What is attention deficit/hyperactivity disorder?
Attention deficit/hyperactivity disorder (ADHD)—also known as hyperactivity or attention deficit disorder (ADD)—is a common developmental disorder in children. Children with ADHD generally have problems paying attention or concentrating, can’t seem to follow directions, and are easily bored and/or frustrated with tasks. They also tend to move constantly and to be impulsive (not able to think before they act). Although these behaviors are common in children, they occur more often than usual and are more severe in a child with ADHD. With this disorder, these behaviors also interfere with the child’s functioning at school, home or both.
What are the symptoms of ADHD?
Symptoms of ADHD are generally grouped into three categories: inattention, hyperactivity (too much activity) and impulsiveness.
Inattention
- 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
- 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
- Has difficulty waiting for his or her turn
- Blurts out answers before the question has been completed
- Often interrupts others
What causes ADHD?
The exact cause of ADHD is not known, although researchers continue to study the brain for clues. The fact that ADHD tends to run in families suggests that heredity might play a part. Experts also believe an imbalance of the chemicals that help nerve cells in the brain communicate with each other, called neurotransmitters, might be a factor in the development of symptoms. Further, new techniques for studying the brain have shown that the areas of the brain that control attention are less active in children with ADHD than in children without the disorder.
Other factors that might contribute to the development of ADHD or that might trigger symptoms include the following:
- Poor nutrition, infections and substance abuse during pregnancy might be contributing factors, since they can affect the development of the baby’s brain.
- Exposure to toxins, such as lead, in early childhood also can affect brain development and might lead to ADHD symptoms.
- Injury to the brain or a brain disorder might trigger ADHD symptoms.
It is important to note that eating too much sugar does not cause ADHD; however, a proper diet is essential for normal development in children.
How common is ADHD?
ADHD is the most commonly diagnosed disorder of children. It is estimated to affect 3 percent to 5 percent of children (nearly 2 million American 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. However, ADHD can continue into the teen years and adulthood.
How is ADHD diagnosed?
If symptoms are present, the doctor will begin an evaluation by performing a complete medical history and physical examination. Although there are no laboratory tests for ADHD, the doctor might use various diagnostic tests—such as X-rays and blood tests—to determine if there is a physical disorder causing the symptoms. Certain mental disorders, such as depression and anxiety disorder, have some symptoms that are similar to those of ADHD. For that reason, a complete psychiatric assessment is needed to make a diagnosis of ADHD.
If no physical disorder is found, the child might be referred to a specialist in childhood development disorders, such as a child and adolescent psychiatrist or psychologist, pediatric neurologist, developmental pediatrician, or another health professional who is specially trained to diagnose and treat ADHD. The doctor bases his or her diagnosis on the child’s symptoms and behavior. The doctor often seeks input from the child’s parents, teachers and other adults who are familiar with the child’s symptoms.
How is ADHD treated?
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 might be used to help control the hyperactivity and impulsive behavior, and increase attention span. Commonly used stimulants include methylphenidate (Ritalin), dextroamphetamine (Dexedrine) and an amphetamine-mixed salts drug (Adderall). Some children with ADHD respond to antidepressant medications such as bupropion (Wellbutrin).
- Psychosocial therapies — These are treatment approaches that focus on the behavioral, psychological, social and work/school problems associated with the disorder. Psychosocial therapies that might be used for ADHD include:
- Special education — This is an approach to education that is structured to meet the child’s unique educational needs. Children with ADHD generally benefit most from a highly structured environment and use of routines.
- Behavior modification — This includes strategies for supporting positive behavior and decreasing problem behavior by the child.
- Psychotherapy (counseling) — Psychotherapy can help a person with ADHD learn better ways to handle their emotions and frustration, and improve their self-esteem. Counseling also might help family members better understand the child’s disorder and cope with the challenges of living with a child who has ADHD.
- Social skills training — This can help the child learn new behaviors, such as taking turns and sharing, that will enable him or her to better function in social situations.
- Support groups — Support groups are generally made up of people with similar problems and needs, which 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 the disorder.
What are the side effects of treatment?
The medications used to treat ADHD are generally safe and well-tolerated. However, certain side effects might occur. Common side effects of stimulants include loss of appetite and trouble sleeping. One stimulant, pemoline, can cause liver failure in some children. For this reason, this drug is rarely used. Common side effects of the antidepressants include dry mouth, sleepiness and irregular heartbeat.
What are the complications associated with ADHD?
Without treatment, ADHD can interfere with a child’s performance in school, and ability to make and keep friends, which can negatively impact the child’s self-esteem. Children with ADHD are at risk for developing a conduct disorder, depression or an anxiety disorder. They also are more likely to have a learning disorder. Teens with ADHD are at greater risk for car accidents, early pregnancy, tobacco and alcohol use.
What is the outlook for people with ADHD?
Most people with ADHD (between 70 percent and 80 percent) experience at least some relief of symptoms with treatment. Many of the symptoms of ADHD diminish by early adulthood. However, up to 50 percent of people with ADHD as children continue to have some problems as adults.
Can ADHD be prevented?
ADHD cannot be prevented or cured. However, early identification and diagnosis of the disorder, as well as a carefully designed treatment and education plan, can help a child 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.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 12/5/2006…#13668
