ADHD is one of the most common neurodevelopment disorders of childhood. It is often diagnosed in childhood and can last into adulthood. Children with ADHD may have trouble paying attention, maintaining social relationships, and controlling impulsive behaviors (such as acting without considering consequences), or be excessively active.

Signs and symptoms

It is normal for children to have trouble focusing and displaying age-appropriate behaviors at one time or another. However, children with ADHD do not grow out of these behaviors. The symptoms are typically regular, and may cause difficulty at school, at home, or with friends.

A child with ADHD might do one or more of these things:

• daydream frequently
• forget or lose things often
• squirm or fidget
• talk excessively
• make careless mistakes
• take unnecessary risks
• behave impulsively or compulsively
• struggle to take turns
• have problems getting along with others
• have difficulty finishing tasks

Types

There are three different types of ADHD:

• Predominantly Inattentive Presentation: It is hard for the individual to organize or finish a task, to pay attention to details, or to follow instructions or conversations. The person is easily distracted or forgets details of daily routines.
• Predominantly Hyperactive-Impulsive Presentation: The person fidgets and talks a lot, and finds it hard to sit still for long (e.g., throughout a meal or while doing homework). Smaller children may run, jump, or climb constantly. The individual feels restless and has trouble with impulsivity, such as interrupting, grabbing, or speaking at inappropriate times. It is hard for the person to wait their turn or listen to directions. A person with impulsiveness may have more accidents and injuries than others.
• Combined Presentation: Symptoms of the above two types are equally present in the person.

Because symptoms can change over time, the presentation may change over time as well.

Causes

Scientists are studying causes and risk factors to find ways to manage and reduce cases of ADHD. The causes and risk factors for ADHD are unknown, but research shows that genetics play an important role. Recent studies link genetic factors with ADHD.

In addition to genetics, scientists are studying other possible causes and risk factors:

• Brain injury
• Exposure to environmental risks (e.g., lead) during gestation or at a young age
• Alcohol and tobacco exposure during gestation
• Premature delivery
• Low birth weight

Research does not support the popularly held views that ADHD is caused by eating too much sugar, watching too much television, parenting, or social and environmental factors, such as poverty or family chaos. Of course, many things, including these, might make symptoms worse. But the evidence is not strong enough to conclude that they are the main causes of ADHD.

When to see a doctor

If you or your doctor has concerns about ADHD, you can take your child to a specialist such as a child psychologist, child psychiatrist, or developmental pediatrician, or you can contact your local early intervention agency (for children under 3) or public school (for children 3 and older).

Diagnosis

Determining if a child has ADHD is a process with several steps. There is no single test to diagnose ADHD, and many other problems—such as anxiety, depression, trouble sleeping, and certain learning disabilities—can have similar symptoms. One step of the process involves having a medical exam, including hearing and vision tests, to rule out other problems with symptoms similar to ADHD’s. Diagnosing ADHD usually includes a checklist for rating ADHD symptoms and taking a history of the child from parents, teachers, and sometimes, the child.

Treatments

In most cases, ADHD is best treated with a combination of behavior therapy and medication. For children aged 4–5 with ADHD, behavior therapy, particularly for parents, is recommended before medication is tried. What works best can depend on the child and family. Good treatment plans will include close monitoring, follow-ups, and making changes along the way.

Resources