or procrastination as I do-- she is generally fairly organized and doesn't have too much trouble with task initiation as long as it's not something she's expecting to be difficult/unpleasant, in which case she's more likely to avoid it.  However, her teacher has mentioned that she can be inattentive in class and has marked it on her report card a few times (although at parent-teacher conference she said it was not to the level that she would actively flag it for us as a reason to screen her for ADHD), and I see her careless mistakes on tests and quizzes as well as her struggles to pay attention to and retain information on topics that bore her.

My questions:
1) Does this sound like actual ADHD to you, or is it probably just a cluster of subclinical ADHD-like symptoms? I don't want to push for a diagnosis (or spend a lot of money evaluating her for one) if it doesn't really seem like she has it, but I also don't want her to fall through the cracks if it's a situation where her presentation just happens to be heavy on symptoms that aren't listed in the DSM currently but maybe should be.  
2) If it might be actual ADHD, what are our options for exploring a diagnosis, given the lack of full alignment with the DSM criteria? How strictly do most evaluators stick to the "6 out of 9" requirement? I see there is an option in the DSM for "unspecified ADHD" for people who don't meet the full criteria, but is that actually used, and if so, are there particular places more willing to explore it? Would it require a full neuropsych and if so, where? (Ideally Children's or KKI or somewhere else that takes insurance, but open to any suggestions.)

Thanks so much!