Attention-Deficit / Hyperactivity Disorder (ADHD) in Children
What is ADHD?
ADHD, also called attention-deficit disorder, is a behavior disorder, usually first
diagnosed in childhood, that is characterized by inattention, impulsivity, and, in
some cases, hyperactivity. These symptoms usually happen together. However, one may
happen without the other(s).
The symptoms of hyperactivity, when present, are almost always apparent by the age
of 7 and may be present in very young preschoolers. Inattention or attention-deficit
may not be evident until a child faces the expectations of elementary school.
What are the different types of ADHD?
Three major types of ADHD include the following:
ADHD, combined type. This, the most common type of ADHD, is characterized by impulsive and hyperactive
behaviors as well as inattention and distractibility.
ADHD, impulsive/hyperactive type. This, the least common type of ADHD, is characterized by impulsive and hyperactive
behaviors without inattention and distractibility.
ADHD, inattentive and distractible type. This type of ADHD is characterized predominately by inattention and distractibility
What causes attention-deficit/hyperactivity disorder?
ADHD is one of the most researched areas in child and adolescent mental health. However,
the precise cause of the disorder is still unknown. Available evidence suggests that
ADHD is genetic. It is a brain-based biological disorder. Low levels of dopamine (a
brain chemical), which is a neurotransmitter (a type of brain chemical), are found
in children with ADHD. Brain imaging studies using PET scanners (positron emission
tomography; a form of brain imaging that makes it possible to observe the human brain
at work) show that brain metabolism in children with ADHD is lower in the areas of
the brain that control attention, social judgment, and movement.
Who is affected by attention-deficit/hyperactivity disorder?
Estimates suggest that about 4% to 12% of children have ADHD. Boys are 2 to 3 times
more likely to have ADHD of the hyperactive or combined type than girls.
Many parents of children with ADHD experienced symptoms of ADHD when they were younger.
ADHD is commonly found in brothers and sisters within the same family. Most families
seek help when their child's symptoms begin to interfere with learning and adjustment
to the expectations of school and age-appropriate activities.
What are the symptoms of attention-deficit/hyperactivity disorder?
The following are the most common symptoms of ADHD. However, each child may experience
symptoms differently. The 3 categories of symptoms of ADHD include the following:
Short attention span for age (difficulty sustaining attention)
Difficulty listening to others
Difficulty attending to details
Poor organizational skills for age
Poor study skills for age
Often interrupts others
Has difficulty waiting for his or her turn in school and/or social games
Tends to blurt out answers instead of waiting to be called on
Takes risks often, and often without thinking before acting
Seems to be in constant motion; runs or climbs, at times with no apparent goal except
Has difficulty remaining in his or her seat even when it is expected
Fidgets with hands or squirms when in his or her seat and fidgets excessively
Has difficulty engaging in quiet activities
Loses or forgets things repeatedly and often
Inability to stay on task and shifts from one task to another without bringing any
The symptoms of ADHD may resemble other medical conditions or behavior problems. Keep
in mind that many of these symptoms may happen in children and teens who do not have
ADHD. A key element in diagnosis is that the symptoms must significantly get in the
way of the child effectively functioning in his or her home and school environments.
Always talk with your child's healthcare provider for a diagnosis.
How is attention-deficit/hyperactivity disorder diagnosed?
ADHD is the most commonly diagnosed behavior disorder of childhood. A pediatrician,
child psychiatrist, or a qualified mental health professional usually identifies ADHD
in children. A detailed history of the child's behavior from parents and teachers,
observations of the child's behavior, and psychoeducational testing contribute to
making the diagnosis of ADHD. Because ADHD is a group of symptoms, diagnosis depends
on evaluating results from several different sources, including physical, neurological,
and psychological testing. Certain tests may be used to rule out other conditions,
and some may be used to test intelligence and certain skill sets. Talk with your child's
healthcare provider for more information.
Treatment for attention-deficit/hyperactivity disorder
Your child's healthcare provider will figure out the best treatment for your child
How old you are
His or her overall health and past health
How affected he or she is
How well your child can handle specific medicines, procedures, or therapies
How long the condition is expected to last
Your opinion or preference
Major components of treatment for children with ADHD include parental support and
education in behavioral training, appropriate school placement, and medicine. Treatment
with a psychostimulant is highly effective in most children with ADHD.
Treatment may include:
Psychostimulant medicines. These medicines are used for their ability to balance chemicals in the brain that
prohibit the child from maintaining attention and controlling impulses. They help
"stimulate" or help the brain to focus and may be used to reduce the major characteristics
Medicines that are commonly used to treat ADHD include the following:
Psychostimulants have been used to treat childhood behavior disorders since the 1930s
and have been widely studied. Traditional immediate release stimulants take effect
in the body quickly, work for 1 to 4 hours. They are then eliminated from the body.
Many long-acting stimulant medicines are also available, lasting 8 to 9 hours, and
needing 1 daily dosing. Doses of stimulant medicines need to be timed to match the
child's school schedule to help the child pay attention for a longer period of time
and improve classroom performance. The common side effects of stimulants may include
Most side effects of stimulant use are mild, decrease with regular use, and respond
to dose changes. Always discuss potential side effects with your child's healthcare
Antidepressant medicines may also be given to children and adolescents with ADHD to
help improve attention while decreasing aggression, anxiety, and/or depression.
Psychosocial treatments. Parenting children with ADHD may be difficult and can present challenges that create
stress within the family. Classes in behavior management skills for parents can help
reduce stress for all family members. Training in behavior management skills for parents
usually happens in a group setting which encourages parent-to-parent support. Behavior
management skills may include the following:
Teachers may also be taught behavior management skills to use in the classroom setting.
Training for teachers usually includes use of daily behavior reports that communicate
in-school behaviors to parents.
Behavior management techniques tend to improve targeted behaviors (such as completing
school work or keeping the child's hands to himself or herself), but are not usually
helpful in reducing overall inattention, hyperactivity, or impulsivity.
Prevention of attention-deficit/hyperactivity disorder
Preventive measures to reduce the incidence of ADHD in children are not known at this
time. However, early detection and intervention can reduce the severity of symptoms,
decrease the interference of behavioral symptoms on school functioning, enhance the
child's normal growth and development, and improve the quality of life experienced
by children or adolescents with ADHD.