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.

Children playing in the grass at a park

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 about 5% of school-aged kids, and boys are diagnosed at twice the rate of girls. Adults can also have ADHD, but diagnosis is less common.

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?

Symptoms can be different for each child and can vary by age and sex. Common ADHD signs and symptoms include:

  • Trouble paying attention
  • Trouble focusing on one thing at a time
  • Trouble listening when being spoken to
  • Trouble doing activities quietly
  • Trouble sitting still
  • Trouble thinking before acting
  • Trouble keeping track of things
  • Trouble waiting one’s turn and often interrupting
  • Trouble remembering to do routine tasks (e.g., homework and chores)
  • Trouble 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)
  • More frequent accidental injuries than is typical
  • Struggles with self-esteem
  • Trouble getting along with peers

It’s important to note that not all children with ADHD have the same symptoms. Some may be overactive and impulsive, and others may mainly have difficulty focusing. Some children experience both types of symptoms.

 

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.

Managing Your Child’s ADHD: Tips for Parents & Caregivers

  • Catch your child being good. Notice the things you like about your child’s behavior and express your appreciation of the good behavior. Be specific about what you appreciate so that your child knows what to keep doing.
  • Use clear commands. Be clear and specific when giving instructions (for example, “walk please,” instead of saying “don’t run”). Use one command at a time, as multiple steps can be difficult for children with ADHD to follow.
  • Praise your child’s good behavior and ignore inappropriate behavior. Give positive feedback for good behavior and try to actively ignore misbehavior if it’s safe to. Because your reactions, even if negative, can be rewarding to your child, taking this attention away is a direct consequence for inappropriate behaviors that can help to decrease these behaviors from occurring as frequently in the future. However, never ignore dangerous behaviors, such as your child harming themselves. Active ignoring means still being aware of what your child is doing so that once he/she displays positive behaviors, you are ready to show appreciation.
  • Use consequences and rewards. Make sure consequences and rewards are used immediately. Rewards should be used after positive behaviors to increase the likelihood that they will happen more. For example, a reward may be allowing your child to choose a dessert after finishing dinner. On the other hand, consequences should be used after challenging behaviors to help decrease their frequency and help your child learn what is not appropriate. A consequence may be removing your attention (as described above) or removing video games if a child refuses to do chores. It is important that the rewards and consequences are things your child cares about, are fair for the behavior and are things that you can follow through with each time.
  • Identifying and labeling emotions. Children are born with the ability to express emotions but not the ability to know how to appropriately express them. Teach your child about emotion and ways to express emotion by commenting on your child’s feelings, and your own and others’ emotions. For example, sharing “I am very sad today,” or saying, “I know you are mad, but it is not ok to hit others when you’re mad.”
  • Developing routines. Help your child develop strategies to organize themselves. These might include a written daily schedule, a homework notebook, a chore chart, etc.
  • Give frequent breaks. When your child is doing a difficult task, such as homework, build in frequent, short breaks (about 5 minutes) to help with concentration.
  • Find treatment for your child. Your child may benefit from parent training, therapy/counseling and/or medication. Talk with your child’s doctor to decide what will work best for your family.