My son is ADHD and we had more problems with the hyperactivity/impulsivity than the attention problems. He is very bright, but does have a tough time staying on task. Looking back, he had the signs from a very early age, but we didn't start medicating until he was going into 3rd grade.
Some signs...
Impulsivity... The self control that seems to come so naturally to other kids just isn't there. This is to an extreme, not just a few things here and there. Things like running into the street, pinching another child, getting into your personal space over and over again.
Strange Noises... This was a big one for us, and became more and more obvious as he got older. He would repeat a word or phrase over and over again. It's as if this word is running on a reel in his head and he opens his mouth and the word keeps coming out. Or he would shout out a noise during class--like he had so much extra energy that this was the only way he could get it out of him.
Never sitting still... NEVER! When he was 3 weeks old my friend babysat for him for a few hours and I'll always remember her commenting to me, "I know why he gave you such a rough time (bedrest, early labor)...He NEVER stops moving!" When he was 3 his teacher had him run up and down the halls of the school when she saw the signs coming. He still stands to do his schoolwork.
Hyperfocus... While ADHD do have attention problems, it's not all of the time. What I see is an inability to "shift gears." If he's playing legos or doing a puzzle, he can concentrate so intently that he doesn't even notice what's going on around him. If it's time to stop working on the puzzle or legos--even to do something else that he enjoys--he has a really hard time shifting away from that activity.
Not quite in sync with the other kids...All kids do some things that look like ADHD, but ADHD kids are always just a bit more...well, more. They talk all of the time and have a harder time socially. They aren't necessarily unpopular, but they often do things that irritate the other kids.
Overstimulization increases the symptoms...When my son becomes overstimulated, the above characterisics are multiplied. Even on the meds this can happen. I keep an eye out for the triggers--the big one for him is crowds, also, something exciting happening like a visit from Grandma, a lot of different things going on around him to catch his attention. Hunger also seems to do it.
We finally started medicating in third grade for a couple of reasons. It was obvious that he was more and more "different" from the other kids and it was starting to affect him socially. Also, he would be starting the gifted program and we were concerned about him falling behind. We still have issues with him, as he's on a relatively low dosage of Adderall. The big thing we are working on is self control. We're trying to teach him that he might always have these impulses, he just needs to find a different outlet. We try to keep him active as much as possible too.
One last thing--ADHD kids have the opposite reaction to caffeine as most kids. I asked my doctor about this when I noticed that he actually seemed calmer after drinking a coke and she said it was true. On the days that we don't give him his meds, I allow him to drink a coke (preferably diet) at breakfast or lunch.
Good luck! It's a frustrating road, and medication is not a cure all. It just helps them learn how to handle things. One thing that always stuck with me was something I read on a message board when we were researching ADHD. One mom said that medication turned her child into the kid he was supposed to be--the boy that she always knew he could be. I understand what she meant.
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when ds had to be totaly sedated for an mri the pediatric anesthitist took great care in reviewing his medical records to determine the right combo of drugs.
