Attention Deficit Hyperactivity Disorder: What Is ADHD?
The National Institute of Mental Health (NIMH) estimates that 3% to 5% of children have ADHD. Some experts, though, say ADHD may occurs in 8% to 10% of school-aged children. Experts also question whether kids really outgrow ADHD. What that means is that this disorder may be more common in adults than previously thought.
Children with ADHD generally have problems paying attention or concentrating. They can't seem to follow directions and are easily bored or frustrated with tasks. They also tend to move constantly and are impulsive, not stopping to think before they act. These behaviors are generally common in children. But they occur more often than usual and are more severe in a child with ADHD.
The behaviors that are common with ADHD interfere with a child's ability to function at school and at home.
Adults with ADHD may have difficulty with time management, organizational skills, goal setting, and employment. They may also have problems with relationships, self-esteem, and addictions.
What are ADHD symptoms in children?
Symptoms of ADHD in children are generally grouped into three categories: inattention, hyperactivity, and impulsiveness.
Inattention -- A child with ADHD:
- Is easily distracted
- Does not follow directions or finish tasks
- Does not appear to be listening when someone is speaking
- Does not pay attention and makes careless mistakes Is forgetful about daily activities
- Has problems organizing daily tasks
- Avoids or dislikes activities that require sitting still or a sustained effort
- Often loses things, including personal items
- Has a tendency to daydream
Hyperactivity -- A child with ADHD:
- Often squirms, fidgets, or bounces when sitting
- Does not stay seated as expected
- Has difficulty playing quietly
- Is always moving, such as running or climbing on things (In teens and adults, this is more commonly described as a sense of restlessness)
- Talks excessively
Impulsivity -- A child with ADHD:
- Has difficulty waiting for his or her turn
- Blurts out answers before the question has been completed
- Often interrupts others
What are ADHD symptoms in adults?
Adult ADHD symptoms may be different than the symptoms in children. In addition, they may stem directly from ADHD or may be the result of behavioral issues. Symptoms include:
- Chronic lateness and forgetfulness
- Low self-esteem
- Employment problems
- Difficulty controlling anger
- Substance abuse or addiction
- Poor organization skills
- Low frustration tolerance
- Chronic boredom
- Difficulty concentrating when reading
- Mood swings
- Relationship problems
What causes ADHD?
The exact cause of ADHD is not known, although researchers continue to study the brain for clues. They suspect that there are several factors that may contribute to the condition, including:
- Heredity: The fact that ADHD tends to run in families suggests that children may inherit a tendency to develop ADHD from their parents.
- Chemical imbalance: Experts believe an imbalance of brain chemicals (neurotransmitters) that transmit nerve impulses may be a factor in the development of ADHD symptoms.
- Brain changes: Areas of the brain that control attention are less active in children with ADHD than in children without ADHD.
The following are other factors that may contribute to the development of ADHD or that may trigger symptoms:
- Poor nutrition, infections, and substance abuse (including cigarette and alcohol use) during pregnancy may be contributing factors. That's because they can affect the development of the baby's brain.
- Exposure to toxins, such as lead or PCBs, in early childhood can also affect brain development.
- Injury to the brain or a brain disorder may play a part in the development of ADHD.
Quick GuideADHD Symptoms in Children
Eating too much sugar does not cause a child to develop ADHD. A proper diet is essential, though, for normal development in children. ADHD is also not caused by watching too much TV, a poor home life, poor schools, or food allergies.
How common is ADHD?
ADHD is the most commonly diagnosed mental disorder of children and is more common in boys than in girls. It most often is discovered during the early school years, when a child begins to have problems paying attention. ADHD can continue into the teen years and on into adulthood.
How is ADHD diagnosed?
If symptoms are present, the doctor will begin an evaluation by taking a complete medical history and doing a physical examination. There are no laboratory tests for ADHD. The doctor, though, may use various tests -- such as blood tests -- to determine if there is a physical disorder or other problem causing the symptoms.
Certain mental illnesses, such as depression and anxiety disorders, have some symptoms that are similar to those of ADHD. For that reason, a complete psychiatric assessment is needed to accurately diagnosis ADHD.
If no physical disorder is found, the child may be referred to a specialist in childhood development disorders. That may be a child and adolescent psychiatrist or psychologist, a pediatric neurologist, a developmental pediatrician, or another health professional. It should be someone specially trained to diagnose and treat ADHD. The doctor bases his or her diagnosis on the child's symptoms and behavior. The doctor may ask for input from the child's parents, teachers, and other adults who are familiar with the child's symptoms.
Researchers all agree that ADHD is not an adult-onset disorder. To be ADHD, symptoms must be verified as being present from childhood. Adults who are thought to have ADHD will be asked questions about their childhood. In particular, they will be asked about such things as:
The answers will help the doctor make an accurate ADHD diagnosis.
What is the treatment for ADHD?
ADHD cannot be cured. But many of the symptoms that interfere with functioning and cause distress can be controlled. Treatment for ADHD often includes a combination of medication and various psychosocial therapies.
Medication: Certain medications called stimulants may be used to help control hyperactivity and impulsive behavior and increase attention span. Commonly used stimulants include:
Sometimes stimulant drugs have worrisome side effects for children. In that case, nonstimulant medications such as Intuniv or Strattera may be prescribed for children with ADHD who are older than 6.
Psychosocial therapies: These are treatment approaches that focus on the behavioral, psychological, social, and work/school problems associated with the illness. Psychosocial therapies that may be used for ADHD include:
- Special education: Special education is a type of education that is structured to meet a child's unique educational needs. Children with ADHD generally benefit most from a highly structured environment and use of routines.
- Behavior modification: Behavior modification includes strategies for supporting good behavior and decreasing a child's problem behavior.
- Psychotherapy (counseling): Psychotherapy can help a child or adult with ADHD learn better ways to handle their emotions and frustration. It can also help improve their self-esteem. Counseling may help family members better understand the child or adult with ADHD.
- Social skills training: Social skills training can help a child learn new behaviors, such as taking turns and sharing. This will enable the child to better function in social situations.
- Support groups: Support groups are generally made up of people with similar problems and needs. This can help with acceptance and support. Groups also can provide a forum for learning more about a disorder and the latest approaches to treatment. These groups are helpful for adults with ADHD or parents of children with ADHD.
What is the outlook for children and adults with ADHD?
It is very important for children and adults with symptoms of ADHD to seek professional care. Without treatment, ADHD can interfere with a child's performance in school as well as the child's ability to make and keep friends. This can have a negative impact on the child's self-esteem.
In addition, children with ADHD are at risk for developing conduct disorder, depression, or an anxiety disorder. They are also more likely to have a learning disorder. Teens with ADHD are at greater risk for car accidents, pregnancy, and tobacco and alcohol use. Adults with ADHD have difficulty with time management, employment, and relationships.
But, when treated, most people with ADHD -- between 70% and 80% -- experience at least some relief of symptoms. Many of the symptoms of ADHD diminish by early adulthood. However, up to 50% of people with ADHD as children continue to have problems as adults.
Is there a way to prevent ADHD?
ADHD cannot be prevented or cured. However, early identification and diagnosis, as well as a carefully designed treatment and education plan, can help a child or adult with ADHD adjust to the disorder. Many people with ADHD learn to focus their attention, develop their personal strengths, minimize disruptive behavior, and become productive and successful.
WebMD Medical Reference
American Academy of Family Physicians: "ADHD: What Parents Should Know."
Attention Deficit Disorder Resources: "Behavioral Treatment for ADHD."
CHADD: "Children and Adults with Attention Deficit Hyperactivity Disorder."
National Resource Center on ADHD: "Symptoms and Diagnostic Criteria."
National Institute of Mental Health: "Attention Deficit / Hyperactivity Disorder."
Reviewed by Patricia Quinn, MD on July 07, 2012
© 2012 WebMD, LLC. All rights reserved.
Quick GuideADHD Symptoms in Children
Daily Health News
Subscribe to MedicineNet's Children's Health & Parenting Newsletter