Overview

Attention-deficit/hyperactivity disorder (ADHD) is a chronic condition that affects millions of children and can continue into adulthood. It is characterized by a combination of persistent problems, including difficulty sustaining attention, hyperactivity, and impulsive behavior.

Children with ADHD may face challenges such as low self-esteem, troubled relationships, and poor school performance. While some symptoms may lessen with age, others may persist into adulthood. However, individuals can learn strategies to manage their symptoms and be successful.

Treatment for ADHD does not cure the condition, but it can help manage symptoms effectively. The typical approach involves a combination of medications and behavioral interventions. Early diagnosis and treatment are crucial for achieving positive outcomes.

Symptoms

ADHD is characterized by two primary features: inattention and hyperactive-impulsive behavior. These symptoms may start before the age of 12 and can be noticeable as early as 3 years old. ADHD symptoms can vary in severity and may persist into adulthood.

There are three subtypes of ADHD:

  • Predominantly inattentive: The majority of symptoms involve inattention.
  • Predominantly hyperactive/impulsive: The majority of symptoms are hyperactive and impulsive.
  • Combined: A mix of inattentive and hyperactive/impulsive symptoms.

Children with ADHD may exhibit the following symptoms:

Inattention

  • Fail to pay close attention to details or make careless mistakes
  • Have trouble staying focused in tasks or play
  • Appear not to listen when spoken to directly
  • Have difficulty following through on instructions and tasks
  • Struggle with task organization
  • Avoid or dislike tasks requiring mental effort
  • Lose items needed for tasks
  • Be easily distracted and forgetful

Hyperactivity and Impulsivity

  • Fidget, tap hands or feet, squirm in seat
  • Have difficulty staying seated
  • Be constantly on the go
  • Engage in inappropriate running or climbing
  • Have trouble playing quietly
  • Talk excessively
  • Blurt out answers, interrupting others
  • Have difficulty waiting for turn and frequently interrupt

It’s important to note that most healthy children can exhibit inattentive, hyperactive, or impulsive behavior at times, which is typical for their age. A medical evaluation is necessary to diagnose ADHD.

When to See a Doctor

If you suspect your child shows signs of ADHD, it’s essential to see a pediatrician or family doctor. A medical evaluation will help rule out other possible causes of your child’s difficulties before considering ADHD as a diagnosis.

Causes

The exact cause of ADHD is not clear, but research is ongoing. Factors that may contribute to its development include genetics, environmental factors, and problems with the central nervous system during critical stages of development.

Risk Factors

Risk factors for ADHD may include having blood relatives with ADHD or other mental health disorders, exposure to environmental toxins, maternal drug use, alcohol use or smoking during pregnancy, and premature birth. Sugar has not been proven to cause hyperactivity, and other issues in childhood can lead to difficulty sustaining attention without being ADHD.

Complications

ADHD can present challenges for children, affecting their academic performance, self-esteem, relationships with peers and adults, and increasing the risk of accidents and injuries. Individuals with ADHD are also more likely to have coexisting conditions, such as oppositional defiant disorder, conduct disorder, learning disabilities, substance use disorders, anxiety disorders, mood disorders, autism spectrum disorder, and tic disorder or Tourette syndrome.

Prevention

To reduce the risk of ADHD in children:

  • Avoid anything that could harm fetal development during pregnancy, such as alcohol, recreational drugs, or smoking cigarettes.
  • Protect your child from exposure to pollutants and toxins, including cigarette smoke and lead paint.
  • Limit screen time for children in their early years.

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Diagnosis

A child shouldn’t receive a diagnosis of attention-deficit/hyperactivity disorder (ADHD) unless the core symptoms start before age 12 and create significant problems at home and school on an ongoing basis. There’s no specific test for ADHD, but the diagnosis will likely include:

  • Medical exam to rule out other possible causes of symptoms
  • Information gathering about medical history, family history, and school records
  • Interviews or questionnaires with family members, teachers, caregivers, etc.
  • ADHD criteria from the Diagnostic and Statistical Manual of Mental Disorders DSM-5
  • ADHD rating scales to collect and evaluate information

Diagnosing ADHD in young children is more challenging, as signs may be mistaken for developmental problems. Evaluation by specialists like psychologists, psychiatrists, or speech pathologists may be necessary.

Other Conditions That Resemble ADHD

Various medical conditions or treatments may cause symptoms similar to ADHD, including learning or language problems, mood disorders, seizure disorders, vision or hearing problems, autism spectrum disorder, medical problems, or medications affecting thinking or behavior, sleep disorders, and brain injury.

Treatment

Treatment for ADHD in children may involve medications, behavior therapy, counseling, and education services. Standard treatments can alleviate many symptoms, but they don’t cure ADHD. Finding the most effective treatment for your child may take time.

Stimulant Medications

Stimulant drugs are the most commonly prescribed medications for ADHD. They help improve signs of inattention and hyperactivity by boosting and balancing neurotransmitter levels in the brain. Examples include:

  • Amphetamines: dextroamphetamine (Dexedrine), dextroamphetamine-amphetamine (Adderall XR, Mydayis), and lisdexamfetamine (Vyvanse)
  • Methylphenidates: methylphenidate (Concerta, Ritalin) and dexmethylphenidate (Focalin)

Stimulants are available in short-acting and long-acting forms. Proper dosing may take time, and side effects should be monitored.

Other Medications

Other medications like atomoxetine (Strattera), bupropion (Wellbutrin), guanfacine (Intuniv), and clonidine (Catapres, Kapvay) may also be used to treat ADHD. These work slower than stimulants and may be good alternatives if stimulants cause side effects or are not suitable due to health issues.

Suicide Risk

There have been concerns about increased suicidal thinking with nonstimulant ADHD medication or antidepressants. Contact your child’s doctor if you notice any signs of suicidal thinking or depression.

Giving Medications Safely

Parents should ensure their child takes the prescribed medication correctly and safely. Stimulant medications are considered safe when used as prescribed. Be cautious about misuse or abuse by others.

ADHD Behavior Therapy

Behavior therapy, social skills training, parent skills training, and counseling can benefit children with ADHD. Collaboration among teachers, parents, therapists, and physicians is essential for the best results. Addressing coexisting conditions, such as anxiety or depression, may also be necessary.

Monarch eTNS System

The Monarch external Trigeminal Nerve Stimulation (eTNS) System is a new medical device approved by the U.S. Food and Drug Administration to treat ADHD in children aged 7 to 12 who are not taking ADHD prescription medicine. It generates low-level electrical stimulation through a patch on the child’s forehead, targeting areas related to attention, emotion, and behavior.

Lifestyle and Home Remedies

Creating an environment in which your child can succeed is essential for managing ADHD. Some suggestions include:

Children at Home

  • Show affection and appreciation regularly
  • Encourage activities that improve self-esteem
  • Use simple words and demonstrate when giving directions
  • Avoid difficult situations for your child
  • Use timeouts or appropriate consequences for discipline
  • Work on organization skills
  • Keep a regular schedule for meals, naps, and bedtime
  • Encourage social interaction
  • Promote healthy lifestyle habits, including adequate rest, a balanced diet, and regular exercise

Children in School

  • Learn about school programs that can support your child
  • Stay in close communication with teachers
  • Advocate for your child’s needs

Alternative Medicine

While there’s little scientific evidence supporting alternative medicine treatments for ADHD, some therapies, such as yoga or meditation, may help children relax and manage symptoms. Special diets, vitamin or mineral supplements, herbal remedies, proprietary formulations, essential fatty acids, and neurofeedback training have been tried but require further research for conclusive evidence.

Coping and Support

Caring for a child with ADHD can be challenging for the entire family. Seek support from social services or support groups, which can offer helpful information about coping with ADHD. Make time for self-care and nurture your relationships, as a strong bond between partners can ease parenting challenges. Be patient, set small goals, and make gradual changes in behavior.

Resources

Various resources, including books, guides, and websites, provide information on ADHD and coping strategies. Be cautious of unproved remedies or conflicting advice.

Preparing for Your Appointment

If you suspect your child has ADHD, start by taking them to a family doctor or pediatrician. Your doctor may refer you to a specialist based on the initial evaluation. Before the appointment, make lists of symptoms, medications, and questions for the doctor.

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