Attention Deficit Hyperactivity Disorder (ADHD)

ADHD in Children

It can feel overwhelming when your child is diagnosed with Attention Deficit Hyperactivity Disorder (ADHD). Knowing how to support a child experiencing hyperactivity, trouble focusing or issues getting along with peers can be hard for parents and caregivers. The mental health experts at CHOC are here to help you understand signs and symptoms, explain medication, discuss treatment options and work with you to manage your child’s ADHD.

What is Attention Deficit Hyperactivity Disorder (ADHD)?

Attention Deficit Hyperactivity Disorder (ADHD) is a mental health condition affecting children’s and adolescents’ ability to pay attention, remain focused and control their behaviors. It is estimated to affect up to 11% of school-aged kids, and boys are diagnosed at twice the rate of girls. Adults can also have ADHD, but diagnosis is less common in adulthood.

Children with ADHD may have trouble getting organized or remembering things. ADHD may make a child feel overstimulated, restless, impatient and like it’s difficult to fit in with other kids. These behaviors can make it challenging for kids and adolescents to function at school and home. As children become teens and young adults, they may have trouble thinking before acting or speaking, keeping track of things and focusing on one thing at a time.

What Causes ADHD in Children?

There is no one factor that causes ADHD in children. However, research has shown that both genetics and the environment play a role in the presence of ADHD symptoms. For example, a child who is diagnosed with ADHD is likely to have a parent, sibling, or other close relative who also has ADHD. In addition to genetics, several other things have been linked to an increase risk of ADHD:

  • Being born prematurely
  • Experiencing a head injury
  • Exposure to lead as a child
  • Exposure to toxins (e.g., cigarette smoke) before being born

What are the Signs & Symptoms of ADHD in Children?

Types of ADHD

ADHD symptoms can be separated into three categories of ADHD: hyperactive/impulsive, inattentive and combined. It’s important to note that not all children with ADHD have the same symptoms. Some may be more overactive and impulsive, while others may mainly have difficulty focusing. Some children experience both types of symptoms.

It is important to note what types of symptoms your child experiences in different settings, such as in school, at home, in outside activities and in other situations to get the most complete picture of your child’s ADHD. Your care provider can help you determine which type of ADHD your child has to figure out the best treatment options.

Hyperactive/Impulsive ADHD symptoms

  • Trouble doing activities quietly
  • Excessive talking or chattering at inappropriate times
  • Trouble sitting still
  • Trouble thinking before acting
  • Running or climbing excessively at inappropriate times
  • Trouble waiting one’s turn and often interrupting
  • Difficulty in school; lower grades or getting in trouble with the teacher (note: not all kids with ADHD will struggle in school, and not all kids who struggle in school have ADHD)
  • More frequent accidental injuries than is typical

Inattentive ADHD symptoms

  • Trouble paying attention
  • Frequent daydreaming
  • Issues focusing on one thing at a time
  • Trouble listening when being spoken to
  • Difficulty keeping track of things
  • Trouble remembering to do routine tasks (e.g., homework and chores)
  • Avoidance or reluctance to engage in tasks that require sustained mental effort, such as schoolwork or homework
  • Frequent loss of things that are necessary for tasks or activities like toys, school assignments, pencils, books or tools
  • Issues with following instructions that have multiple steps
  • Difficulty in school; lower grades or getting in trouble with the teacher (note: not all kids with ADHD will struggle in school, and not all kids who struggle in school have ADHD)
  • Struggles with self-esteem
  • Trouble getting along with peers

Combined ADHD

Some kids with ADHD experience symptoms of both hyperactive/impulsive ADHD and inattentive ADHD, also known as combined ADHD. In order to receive a diagnosis of combined ADHD, kids must experience several symptoms from each type. This type of ADHD can have more of an impact on a child’s functioning and may be more difficult to manage due to the large variety of symptoms the child may experience.

ADHD Diagnosis in Children

ADHD diagnosis should be done by a healthcare professional, such as a primary care doctor, therapist, school psychologist or psychiatrist. When diagnosing ADHD, providers look for at least 6 of the common symptoms of ADHD above occurring in more than one setting (for example: symptoms occur at home and in daycare or school).

ADHD can sometimes be mistaken for other mental health conditions. For instance, anxiety, depression and learning disorders can also make it hard for a child to focus. It is also possible for ADHD to exist alongside anxiety, depression or learning problems. Since symptoms can look so different in each child, getting diagnosed by a professional with experience working with ADHD in kids is important to help figure out the right treatment for your child.

Smiling kid sitting at a desk in classroom

ADHD Treatment

ADHD symptoms are manageable, especially with extra support. Early intervention is always recommended to help your child learn skills that they will carry throughout their life. When treatment is delayed, a child with ADHD is more likely to have worsening symptoms or additional mental health conditions. Appropriate treatment options vary for each child depending on their symptoms and best fit for the family. Treatment may include one, or a combination, of these common options:

  • Therapy or counseling: Behavior therapy is the most effective for children with ADHD. It helps strengthen your child’s positive behaviors and decrease the more challenging behaviors that interfere with functioning. This can happen by a therapist directly working with your child, but a lot of it also includes helping parents, siblings and other family members learn how to foster positive behaviors outside of therapy, too.
  • School resources: If your child’s behaviors have been interfering at school, consider talking to a school counselor about a 504 plan. This is a document that allows for environmental changes in the school setting to help your child better succeed. Some examples of possible changes include extra time on tests and assignments, prepared study guides and being seated near the front of the class to reduce distractions.
  • Medication: Your child may also benefit from medication to help regulate behaviors.

ADHD Medication for Children

After your child gets an ADHD diagnosis, doctors may also prescribe medicine to treat it. Medicine doesn’t cure ADHD, but it can help boost the ability to pay attention, to slow down, to show more self-control and to regulate behaviors.

It is important to talk to your child’s primary care doctor or a child psychiatrist to decide if medication is the most appropriate treatment for your child. There are a variety of medications for kids and teens with ADHD. All ADHD medicines require a prescription. Some children may have existing medical conditions that will affect what ADHD medication is safe for them, so be sure to talk to your doctor.