ADHD in Children

What is ADHD or ADD?

It’s normal for children to occasionally forget their homework, daydream during class, act without thinking, or get fidgety at the dinner table. But inattention, impulsivity, and hyperactivity are also signs of attention deficit hyperactivity disorder (ADHD), sometimes known as attention deficit disorder or ADD.

ADHD is a common neurodevelopmental disorder that typically appears in early childhood, usually before the age of seven. ADHD makes it difficult for children to inhibit their spontaneous responses—responses that can involve everything from movement to speech to attentiveness. We all know kids who can’t sit still, who never seem to listen, who don’t follow instructions no matter how clearly you present them, or who blurt out inappropriate comments at inappropriate times. Sometimes these children are labeled as troublemakers, or criticized for being lazy and undisciplined. However, they may have ADHD.

Is it normal kid behavior or is it ADHD?

It can be difficult to distinguish between ADHD and normal “kid behavior.” If you spot just a few signs, or the symptoms appear only in some situations, it’s probably not ADHD. On the other hand, if your child shows a number of ADHD signs and symptoms that are present across all situations—at home, at school, and at play—it’s time to take a closer look.

Life with a child with ADHD can be frustrating and overwhelming, but as a parent there is a lot you can do to help control symptoms, overcome daily challenges, and bring greater calm to your family.

ADHD symptoms

When many people think of attention deficit disorder, they picture an out-of-control kid in constant motion, bouncing off the walls and disrupting everyone around. But the reality is much more complex. Some children with ADHD are hyperactive, while others sit quietly—with their attention miles away. Some put too much focus on a task and have trouble shifting it to something else. Others are only mildly inattentive, but overly impulsive.

The signs and symptoms a child with attention deficit disorder has depend on which characteristics predominate.

Children with ADHD may be:

• Inattentive, but not hyperactive or impulsive.
• Hyperactive and impulsive, but able to pay attention.
• Inattentive, hyperactive, and impulsive (the most common form of ADHD).

Children who only have inattentive symptoms of ADHD are often overlooked, since they're not disruptive. However, the symptoms of inattention have consequences: getting in hot water with parents and teachers for not following directions; underperforming in school; or clashing with other kids over not playing by the rules.

Which one of these children may have ADHD?

A. The hyperactive boy who talks nonstop and can't sit still.
B. The quiet dreamer who sits at her desk and stares off into space.
C. Both.

The correct answer is “C.”

ADHD symptoms at different ages

Because we expect very young children to be easily distractible and hyperactive, it's the impulsive behaviors—the dangerous climb, the blurted insult—that often stand out in preschoolers with ADHD. By age four or five, though, most children have learned how to pay attention to others, to sit quietly when instructed to, and not to say everything that pops into their heads. So by the time children reach school age, those with ADHD stand out in all three behaviors: inattentiveness, hyperactivity, and impulsivity.

ADHD in girls

Girls are less likely to be diagnosed and treated for ADHD than boys. Some people even mistakenly believe that the condition only occurs in boys. In actuality, the symptoms of ADHD can look different in girls in ways that make the disorder harder to notice.

Girls with ADHD may not seem as hyperactive, impulsive, or disruptive in class as boys. However, they may quietly struggle with anxiety, forgetfulness, disorganization, and lack of focus. Girls with ADHD may also use better coping strategies to compensate for their difficulties, such as putting in extra effort into their schoolwork. 

Many girls don't receive a formal ADHD diagnosis until later in life. By that time, they’ve likely had to endure the consequences of living with an unrecognized and untreated disorder. These consequences could include problems in school and relationships, as well as low self-confidence or even depression. Getting an early and accurate diagnosis is the best way to ensure your child gets the support she needs

Inattentiveness signs and symptoms of ADHD

It isn't that children with ADHD can't pay attention: when they're doing things they enjoy or hearing about topics in which they're interested, they have no trouble focusing and staying on task. But when the task is repetitive or boring, they quickly tune out.

Staying on track is another common problem. Children with ADHD often bounce from task to task without completing any of them, or skip necessary steps in procedures. Organizing their schoolwork and their time is harder for them than it is for most children. Kids with ADHD also have trouble concentrating if there are things going on around them; they usually need a calm, quiet environment in order to stay focused.

Symptoms of inattention in children

Your child may:

• Have trouble staying focused; be easily distracted or get bored with a task before it's completed.
• Appear not to listen when spoken to.
• Have difficulty remembering things and following instructions; not pay attention to details or makes careless mistakes.
• Have trouble staying organized, planning ahead, and finishing projects.
• Frequently lose or misplace homework, books, toys, or other items.

Hyperactivity signs and symptoms of ADHD

The most obvious sign of ADHD is hyperactivity. While many children are naturally quite active, kids with hyperactive symptoms of attention deficit disorder are always moving. They may try to do several things at once, bouncing around from one activity to the next. Even when forced to sit still, which can be very difficult for them, their foot is tapping, their leg is shaking, or their fingers are drumming.

Symptoms of hyperactivity in children

Your child may:

• Constantly fidget and squirm.
• Have difficulty sitting still, playing quietly, or relaxing.
• Move around constantly, often running or climbing inappropriately.
• Talk excessively.
• Have a quick temper or “short fuse.”

Impulsive signs and symptoms of ADHD

The impulsivity of children with ADHD can cause problems with self-control. Because they censor themselves less than other kids do, they'll interrupt conversations, invade other people's space, ask irrelevant questions in class, make tactless observations, and ask overly personal questions. Instructions like, “Be patient” and “Just wait a little while” are twice as hard for children with ADHD to follow as they are for other youngsters.

Children with impulsive signs and symptoms of ADHD also tend to be moody and to overreact emotionally. As a result, others may start to view the child as disrespectful, weird, or needy.

Symptoms of impulsivity in children

Your child may:

• Act without thinking.
• Guess, rather than taking time to solve a problem; blurt out answers in class without waiting to be called on or hear the whole question.
• Intrude on other people's conversations or games.
• Often interrupt others; say the wrong thing at the wrong time.
• Be unable to keep powerful emotions in check, resulting in angry outbursts or temper tantrums.

Positive effects of ADHD in children

ADHD has nothing to do with intelligence or talent. What's more, kids with attention deficit disorder often demonstrate the following positive traits:

Creativity. Children who have ADHD can be marvelously creative and imaginative. The child who daydreams and has ten different thoughts at once can become a master problem-solver, a fountain of ideas, or an inventive artist. Children with ADHD may be easily distracted, but sometimes they notice what others don't see.

Flexibility. Because children with ADHD consider a lot of options at once, they don't become set on one alternative early on and are more open to different ideas.

Enthusiasm and spontaneity. Children with ADHD are rarely boring! They're interested in a lot of different things and have lively personalities. In short, if they're not exasperating you (and sometimes even when they are), they're a lot of fun to be with.

Energy and drive. When kids with ADHD are motivated, they work or play hard and strive to succeed. It actually may be difficult to distract them from a task that interests them, especially if the activity is interactive or hands-on.

Is it really ADHD?

Just because a child has symptoms of inattention, impulsivity, or hyperactivity does not mean that they have ADHD. Certain medical conditions, psychological disorders, and stressful life events can cause symptoms that look like ADHD.

Before an accurate diagnosis of ADHD can be made, it is important that you see a mental health professional to explore and rule out the following possibilities:

Learning disabilities or problems with reading, writing, motor skills, or language.

Major life events or traumatic experiences, such as a recent move, death of a loved one, bullying, or divorce.

Psychological disorders including anxiety, depression, or bipolar disorder.

Behavioral disorders such as conduct disorder, reactive attachment disorder, and oppositional defiant disorder.

Medical conditions, including thyroid problems, neurological conditions, epilepsy, and sleep disorders.

Helping a child with ADHD

Whether or not your child's symptoms of inattention, hyperactivity, and impulsivity are due to ADHD, they can cause many problems if left untreated. Children who can't focus and control themselves may struggle in school, get into frequent trouble, and find it hard to get along with others or make friends. These frustrations and difficulties can lead to low self-esteem as well as friction and stress for the whole family.

But treatment can make a dramatic difference in your child's symptoms. With the right support, your child can get on track for success in all areas of life.

If your child struggles with symptoms that look like ADHD, don't wait to seek professional help. You can treat your child's symptoms of hyperactivity, inattention, and impulsivity without having a diagnosis of attention deficit disorder. Options to start with include getting your child into therapy, implementing a better diet and exercise plan, and modifying the home environment to minimize distractions.

If you do receive a diagnosis of ADHD, you can then work with your child's doctor, therapist, and school to make a personalized treatment plan that meets their specific needs. Effective treatment for childhood ADHD involves behavioral therapy, parent education and training, social support, and assistance at school. Medication may also be used; however, it should never be the sole attention deficit disorder treatment.

Parenting tips for children with ADHD

If your child is hyperactive, inattentive, or impulsive, it may take a lot of energy to get them to listen, finish a task, or sit still. The constant monitoring can be frustrating and exhausting. Sometimes you may feel like your child is running the show. But there are steps you can take to regain control of the situation, while simultaneously helping your child make the most of their abilities.

While attention deficit disorder is not caused by bad parenting, there are effective parenting strategies that can go a long way to correct problem behaviors. Children with ADHD need structure, consistency, clear communication, and rewards and consequences for their behavior. They also need lots of love, support, and encouragement.

There are many things parents can do to reduce the signs and symptoms of ADHD without sacrificing the natural energy, playfulness, and sense of wonder unique in every child.

Take care of yourself so you're better able to care for your child. Eat right, exercise, get enough sleep, find ways to reduce stress, and seek face-to-face support from family and friends as well as your child's doctor and teachers.

Establish structure and stick to it. Help your child stay focused and organized by following daily routines, simplifying your child's schedule, and keeping your child busy with healthy activities.

Set clear expectations. Make the rules of behavior simple and explain what will happen when they are obeyed or broken—and follow through each time with a reward or a consequence.

Encourage exercise and sleep. Physical activity improves concentration and promotes brain growth. Importantly for children with ADHD, it also leads to better sleep, which in turn can reduce the symptoms of ADHD.

Help your child eat right. To manage symptoms of ADHD, schedule regular healthy meals or snacks every three hours and cut back on junk and sugary food.

Teach your child how to make friends. Help them become a better listener, learn to read people's faces and body language, and interact more smoothly with others.

School tips for children with ADHD

ADHD, obviously, gets in the way of learning. You can't absorb information or get your work done if you're running around the classroom or zoning out on what you're supposed to be reading or listening to. Think of what the school setting requires children to do: Sit still. Listen quietly. Pay attention. Follow instructions. Concentrate. These are the very things kids with ADHD have a hard time doing—not because they aren't willing, but because their brains won't let them.

But that doesn't mean kids with ADHD can't succeed at school. There are many things both parents and teachers can do to help children with ADHD thrive in the classroom. It starts with evaluating each child's individual weaknesses and strengths, then coming up with creative strategies for helping them focus, stay on task, and learn to their full capability.