ADHD

ADHD

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common mental disorders affecting children. ADHD also affects many adults. Symptoms of ADHD include inattention (not being able to keep focus), hyperactivity (excess movement that is not fitting to the setting), and impulsivity (hasty acts that occur at the moment without thought).

An estimated 8.4 percent of children and 2.5 percent of adults have ADHD.1,2 ADHD is often first identified in school-aged children when it leads to disruption in the classroom or problems with schoolwork. It can also affect adults. It is more common among boys than girls.

Symptoms and Diagnosis

Many ADHD symptoms, such as high activity levels, difficulty remaining still for long periods of time, and limited attention spans, are common to young children in general. The difference in children with ADHD is that their hyperactivity and inattention are noticeably greater than expected for their age and cause distress and/or problems functioning at home, at school, or with friends.

ADHD is diagnosed as one of three types: inattentive type, hyperactive/impulsive type, or combined type. Diagnosis is based on the symptoms that have occurred over the past six months.

Inattentive type – six (or five for people over 17 years) of the following symptoms occur frequently:

  • Doesn’t pay close attention to details or makes careless mistakes in school or job tasks.
  • Has problems staying focused on tasks or activities, such as during lectures, conversations, or long reading.
  • Does not seem to listen when spoken to (i.e., seems to be elsewhere).
  • Does not follow through on instructions and doesn’t complete schoolwork, chores, or job duties (may start tasks but quickly loses focus).
  • Has problems organizing tasks and work (for instance, does not manage time well; has messy, disorganized work; misses deadlines).
  • Avoids or dislikes tasks that require sustained mental effort, such as preparing reports and completing forms.
  • Often loses things needed for tasks or daily life, such as school papers, books, keys, wallet, cell phone, and eyeglasses.
  • Is easily distracted.
  • Forgets daily tasks, such as doing chores and running errands. Older teens and adults may forget to return phone calls, pay bills, and keep appointments.

Hyperactive/impulsive type – six (or five for people over 17 years) of the following symptoms occur frequently:

  • Fidgets with or taps hands or feet, or squirms in seat.
  • Not able to stay seated (in the classroom, workplace).
  • Runs about or climbs where it is inappropriate.
  • Unable to play or do leisure activities quietly.
  • Always “on the go,” as if driven by a motor.
  • Talks too much.
  • Blurts out an answer before a question has been finished (for instance may finish people’s sentences, can’t wait to speak in conversations).
  • Has difficulty waiting for his or her turn, such as while waiting in line.
  • Interrupts or intrudes on others (for instance, cuts into conversations, games or activities, or starts using other people’s things without permission). Older teens and adults may take over what others are doing.

There is no lab test to diagnose ADHD. Diagnosis involves gathering information from parents, teachers, and others, filling out checklists, and having a medical evaluation (including vision and hearing screening) to rule out other medical problems. The symptoms are not the result of a person being defiant or hostile or unable to understand a task or instructions.

The Causes of ADHD

Scientists have not yet identified the specific causes of ADHD. There is evidence that genetics contributes to ADHD. For example, three out of four children with ADHD have a relative with the disorder. Other factors that may contribute to the development of ADHD include being born prematurely, brain injury and the mother smoking, using alcohol, or having extreme stress during pregnancy.

ADHD and the School-Aged Child

Teachers and school staff can provide parents and doctors with information to help evaluate behavior and learning problems and can assist with behavioral training. However, school staff cannot diagnose ADHD, make decisions about treatment, or require that a student take medication to attend school. Only parents and guardians can make those decisions with the child’s physician.

Students whose ADHD impairs their learning may qualify for special education under the Individuals with Disabilities Education Act or for a Section 504 plan (for children who do not require special education) under the Rehabilitation Act of 1973. Children with ADHD can benefit from study skills instruction, changes to the classroom setup, alternative teaching techniques, and a modified curriculum.

ADHD and Adults

Many adults with ADHD do not realize they have the disorder. A comprehensive evaluation typically includes a review of past and current symptoms, a medical exam and history, and the use of adult rating scales or checklists. Adults with ADHD are treated with medication, psychotherapy, or a combination. Behavior management strategies, such as ways to minimize distractions and increase structure and organization, and involving immediate family members can also be helpful.

Related Conditions

Social communication disorder


Physician Review By:

Ranna Parekh, M.D., M.P.H.
July 2017

References

(1) Danielson, ML, et al. Prevalence of Parent-Reported ADHD Diagnosis and Associated Treatment Among U.S. Children and Adolescents, 2016. Journal of Clinical Child & Adolescent Psychology, Volume 47, 2018 – Issue 2

(2) Simon V , Czobor P , Bálint S , et al: :Prevalence and correlates of adult attention-deficit hyperactivity disorder: a meta-analysis. Br J Psychiatry194(3):204–211, 2009

Parent’s Medication Guide: ADHD

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Created in collaboration with the American Academy of Child and Adolescent Psychiatry (AACAP). Also available in Spanish.

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