Symptom expression in hyperactive children: an analysis of observations

Hyperactivity is typically diagnosed when children display overactivity, inappropriate inattention, and impulsivity during the school day when involved in tasks that require sustained and voluntary attention. However, distinguishing children with hyperactivity from children with other learning and behavior disorders is often difficult because of an overlap in symptom expression. Some studies have failed to find any factors associated only with the hyperactive syndrome. The present study compared the behavior of students diagnosed as hyperactive or having attention deficit disorder to students diagnosed as having learning disabilities. Symptoms associated with overactivity, inattention, and impulsivity of 19 hyperactive and 17 nonhyperactive (learning disordered) students were observed and counted using a direct diagnostic procedure following a momentary time sampling technique. Analyses revealed that differences between the groups were often qualitative rather than quantitative, and only a few symptoms distinguished one diagnosis from the other. Hyperactive students demonstrated more talking, unsystematic search, and motor impersistence than nonhyperactive students. Nonhyperactive students demonstrated more upper extremity movement and displayed more inattention when engaged in visual tasks than hyperactive students. The findings questioned the use of general categories of behavior such as overactivity to discriminate hyperactive from nonhyperactive students. Implications for diagnosis and the need for continued studies are reviewed.