Attention deficit hyperactivity disorder (ADHD) is a disorder that appears in early childhood. You may know it by the name attention deficit disorder, or ADD. ADD/ADHD makes it difficult for people 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 ADD/ADHD.
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 disorder (ADD/ADHD), which can affect your child’s ability to learn and get along with others. The first step to addressing the problem is to recognize the signs and symptoms.
The three primary characteristics of ADD/ADHD are inattention, hyperactivity, and impulsivity. The signs and symptoms a child with attention deficit disorder has depends on which characteristics predominate.
Children with ADD/ADHD may be:
1). Inattentive, but not hyperactive or impulsive.
2). Hyperactive and impulsive, but able to pay attention.
3). Inattentive, hyperactive, and impulsive (the most common form of ADD/ADHD).
Children who only have inattentive symptoms of ADD/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.
The exact causes of ADHD are not known with certainty.
Experts do know that ADHD has a strong genetic component. In addition, they think that genes that control the levels of certain chemicals in the brain called neurotransmitters seem to be different in those with ADHD.
In some cases, though, there is no genetic link to ADHD, but other common behaviors, such as smoking or drinking during pregnancy, as well as other obstetrical complications have been linked to ADHD in children.
Babies with low birth weight may have an increased risk of ADHD. The same is true for children who have had head injuries, particularly an injury to the frontal lobe. Young children who are exposed to lead or other environmental toxins such as PCBs or pesticides early in life may also have a higher risk of ADHD.
ADHD always begins in childhood. For some people, though, ADHD is not diagnosed until adulthood. That means adults who are newly diagnosed have actually had ADHD for years, and have had to endure symptoms as they’ve matured. In addition, research shows that between 30% and 70% of children with ADHD continue to have symptoms of the disorder when they become adults.
Children with ADHD show signs of inattention, hyperactivity, and/or impulsivity in specific ways. These children:
Are in constant motion
Squirm and fidget
Do not seem to listen
Have difficulty playing quietly
Often talk excessively
Interrupt or intrude on others
Are easily distracted
Do not finish tasks
Some behaviors can appear to be ADHD-related, but are not. Some causes of ADHD-like behavior are:
A sudden life change (such as divorce, a death in the family, or moving)
Undetected seizures
Medical disorders affecting brain function
Anxiety
Depression
Your child’s primary care doctor can determine whether your child has ADHD using standard guidelines developed by the American Academy of Pediatrics, who say the condition may be diagnosed in children ages 4 to 18 years.
Know, however, that it is very difficult to diagnose ADHD in children younger than 5 years of age. That’s because many preschool children have some of the symptoms seen in ADHD in various situations. In addition, children change very rapidly during the preschool years
The process of diagnosing ADHD requires several steps and involves gathering a lot of information from multiple sources. You, your child, your child’s school, and other caregivers should be involved in assessing your child’s behavior.
A health care provider will obtain a medical history to help put a child’s behavior in context. The health care provider will also ask what symptoms a child is showing, how long the symptoms have been occurring, and how the behavior affects a child and his or her family. The health care provider will also conduct a physical examination to rule out other medical causes for the behaviors you are seeing.
Treatment of ADHD helps control the ADHD symptoms, including inattention, hyperactivity, and impulsivity. Consistent ADHD treatment can improve the ability of the person with ADHD to function better in school, at work, and in social situations.
Treatment for ADHD is multifaceted. It consists of ADHD medications or behavioral modification therapy or both. ADHD treatment should be tailored to meet the unique needs of the child or adult who has ADHD as well as the needs of the family.
Studies have established the safety and effectiveness of using stimulant medications, other drugs, and behavioral therapy. These treatments do more than simply relieve the symptoms of ADHD. They also improve the child’s ability to follow rules and to improve relationships with peers and parents.
There are two treatment strategies that have been shown to be effective for elementary-school-aged children with ADHD. The first is a closely monitored medication treatment program. The second is a program that combines medication with intensive behavior therapy. In a large study, nine out of 10 children improved substantially with one of these two treatment strategies.
The most effective approach to treatment for children and adolescents with ADHD is a multidisciplinary approach. This approach includes multiple elements that work best together and support each other.