Impulsivity

Symptoms

Impulsivity

What is impulsivity?
Features of impulsivity
Common causes of impulsivity
When to approach your health care professional
Questions your health care professional may ask
Examinations/tests your health care professional may perform
How is hyperactivity treated?
What can families, parents and teachers do to help?

What is impulsivity?

Impulsive individuals tend to act without forethought. They may react rapidly and without planning, often without regard to the consequences on themselves or others.

Features of impulsivity

Some examples of impulsive behaviours include:

Engaging in dangerous activities without considering possible consequences
Difficulty waiting turns
Calling out in class
Intruding in on or interrupting conversations or games
Blurting out answers before questions have been completed

Common causes of impulsivity

Attention deficit hyperactivity disorder (ADHD)
Alcohol or drug abuse
Delirium
Dementia
Head injury
Mood disorders
Psychotic disorders
Conduct disorder
Antisocial personality disorder
Borderline personality disorder
Bulimia nervosa, anorexia nervosa
Intermittent explosive disorder
Adjustment disorder

Attention-Deficit/Hyperactivity Disorder (ADHD) Evaluation Tool

Does your child have problems paying attention?
Do they fidget, talk a lot, or run around with seemingly endless energy?
Do they have trouble waiting their turn, and 'butt into' games or conversations?

If the answer to any of these is yes, you might want to find out whether your child is exhibiting symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD). All children at some time or another will tend to be inattentive, hyperactive or impulsive. However some children will exhibit these qualities most of the time, and more than their peers.

Please complete the survey below to find out if you need to consult your GP about these symptoms. It is important to keep in mind that symptoms of ADHD are often common in many energetic children; therefore it might help to compare your child to other children in the same age group.

Evaluation

Your child is unlikely to be experiencing symptoms of ADHD. You probably don't need to be concerned.

Evaluation

Your child is unlikely to be experiencing symptoms of ADHD. However, if you are concerned, you should show this survey to your GP at your next consult.

Evaluation

Your child may be experiencing some of the symptoms of ADHD. These symptoms may be able to be managed by your doctor. You should book an appointment with your GP and take this survey with you for further discussion.

Evaluation

Your child may be experiencing some of the symptoms of ADHD. These symptoms may be able to be managed by your doctor. You should book an appointment with your GP as soon as possible and take this survey with you for further discussion.

This information will be collected for educational purposes, however it will remain anonymous.

This tool needs Javascript enabled to run.Add up your answers to the following questions:

Does your child fail to pay attention to details during tasks? For example, a teacher may have reported careless errors in schoolwork.

Yes: 1 point
Not more than other children of the same age: 0 points

Does your child have trouble sustaining attention during tasks or games? For example they appear to easily lose interest and become distracted.

Yes: 1 point
Not more than other children of the same age: 0 points

Do they have trouble following through on instructions, and often fail to finish schoolwork, homework or chores?

Yes: 1 points
Not more than other children of the same age: 0 points

Do they have trouble listening, even when spoken to directly?

Yes: 1 point
Not more than other children of the same age: 0 points

Could your child be described using the following three words: forgetful; disorganised; or easily distracted?

Yes, to all three: 3 points
Yes, to two only: 2 points
Yes, to one only: 1 point
None of these words could describe my child: 0 points

Does your child avoid or dislike activities that require sustained mental attention such as schoolwork or homework?

Yes: 1 point
Not more than other children of the same age: 0 points

Does your child fidget, squirm in their seat, or get up from their seat in situations where sitting still or remaining seated are expected?

Yes: 1 point
Not more than any other child of the same age: 0 points

Does your child have difficulty 'playing quietly'?

Yes: 1 point
Not more than any other child of the same age: 0 points

Does your child act as if driven by a motor, often running or climbing excessively, and in situations where it is inappropriate?

Yes: 1 point
Not more than any other child of the same age: 0 points

Does your child talk excessively and/or blurt out answers before questions have been completed?

Yes, to both: 2 points
Yes, to one only: 1 points
Not compared to children of the same age: 0 points

Does your child have difficulty waiting their turn and/or interrupt or intrude on the conversations or games of others?

Yes, to both: 2 points
Yes, to one only: 1 point
Not compared to children of the same age: 0 points

On the scale below, please indicate how much you feel these symptoms impact on your child's quality and enjoyment of their social and academic life
(1 indicates that their life is not affected by the symptoms and 10 indicates their life is severely affected).

Scoring: a rating of 1-5 is worth 0 points, 6-10 is worth 1 point.

0 to 2 points

Your child is unlikely to be experiencing symptoms of ADHD. You probably don't need to be concerned.

3 to 5 points

Your child is unlikely to be experiencing symptoms of ADHD. However, if you are concerned, you should show this survey to your GP at your next consult.

6 to 11 points

12 and above

When to approach your health care professional

Some degree of impulsivity is considered normal in most people. Impulsive behaviour becomes significant when it is persistent, severe, and affects performance at work, in school or in social relationships. This may be due to one or more of the underlying conditions.

In children, disorders like ADHD often begin before preschool age, but for most children it goes unnoticed until they land into trouble at school. Occasionally teachers may be first to recognise that the child has a problem. The first port of call is often the family general practitioner or school psychologist, who will assess the patient and initiate appropriate management or referrals.

Questions your health care professional may ask

During the consultation, the health care professional may ask you to describe the symptoms, including their onset and development. He/she may also ask about the patient's past illnesses or injuries, current medications (prescribed and over the counter), and family history, particularly of psychiatric disorders.

In children, also important are the details of the pregnancy, delivery, and the developmental milestones, including risk factors such as maternal smoking, alcohol, drug use and major illness. The healthcare professional may also ask about your family's social life and the presence of any stressful events.

Examinations/tests your health care professional may perform

The doctor may perform the following examinations:

Observation of mental status
Height, weight, head circumference measurements (children)
Blood pressure and pulse
Hearing and vision testing
Developmental assessment
Nutritional status assessment
Examination of the nervous system

Often, other tests may be required, which may consist of:

Questionnaires to be filled out by the parents and school teacher
Tests of intelligence, individual subject areas, language skills, attention and executive functioning
Blood tests and imaging may sometimes be required

How is impulsivity treated?

Specific treatment for impulsivity varies from patient to patient depending on the underlying cause. In most cases, several different treatment strategies may be used at the same time on one patient. In addition to using medicines, some patients may benefit from behavioural therapy, parent training and school based interventions.

What can families, parents and teachers do to help?

The treatment for conditions with impulsivity may involve medications and/or behavioural therapies. Families and parents can help by learning about the diagnosis, causes, features and treatment, in order to help manage the condition and understand what the patient is going through.

In children with ADHD, good behavioural management principles and strategies are important in managing impulsive behaviours. Some centers offer parent training, which has been shown to be an effective intervention. Teachers can help improve school behaviour and academic achievement by implementing school-based interventions (e.g. token economy systems).

Useful information

For more information on childhood ADHD and its symptoms and treatments, as well as some useful tools and animations, see Childhood ADHD.

For more information on ADHD in adults and its treatments, as well as some useful tools and animations, see Adult ADHD.

Reference

Soanes C, Stevenson A [Eds]. Impulsive adjective. In: The Oxford Dictionary of English (revised edition). Oxford University Press. 2003.
Moeller F, Barratt E, Dougherty, D, Schimitz J, Swann A. Psychiatric aspects of impulsivity. American Journal of Psychiatry. 2001; 158(11): 1783-93.
Sadock B, Sadock V. Chapter 39: Attention deficit disorders. In: Kaplan and Sadock's Comprehensive Textbook of Psychiatry, 8^th ed. Lippincott Williams & Wilkins, Philadelphia. 2005.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders DSM-IV-TR, 4^th ed. American Psychiatric Association, Washington DC. 2000.
First M, Frances A, Pincus H. DSM-IV-TR Handbook of Differential Diagnosis. American Psychiatric Publishing, Arlington. 2002.
Schweitzer J, Cummins T, Kant C. Attention-deficit/hyperactivity disorder. Medical Clinics of North America. 2001; 85(3): 757-77.
The MTA Cooperative Group. A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. Archives of General Psychiatry. 1999; 56(12): 1073-86.