ADHD (Attention Deficit Hyperactivity Disorder) is one of the most common neurodevelopmental disorders of childhood. It affects about 11 percent of school-age children, according to the national nonprofit CHADD (Children and Adults with Attention Deficit Disorder).
ADHD is divided into three types:
- Mainly inattentive introduction
- Mainly hyperactive impulsivity
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As a neurodevelopmental disorder, ADHD results from dysfunction of the brain and nervous system.
Adults can also be diagnosed with ADHD, usually because ADHD in children persists into adulthood. About two-thirds of children with ADHD continue to experience symptoms into adulthood.
ADHD signs and symptoms
Children with ADHD are far more sedentary, concentrating, and attentive than others—often to the point where they have trouble getting along with other children and learning at school. Likewise, AHDH that persists into adulthood can interfere with relationships and job performance.
Symptoms of ADHD depend on the type, but in general, children with ADHD exhibit:
- often forgetful
- Daydreaming and not listening
- Can’t complete the task
- Avoid tasks that require mental concentration
- Forgetfulness – for example, not completing homework or other tasks
- Trouble sitting still, fidgeting and squirming
- dangerous behavior
- Careless (not paying attention to details)
- pattern of frequent mistakes
- Difficulty getting along with other children (eg, reluctance to share or take turns)
In adults, ADHD symptoms can cause problems at work, at home, and in relationships with family, friends, and colleagues. Childhood hyperactivity can turn into restlessness. What’s more, the typical stress of adulthood can make ADHD symptoms worse.
What causes ADHD is unclear, although research suggests genetics may play a role. Other factors that may be associated with a higher risk of ADHD include:
- Brain Injury
- Environmental conditions in fetal development or early life, such as exposure to lead
- Pregnant woman drinking or smoking during pregnancy
- premature birth or low birth weight
Due to a lack of scientific evidence, some myths about the underlying causes of ADHD have been debunked: eating a lot of sugar, watching too much TV, and poverty or unrest in the family. However, these factors may exacerbate ADHD symptoms.
New study finds genetic differences between black and white children with ADHD
ADHD is diagnosed based on symptoms and an interview with a mental health professional such as a psychologist, psychiatrist, neurologist, or primary care provider (usually a pediatrician).
For children, the American Academy of Pediatrics recommends that diagnostic practitioners interview parents, teachers, and other adults who provide care for children to consider their behavior in different settings and situations. Children may also be interviewed, depending on their age.
Ultimately, the diagnosis of ADHD will depend on meeting specific criteria listed in the Diagnostic and Statistical Manual, 5th edition (DSM-5).
The DSM-5 is a manual for evaluating and diagnosing mental disorders, and most diagnosticians use it to evaluate a person and look for signs and symptoms of mental health disorders. According to the CDC, DSM-5 means that a person with ADHD must exhibit persistent patterns of inattention and/or hyperactivity and that these symptoms must interfere with a person’s functioning or development.
These criteria vary by type of ADHD, but in any case, to diagnose any type of ADHD, the person being evaluated must have:
- Severe hyperactivity-impulsivity or inattention symptoms before age 12
- Multiple symptoms in at least two (or more) settings (such as school and home, peers, relatives, or caregivers)
- Demonstrate that these symptoms interfere with functional quality in social, school, or work settings
- A formal evaluation was performed to rule out other major underlying causes of symptoms (eg, mood disorders, personality disorders, or anxiety disorders)
The DSM-5 defines three different types of ADHD. The type of ADHD a person has is determined by the type of symptoms that show the most. Types of ADHD include:
Mainly inattention: Children must have at least six of the following symptoms; adolescents or adults must have five:
- Difficulty concentrating while performing tasks or engaging in gaming activities
- often make careless mistakes
- Often forgets details of daily tasks
- Often easily distracted
- Can’t complete the task
- Often doesn’t seem to be listening when talking directly
- Frequent forgetfulness while performing everyday tasks
- Failure to complete homework or other tasks (problems follow, often diverted)
Mainly hyperactive-impulsive manifestations: Children under 16 must have six symptoms; older adolescents and adults must have five:
- Often fidgeting, clapping hands or feet, wriggling while sitting
- Getting up or leaving frequently when expected to remain seated
- Often runs or climbs inappropriately (adults may be disturbed but do not engage in running or climbing)
- Often unable to participate in quiet leisure activities
- talk constantly
- Often blurts out answers before fully asking questions in a conversation
- Can’t wait while taking turns
- Frequently interrupting conversations while others are speaking
Combined presentation: Two types of symptoms appear proportionally (predominantly hyperactive-impulsive and predominantly inattentive).
Symptoms must be present for at least 6 months and must be considered disruptive in a work, school or social setting and not appropriate for the individual’s developmental level.
A person’s type of ADHD can change over time because it’s common for symptoms to change as a child ages.For example, a child with hyperactivity-impulsivity-predominant ADHD may grow up to be inattentive as an adult.
There are a number of conditions and disorders that can be mistaken for ADHD and must often be ruled out to make a definitive diagnosis, including:
- sleep disorder
- Learning disabilities (specific types)
- vision and hearing problems
ADHD is treated with behavioral therapy, medication, or both. For preschool-aged children—children aged 4 and 5—first-line treatment is behavior-based with parental involvement.
There are several recommended behavioral treatment modalities for ADHD, including:
- Behavior modification: Strategies aimed at increasing appropriate behavior and reducing inappropriate behavior based on a child’s symptoms.
- Behavioral Parent Training: Train parents to respond in a way that promotes the healthy growth and development of their children and strengthens the parent-child relationship.
- Social skills training: Provide a safe environment for children to learn positive social skills, including how to interact with other children at school and with family members at home.
- School Intervention: An action plan (called an IEP) is developed by a trained professional with the child’s teacher and school counselor to implement classroom intervention as necessary.
- Organizational Skills Training: Designed to teach older children organizational and time management skills at school and at home.
Two types of ADHD medications come in short-acting, intermediate-acting, and long-acting forms:
- Psychostimulants improve the ability to ignore distractions and focus thoughts. “They tended to reduce interruptive behavior, restlessness, and other hyperactivity symptoms,” the researchers said. The most commonly used psychostimulants were Ritalin (methylphenidate) and Adderall (dextroamphetamine). Studies show that stimulants improve ADHD symptoms in approximately 70% of adults and 70% to 80% of children.
- Non-stimulant medications can be used as stand-alone medications for ADHD or can be prescribed with other medications. Non-stimulant drugs include Strattera (atomoxetine), Intuniv (guanfacine), and Kapvay (clonidine). A 2009 study found that guanfacine improved working memory, reduced distraction, delayed gratification, and behavioral flexibility in ADHD patients.
Combinations of psychostimulant and non-stimulant drugs are sometimes more effective than either drug alone. According to a 2016 study, guanfacine and d-methylphenidate were effective in improving behavior and cognitive function in those who did not respond to stimulant drugs alone.
The most common side effects of ADHD medications are mild; some subside after taking the medication for a while. If the side effects are not transient, the prescribing doctor may lower the dose or may prescribe a different drug.
Side effects of ADHD medications include:
- Insomnia (difficulty falling asleep)
- loss of appetite
- lose weight
- nervousness or irritability
- The most common side effects include:
- decreased appetite/weight loss
- social withdrawal
Less common side effects of stimulant drugs may include:
- Rebound effects (hyperactivity or moodiness as the drug wears off)
- tics (repetitive muscle movements, such as blinking)
- Slight delay in normal growth pattern
There are many alternative and free treatments that advertise the effectiveness of treating ADHD. However, the CDC warns that many of them have been shown to be neither safe nor effective.That’s not to say natural remedies for ADHD aren’t helping at all — there’s simply not enough evidence that they work.
Alternative treatments for ADHD include:
- Brain gym
- Cogmed: Said to be effective in training working memory in children with ADHD.
- Omega-3 Supplements (Fish Oil Supplements)
- massage therapy
- mindfulness training
Potentially Harmful ADHD Treatments
Talk to your healthcare provider before trying alternative treatments for ADHD. Some can interfere with prescribed ADHD treatments, and some can even be harmful, including:
- Allergy Treatment
- super vitamin
- herbal supplements
- restricted diet
- exercise therapy
- Anti motion sickness treatment
- eye movement training
Living with a child or teen with ADHD can be a challenge for the entire family. As a parent, it’s important to understand ways to help your child overcome the challenges of ADHD, while seeking support and help for yourself when needed.
There are ways to help manage your child’s behavior and cope with common ADHD challenges. You can learn more about ADHD parenting tips at helpguide.org. Access to professional help and education for parents and behavioral therapy for children (as early in the disease process as possible) are essential to helping parents and children with ADHD cope effectively.