What You Need to Know

Have you noticed that your child or teen finds it hard to pay attention? Do they often move around during times when they shouldn’t, act impulsively, or interrupt others? If such issues are ongoing and seem to be impacting your child’s daily life, they may have attention-deficit/hyperactivity disorder (ADHD).

ADHD can impact the social relationships and school performance of children and teens, but there are effective ways available to manage the symptoms of ADHD. Learn about ADHD, how it’s diagnosed, and how to find support.

What is ADHD?

ADHD is a developmental disorder associated with an ongoing pattern of inattention, hyperactivity, and/or impulsivity. Symptoms of ADHD can interfere with daily activities and relationships. ADHD begins in childhood and can continue into the teen years and adulthood.

What are the symptoms of ADHD?

People with ADHD experience an ongoing pattern of the following types of symptoms:

• Inattention—having difficulty paying attention
• Hyperactivity—having too much energy or moving and talking too much
• Impulsivity—acting without thinking or having difficulty with self-control

Some people with ADHD mainly have symptoms of inattention. Others mostly have symptoms of hyperactivity-impulsivity. Some people have both types of symptoms.

Signs of inattention may include:

• Not paying close attention to details or making seemingly careless mistakes in schoolwork or during other activities
• Difficulty sustaining attention in play and tasks, including conversations, tests, or lengthy assignments
• Trouble listening closely when spoken to directly
• Finding it hard to follow through on instructions or to finish schoolwork or chores, or starting tasks but losing focus and getting easily sidetracked
• Difficulty organizing tasks and activities, such as doing tasks in sequence, keeping materials and belongings in order, managing time, and meeting deadlines
• Avoiding tasks that require sustained mental effort, such as homework
• Losing things necessary for tasks or activities, such as school supplies, books, eyeglasses, and cell phones
• Being easily distracted by unrelated thoughts or stimuli
• Being forgetful during daily activities, such as chores, errands, and keeping appointments

Signs of hyperactivity and impulsivity may include:

• Fidgeting and squirming while seated
• Getting up and moving around when expected to stay seated, such as in a classroom
• Running, dashing around, or climbing at inappropriate times or, in teens, often feeling restless
• Being unable to play or engage in hobbies quietly
• Being constantly in motion or on the go and/or acting as if driven by a motor
• Talking excessively
• Answering questions before they are fully asked or finishing other people’s sentences
• Having difficulty waiting one’s turn, such as when standing in line
• Interrupting or intruding on others, for example, in conversations, games, or activities

How is ADHD diagnosed in children and teens?

To be diagnosed with ADHD, symptoms must have been present before the age of 12. Children up to age 16 are diagnosed with ADHD if they have had at least six persistent symptoms of inattention and/or six persistent symptoms of hyperactivity-impulsivity present for at least 6 months. Symptoms must be present in two or more settings (for example, at home or school or with friends or relatives) and interfere with the quality of social or school functioning.

Parents who think their child may have ADHD should talk to their health care provider. Primary care providers sometimes diagnose and treat ADHD. They may also refer individuals to a mental health professional, such as a psychiatrist or clinical psychologist, who can do a thorough evaluation and make an ADHD diagnosis. Stress, sleep disorders, anxiety, depression, and other physical conditions or illnesses can cause similar symptoms to those of ADHD. Therefore, a thorough evaluation is necessary to determine the cause of the symptoms.

During an evaluation, the health care provider or mental health professional may:

• Examine the child’s mental health and medical history.
• Ask permission to talk with family members, teachers, and other adults who know the child well and see them in different settings to learn about the child’s behavior and experiences at home and school.
• Use standardized behavior rating scales or ADHD symptom checklists to determine whether a child or teen meets the criteria for a diagnosis of ADHD.
• Administer psychological tests that look at working memory, executive functioning (abilities such as planning and decision-making), visual and spatial skills, or reasoning skills. Such tests can help detect psychological or cognitive strengths and challenges as well as identify or rule out possible learning disabilities.

Does ADHD look the same in all children and teens?

ADHD symptoms can change over time as a child grows and moves into the preteen and teenage years. In young children with ADHD, hyperactivity and impulsivity are the most common symptoms. As academic and social demands increase, symptoms of inattention become more prominent and begin to interfere with academic performance and peer relationships. In adolescence, hyperactivity often becomes less severe and may appear as restlessness or fidgeting. Symptoms of inattention and impulsivity typically continue and may cause worsening academic, organizational, and relationship challenges. Teens with ADHD also are more likely to engage in impulsive, risky behaviors, including substance use and unsafe sexual activity.

Inattention, restlessness, and impulsivity continue into adulthood for many individuals with ADHD, but in some cases, they may become less severe and less impairing over time.

What causes ADHD?

Researchers are not sure what causes ADHD, although many studies suggest that genes play a large role. Like many other disorders, ADHD probably results from a combination of factors. In addition to genetics, researchers are looking at possible environmental factors that might raise the risk of developing ADHD and are studying how brain injuries, nutrition, and social environments might play a role in ADHD.

What are the treatments for ADHD in children and teens?

Although there is no cure for ADHD, currently available treatments may help reduce symptoms and improve functioning. ADHD is commonly treated with medication, education or training, therapy, or a combination of treatments.

Medication

Stimulants are the most common type of medication used to treat ADHD. Research shows these medications can be highly effective. Like all medications, they can have side effects and require an individual’s health care provider to monitor how they may be reacting to the medication. Nonstimulant medications are also available. Health care providers may sometimes prescribe antidepressants to treat children with ADHD. Sometimes an individual must try several different medications or dosages before finding what works for them.

Psychotherapy and Psychosocial Interventions

Several psychosocial interventions have been shown to help children and their families manage symptoms and improve everyday functioning.

• Behavioral therapy aims to help a person change their behavior. It might involve practical assistance, such as help organizing tasks or completing schoolwork, learning social skills, or monitoring one’s own behavior and receiving praise or rewards for acting in a desired way.
• Cognitive behavioral therapy helps a person to become more aware of attention and concentration challenges and to work on skills to improve focus.
• Family and marital therapy can help family members learn how to handle disruptive behaviors, encourage behavior changes, and improve interactions with children.

All types of therapy for children and teens with ADHD require parents to play an active role. Psychotherapy that includes only individual treatment sessions with the child (without parent involvement) is not effective for managing ADHD symptoms and behavior. This type of treatment is more likely to be effective for treating symptoms of anxiety or depression that may occur along with ADHD.

Parent Education and Support

Mental health professionals can educate the parents of a child with ADHD about the disorder and how it affects a family. They also can help parents and children develop new skills, attitudes, and ways of relating to each other. Examples include parenting skills training, stress management techniques for parents, and support groups that help parents and families connect with others who have similar concerns.

School-Based Programs

Children and adolescents with ADHD typically benefit from classroom-based behavioral interventions and/or academic accommodations. Interventions may include behavior management plans or teaching organizational or study skills. Accommodations may include preferential seating in the classroom, reduced classwork load, or extended time on tests and exams. The school may provide accommodations through what is called a 504 Plan or, for children who qualify for special education services, an Individualized Education Plan (IEP).

How can I help my child at home?

Therapy and medication are the most effective treatments for ADHD. In addition to these treatments, other strategies may help manage symptoms. Encourage your child to:

• Get regular exercise, especially when they seem hyperactive or restless.
• Eat regular, healthy meals.
• Get plenty of sleep.
• Stick to a routine.
• Use homework and notebook organizers to write down assignments and reminders.
• Take medications as directed.

In addition, you can help your child or teen by being clear and consistent, providing rules they can understand and follow. Also, keep in mind that children with ADHD often receive and expect criticism. You can look for good behavior and praise it and provide rewards when rules are followed.