Attention Deficit-Hyperactivity Disorder (ADHD)

What is ADHD in children?

Attention-deficit/hyperactivity disorder (ADHD) is a brain-based, or neurodevelopmental, disorder. It's also called attention deficit disorder. It's often first diagnosed in childhood. There are 3 types:

• ADHD, combined. This is the most common type. A child with this type is impulsive and hyperactive. They also have trouble paying attention and are easily distracted.

• ADHD, impulsive/hyperactive. This is the least common type of ADHD. A child with this type is impulsive and hyperactive. But they don't have trouble paying attention.

• ADHD, inattentive and distractable. A child with this type is mostly inattentive and easily distracted.

What causes ADHD in a child?

The exact cause of ADHD is unknown. But research suggests that it's genetic. It's a brain-based problem. Children with ADHD have low levels of a brain chemical (dopamine). Studies show that brain metabolism in children with ADHD is lower in the parts of the brain that control attention, social judgment, and movement.

Which children are at risk for ADHD?

ADHD tends to run in families. Many parents of children with ADHD had symptoms of ADHD when they were younger. The condition is often found in brothers and sisters within the same family. Boys are more likely to have ADHD of the hyperactive or combined type than girls.

Other things that may raise the risk include:

• Cigarette smoking and alcohol use during pregnancy

• Exposure to lead as a young child

• Brain injuries

• Low birth weight

What are the symptoms of ADHD in a child?

Each child with ADHD may have different symptoms. They may have trouble paying attention. A child may also be impulsive and hyperactive. These symptoms most often happen together. But one may happen without the others.

Below are the most common symptoms of ADHD.

Inattention

• Has a short attention span for age

• Has a hard time listening to others

• Has a hard time attending to details

• Is easily distracted

• Is forgetful

• Has poor organizational skills for age

• Has poor study skills for age

Impulsivity

• Often interrupts others

• Has a hard time waiting for their turn in school or social games

• Tends to blurt out answers instead of waiting to be called on

• Takes risks often, and often without thinking before acting

Hyperactivity

• Seems to always be in motion; runs or climbs, at times with no clear goal except motion

• Has a hard time staying in a seat even when it's expected

• Fidgets with hands or squirms when in a seat

• Talks a lot

• Has a hard time doing quiet activities

• Loses or forgets things repeatedly and often

• Is not able to stay on task and shifts from one task to another without completing any

Keep in mind that many of these symptoms may happen in children and teens who don’t have ADHD. A key part of diagnosis is that the symptoms must greatly affect how the child functions at home and in school. Make sure your child sees their healthcare provider for a diagnosis.

How is ADHD diagnosed in a child?

A pediatrician, child psychiatrist, or a mental health expert may diagnose ADHD. To do so, they will talk with parents and teachers and watch the child. Diagnosis also depends on results from physical, nervous system, and mental health testing. Certain tests may be used to rule out other health problems. Others may check thinking skills and certain skill sets.

How is ADHD treated in children?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.

Treatment for ADHD may include:

• Psychostimulant medicines. These medicines help balance chemicals in the brain. They help the brain focus and may reduce the major symptoms of ADHD.

• Non-stimulant medicines. These can help decrease the symptoms of ADHD and are often used in conjunction with stimulant medicines for even better results.

• Behavior management training for parents. Parenting children with ADHD may be hard. ADHD can cause challenges that create stress within the family. Classes in behavior management skills for parents can help lower stress for all family members. This training often happens in a group setting that encourages parent-to-parent support. Behavior management techniques tend to improve targeted behaviors in a child, such as completing schoolwork.

• Other treatment. Self-management, education programs, and assistance through your child’s school can also help.

How can I help prevent ADHD in my child?

Experts don’t know how to prevent ADHD in children. But spotting and treating it early can lessen symptoms and enhance your child’s normal development. It can also improve your child’s quality of life.

How can I help my child live with ADHD?

Here are things you can do to help your child:

• Keep all appointments with your child’s healthcare provider.

• Talk with your child’s healthcare provider about other providers who will be involved in your child’s care. Your child may get care from a team that may include counselors, therapists, social workers, psychologists, school psychologists, school counselors, teachers, and psychiatrists. Your child’s care team will depend on your child’s needs and how severe the symptoms of ADHD are.

• Adhere to behavioral and educational treatment plans. Work with your team to adjust the plan if it's not working.

• Give medicines as prescribed

• Tell others about your child’s ADHD. Work with your child’s healthcare provider and schools to develop a treatment plan.

• Reach out for support from local community services. ADHD can be stressful. Being in touch with other parents who have a child with ADHD may be helpful.

Key points about ADHD in children

• ADHD is often first diagnosed in childhood. A child with ADHD may have trouble paying attention. They may also be impulsive and hyperactive.

• The cause of ADHD may be genetic. It tends to run in families.

• A healthcare provider diagnoses ADHD after observing a child’s behavior and doing certain tests.

• Treatment often includes medicine. Parents may also get training in behavior management skills. Your child may also be able to take self-management training at school.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.

• Before your visit, write down questions you want answered.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your healthcare provider gives you for your child.

• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.

• Ask if your child’s condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if your child does not take the medicine or have the test or procedure.

• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your child’s healthcare provider after office hours. This is important if your child becomes ill and you have questions or need advice

Online Medical Reviewers:

• Dan Brennan MD
• L Renee Watson MSN RN
• Paul Ballas MD