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Fidgeting with the hands or feet is almost always associated with ADHD. This is because it is a tell-tale sign of hyperactivity. But as always, diagnosis and assessment are not exact sciences. A person might be fidgeting because of some totally unrelated situation. In this case, what signs could help us determine that a person’s behavior is actually ADHD fidgeting?
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ADHD Fidgeting and the DSM-IV Criteria
According to the DSM-IV, ADHD fidgeting is one of the nine ADHD symptoms that characterize hyperactivity and impulsivity - it's not really a problem of attention. To diagnose hyperactivity, six of these symptoms should be persistent for at least six months, and should be considered maladaptive and inappropriate for the individual’s age level. Fidgeting behavior should be clearly excessive and consistently observed for at least 6 months if it’s to be considered an indicator of hyperactivity.
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ADHD Fidgeting Behavior in School-Age Children
What could be considered inappropriate or excessive fidgeting behavior? For school-age children, fidgeting happens whenever there’s an occasion for moving either the hands or feet while in a classroom situation - fiddling with clothing, tipping a chair to lean back, wobbling a chair, banging feet on the floor, tapping fingers or an object on the table are just some examples. These symptoms should be frequent and excessive enough that they are considered harmful to the child's learning or are disruptive to the class. Fidgeting can also be seen in other situations, especially those that require the child to stay in place for some time, e.g. church and social and family events.
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ADHD Fidgeting Behavior in Adults
A 2006 study by Dr. McGough of the UCLA Semel Institute for Neuroscience and Human Behavior explains that ADHD in adults is centered more on being inattentive than on being hyperactive, a different situation to that of children. Therefore ADHD fidgeting in adults should be less as it is more symptomatic of hyperactivity.
Having said that, examples of fidgeting behavior in ADHD adults include being always on the go, talking continually, interrupting others constantly and acting before fully thinking things through.
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ADHD Fidgeting: Solutions
For those who have experience dealing with ADHD children who are always fidgeting, the main course of action is not necessarily to stop the behavior but to conscript it to something more productive. A 2009 study by Dr. Mark Rapport of the University of Central Florida pointed to the possibility that fidgeting might have a useful purpose in learning. Here, strategies that deal with fidgeting revolve around the idea of finding the most productive form of fidgeting possible that isn't disruptive.
Some solutions to this include forms of fidgeting that would make good use of a pencil. Doodling is an allowable compromise provided that it doesn’t take away all the attention from a class lecture. It can help to prevent daydreaming. A soft object such as a pipe cleaner or a small toy can keep hands occupied so that ADHD fidgeting doesn't make a noise and disturb others.
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Fidgeting is sometimes indicative of ADHD and sometimes it is not - it’s supposed to exist with other sets of hyperactive and impulsive behavior. In addition, fidgeting is not something that should be stopped suddenly as it can be managed for more productive purposes.
NB: The content of this article is for information purposes and is not intended to replace sound medical advice and opinion.
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Cloud, J. (2009, Mar 25). Kids with ADHD May Learn Better with Fidgeting. Retrieved from http://www.time.com/time/health/article/0,8599,1887486,00.html.
Kaplan, R. & Stevens,M. (2002). A Review of Adult ADHD: A Neuropsychological and Neuroimaging Perspective. CNS Spectrums, 7(5), 355-362.
McGough, J. & McCracken, J. (2006). Adult Attention Deficit Hyperactivity Disorder: Moving Beyond DSM-IV. American Journal of Psychiatry, 163, 1673-1675. doi: 10.1176/appi.ajp.163.10.1673.
Rapport, M., Bolden, J., Kofler, M., Sarver, D., Raiker, J. & Alderson, R. (2009). Hyperactivity in Boys with Attention-Deficit/Hyperactivity Disorder (ADHD). An Ubiquitous Core Symptom or Manifestation of Working Memory Deficits?. Journal of Abnormal Child Psychology, 37, 521-534. doi: 10.1007/s10802-008-9287-8.
Saddock, B. & Saddock, V. (2003). Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry. Philadelphia: Lippincott Williams and Wilikns.