ADHD

ADHD (attention-deficit/hyperactivity disorder) is a condition that affects how your brain works. Despite its name, ADHD doesn’t mean that you lack attention. It means that it’s harder for you to control your attention or direct it to certain tasks. ADHD causes symptoms like difficulty focusing, trouble sitting still and impulsive behaviors. But it also allows you to “get in the zone” and hyperfocus on things you really enjoy.

ADHD symptoms begin in childhood (commonly between ages 3 and 6) and may continue into adulthood. But some people don’t get a diagnosis until they’re adults. There’s no cure for ADHD, but treatments like medications and behavioral therapies can help manage symptoms.

Millions of children in the U.S. have an ADHD diagnosis (around 1 in 10 kids age 3 to 17). If your child has ADHD, take some time to learn the facts — and the myths. Connecting with other parents whose kids have ADHD can help you find ways to support your child.

ADHD types

There are four types of ADHD that healthcare providers diagnose in children and adults:

• Inattentive ADHD. This involves difficulty focusing, finishing tasks and staying organized. With this type, you have few or no hyperactivity symptoms.
• Hyperactive-impulsive ADHD. This involves difficulty sitting still or having “quiet time.” You have excess energy and are extremely talkative. You may also interrupt others and act without thinking it through first. You may show less obvious trouble with paying attention.
• Combined presentation. This is the most common type of ADHD, and it’s what most people associate with the condition. You have many inattentive symptoms and hyperactive-impulsive symptoms.
• Unspecified presentation. This is when you have severe symptoms that interfere with daily life, but your symptoms don’t meet the official criteria for the types listed above. In this case, providers assign “unspecified ADHD” as the diagnosis.

Providers also use the terms mild, moderate and severe to describe how much symptoms affect your daily life.

ADHD symptoms

ADHD symptoms fall into two big groups:

• Inattention symptoms. These symptoms affect your ability to focus on a task and complete it from start to finish. You might put off tasks that require focusing. You may also seem distracted when someone’s talking to you and lose things a lot.
• Hyperactivity/impulsivity symptoms. These symptoms affect your ability to sit still or feel comfortable staying in one place. You may also have trouble waiting for your turn to speak or do something.

There are nine symptoms in each group, described below. Keep in mind that these are also common behaviors for many kids. Your child doesn’t necessarily have ADHD if they do some of these things from time to time. Healthcare providers have careful criteria for diagnosing ADHD.

Inattention symptoms

You may notice your child:

• Avoids tasks that require focusing for a long time
• Doesn’t pay attention to details or makes seemingly careless mistakes
• Forgets to do things they’re supposed to
• Gets easily distracted by things going on around them, or sometimes their own thoughts
• Has difficulty with organizing things, like toys in their room, supplies in their backpack or steps in a project
• Has trouble staying focused on things they’re doing, including listening to presentations or reading a long passage
• Loses things they need, like school papers or eyeglasses
• Seems distracted or like they’re daydreaming when someone is directly talking to them
• Starts a task easily enough but then gets sidetracked and doesn’t finish it (this might affect things like doing their chores or completing their homework)

Hyperactivity/impulsivity symptoms

You may notice your child:

• Fidgets or makes small movements with their hands or feet, especially when sitting down to eat or do homework
• Gets up when they’re supposed to stay seated
• Has a hard time playing or doing other tasks quietly
• Has difficulty waiting for their turn to do something
• Interrupts what others are doing — for example, jumping into a game other kids are playing or grabbing someone’s toy without permission
• Jumps, climbs, runs or feels restless when they’re supposed to stay in one place
• Seems like they’re always “on the go” or “driven by a motor”
• Speaks out of turn or finishes others’ sentences
• Talks more than you’d expect

ADHD causes

ADHD is genetic. This means your child is born with certain gene changes that cause differences in their brain development (neurodivergence). Often, the gene changes that cause ADHD are passed down within biological families. Kids with ADHD commonly have biological parents or siblings with the condition.

Researchers continue to look into how ADHD affects the brain. Here’s what we know so far. With ADHD, the frontal lobe of your child’s brain is wired in a way that makes it harder for them to use directed attention. Directed attention is the ability to focus on something you don’t find very interesting.

We use directed attention to plan, multitask and solve problems (executive functions). It can take a lot of energy to use directed attention, especially when there are other, more interesting things around us.

If your child has ADHD, it takes even more energy than usual to direct their attention to things they have to do. That means after a long day at school, your child might resist doing a task that otherwise seems simple — like hanging up their coat or backpack. The attention it requires to do these “basic” chores is simply not available to them.

On the other hand, your child is better than most neurotypical kids at using automatic attention. This is the type of attention we use to focus on something we’re interested in. It allows for something called hyperfocus, or the ability to “get in the zone” and do something for hours on end. Your child might use hyperfocus to become really good at a hobby or game or to reach certain goals.

Risk factors

Experts believe that some people have genes that predispose them to ADHD. In other words, the genes make ADHD a possibility for that person. But then, certain environmental factors tip the scales and cause ADHD to develop.

Environmental risk factors include:

• Exposure to certain toxins during fetal development, including tobacco, alcohol or lead
• Low birth weight (the lower the weight, the higher the risk)
• Preterm birth

Complications of this condition

ADHD can affect how your child feels about themselves and how they engage with the world around them. Without proper treatment, your child may have:

• Low self-esteem
• Poor grades and an inability to reach their full potential
• Difficulty in social situations, partly due to peers teasing them or not wanting to hang out with them
• An increased risk of developing substance use disorders when they’re older
• Frequent driving accidents and injuries
• Trouble getting and keeping a job when they’re older

How doctors diagnose ADHD

Healthcare providers diagnose ADHD based on the presence and absence of certain symptoms. They use the criteria listed in the DSM-5-TR.

Your child will receive an ADHD diagnosis if all of the following are true:

• Your child has at least six symptoms from one group (inattention or hyperactivity/impulsivity). Or they have at least six symptoms from each group (for a total of twelve or more).
• Symptoms began before age 12.
• Symptoms occur in at least two settings (for example, at home and at school).
• Symptoms disrupt your child’s daily activity and friendships.
• Another medical condition isn’t responsible for these symptoms.

There’s no lab test (like a blood or urine test) that can diagnose ADHD. Instead, healthcare providers do what’s called an ADHD assessment. This involves talking to you, your child and others — like friends, family members and teachers — to learn more about your child’s behaviors.

Diagnosis occurs in three steps. Providers:

• Identify clusters of behaviors related to attention and activity
• Rule out alternative causes of these behaviors (like depression or anxiety)
• Confirm the presence of any co-occurring conditions (see below)

Children with ADHD often have other mental health conditions, like:

• Anxiety
• Depression
• Oppositional defiant disorder

They may also have other neurodevelopmental disorders, like autism or a learning disability. Your child’s provider may recommend additional assessments to diagnose or rule out these other conditions.

What should I know about ADHD treatment?

ADHD treatments fall into two main groups: behavioral interventions (which teach practical skills) and medications. The exact treatment plan varies according to a person’s age and individual needs.

If your child has ADHD, their provider may recommend one or more of the following:

• Parent training. Therapists teach you how to help your child build on their strengths and improve behaviors that cause them difficulty. For example, you learn how to establish a routine for your child, encourage positive behaviors and respond to negative ones.
• Social skills groups. Your child may benefit from social skills training groups. These groups meet for one or two hours a week, typically over a six-to-12-week period. Your child learns new skills for interacting with peers in a supervised setting.
• Medications (pharmacotherapy). ADHD medications improve your child’s ability to use directed attention, in turn improving symptoms and — more importantly — their quality of life and relationships. Providers monitor your child to see how the medicines are working and whether your child has side effects. They adjust medication types and doses as needed.

The goal of ADHD treatment is to improve symptoms as your child goes about their daily life. For younger children (ages 4 and 5), providers recommend parent training before trying medication. Usually, the best treatment for older kids, adolescents and adults is a combination of behavioral interventions and medication.

There’s currently no evidence that traditional “talk” or “play” therapies help kids with ADHD. But your child’s provider may recommend such therapies for co-occurring conditions.

How can I help my child at home?

Parent training teaches you effective strategies you can use from day to day. Providers can also give you tips tailored to your child’s unique needs. In general, here are some things you can do to help your child. (These aren’t a substitute for treatment your provider recommends, including any medications.)

• Organize items your child needs every day. Have a place for everything and keep everything in its place. This includes clothes, backpacks and school supplies. An organization checklist may be helpful.
• Stick to a schedule. Follow the same routine every day, from wake-up time to bedtime. The schedule should include time for homework and play.
• Use a calendar or planner your child can see. Create a place to write down important reminders, responsibilities and events. These tools may be especially helpful for adolescents and young adults who struggle with time management.
• “Catch” your child being good. Pointing out positive behaviors teaches your child what they should do. When parents pay attention only to inappropriate behaviors, those behaviors happen more. Punishing a child only teaches them what not to do.
• Discipline effectively. Create a consistent system to reward appropriate behavior. Respond to misbehavior with alternatives such as a “time out” or loss of privileges.
• Pick out a homework area. Set up a home workstation in a quiet area without clutter or distractions.
• Set a timer. Have a timeframe for working on homework. If your child doesn’t finish, take a break and set a new time to finish.
• Praise effort and completion. Reward your child’s completed work instead of pointing out what they didn’t finish.

Is ADHD a disability?

Yes, the Americans with Disabilities Act (ADA) considers ADHD a developmental disability. The condition can affect your child’s ability to do their daily activities, including learning at school. Your child may qualify for special education and/or modified instruction in school.

When should I see a healthcare provider?

If you think your child has ADHD, talk to their pediatrician. They’ll diagnose (or rule out) ADHD and make sure your child gets any treatment they need. Be sure to take your child to routine well-checks. Their pediatrician can monitor their development and provide other necessary care.

If you think you have symptoms of ADHD, talk to a healthcare provider. They’ll walk you through the steps of getting a diagnosis as an adult. They’ll also check for the presence of other conditions that have similar symptoms.

How long does ADHD last?

ADHD doesn’t go away but doesn’t have to be an impairing condition. You can’t outgrow it, but treatment can help manage your symptoms. Thanks to effective treatments, some people don’t show impairment from ADHD symptoms once they’ve reached adulthood. But for others, symptoms still affect their daily life. Providers tailor care to each individual’s needs.