ADHD in Children: Symptoms, Diagnosis, and Support

What is ADHD in children?

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

What causes ADHD in children?

Despite decades of research, an exact cause of ADHD in children is unknown. However, the strongest research suggests ADHD may be genetic. Research also hints at environmental factors. However, exact factors haven’t been defined.

Certain risk factors do put children at a higher risk for ADHD. They include:

• Having a blood relative, such as a parent or sibling, who has ADHD or another mental health disorder
• Exposure to environmental toxins—such as lead, found mainly in paint and pipes in older buildings
• Maternal drug use, alcohol use, or smoking during pregnancy
• Premature birth

Although many people believe sugar causes hyperactivity, there’s no proof of this. Many issues in childhood can lead to difficulty sustaining attention, but that’s not the same as ADHD.

ADHD symptoms in children

Struggling with inattention, hyperactivity, and impulsivity most of the time are the primary symptoms of ADHD in children. Specific symptoms for each include:

Inattention.

• Inability to pay attention to details or making careless mistakes in schoolwork
• Difficulty focusing on tasks or playtime
• Appearing not to listen, even when spoken to
• Difficulty completing instructions, tasks, schoolwork, or chores
• Inability to organize tasks and activities
• Avoiding or disliking anything that requires mental effort, such as homework
• Losing things easily and frequently, such as toys, school assignments, and supplies
• Being easily distracted
• Forgetting to complete daily activities, such as chores, hygiene, and assignments

Hyperactivity and impulsivity.

• Fidgeting or tapping their hands or feet
• Squirming in their chairs or having trouble staying seated for long periods of time
• Constantly on the go or needing constant motion
• Running and climbing in situations where it’s not appropriate
• Difficulty playing or completing a quiet activity
• Talking too much, not knowing when to stop
• Blurting out answers, interrupting
• Difficulty with turn-taking
• Intruding or interrupting in others’ conversations, games, or activities

ADHD diagnosis in children

Thanks to increased physician training and growing parental awareness, children who have ADHD are being diagnosed earlier. When making an ADHD diagnosis, doctors consider whether symptoms have been present before the age of 12. Children up to age 16 are diagnosed with ADHD if they have had at least 6 persistent symptoms of inattention and/or 6 persistent symptoms of hyperactivity-impulsivity present for at least 6 months. Symptoms must be present in two or more settings. For example, the symptom occurs at home or school or with friends or relatives and interferes with the quality of social or school functioning.

Talk to your doctor if you think your child has symptoms of ADHD. Although your primary care doctor can likely diagnose and treat ADHD, they may also refer you to a developmental pediatrician or a mental health professional. These may include a psychiatrist or clinical psychologist, who can do a thorough evaluation and make an ADHD diagnosis.

During an evaluation, your doctor or mental health professional may:

• Review your child’s mental health and medical history
• Ask to speak with family members, teachers, and other adults who know the child well and see them in different settings
• Look at checklists and administer tests designed to diagnose ADHD

Types of Tests

There are standardized behavior rating scales or ADHD symptom checklists to determine whether a child or teen meets the criteria for a diagnosis of ADHD. Although there is no single ADHD test, multiple psychological tests can look at working memory, executive functioning (abilities such as planning and decision-making), visual and spatial skills, or reasoning skills. These tests can detect psychological or cognitive (brain) strengths and challenges as well as identify or rule out possible learning disabilities.

Childhood ADHD treatment

There is no cure for ADHD. However, most children who have been diagnosed with ADHD are treated with a combination of prescription medicine, psychological and psychosocial behavioral therapy. They also may participate school-based programs that embrace ADHD-friendly classroom strategies, parent, and school support. Each is dependent on a child’s needs and symptoms.

ADHD medications for children

The most common type of medication used to treat ADHD are “stimulants.” Historically, these medications have been effective. However, as with any medication, there can be side effects. If your child is taking ADHD prescription medicine, they must be monitored by their doctor at regular intervals to check for the appropriate dosage and any side effects. Nonstimulant medications are also available. Sometimes doctors will prescribe antidepressants to treat children with ADHD. However, the Food and Drug Administration (FDA) has not approved these medications for treating ADHD. In many cases, a person diagnosed with ADHD must try several different medications or dosages before finding what works for them.

Complementary Health Approaches

Unlike specific psychotherapy and medication treatments that are scientifically proven to improve ADHD symptoms, complementary health approaches for ADHD, such as natural products, do not qualify as evidence-supported interventions. For more information, visit the National Center for Complementary and Integrative Health website. 

Thanks to growing awareness and treatment approaches, there are many tools available for parenting a child with ADHD today. Primary care doctors, as well as mental health professionals, have become experienced in combining prescription medicine and behavioral therapy to help a child be successful in school, at home, and with peers. Similarly, most schools are equipped with ADHD-friendly classrooms and strategies to assist. Often, these strategies are good for all students, including taking breaks to get up out of their chairs and stretch or move.

It’s important for parents to share with the school administration, teaching staff, and school nurse if their child has ADHD. This enables a discussion of medicine and strategies. It’s also important to look for local parent support groups to share your journey. You may find a tip of nugget of information that will help in your journey.

Also, talk to your mental health professional about coping strategies for your child. ADHD isn’t just a challenge for parents, it is frustrating to the child as well. Learning to recognize their own stresses and how to cope with them can help.

Things to Consider

Be cautious about taking your guidance from online social media platforms. Trends that appear on TikTok and other platforms can potentially do more harm than good. Aways rely on medical professionals. Also, learn to separate fact from fiction. Some of the ADHD myths that often circulate include:

• Only boys can have ADHD
• Too much sugar causes ADHD
• ADHD is caused by poor parenting
• ADHD only affects children and will go away when they grow up

Remember, too, that ADHD can coexist and/or be confused with other conditions such as anxiety and depression. Because stress, sleep disorders, anxiety, depression, and other physical conditions or illnesses can cause similar symptoms to those of ADHD, a thorough evaluation is necessary to determine the cause of the symptoms.

Questions to Ask Your Doctor

• How do I know if my child has ADHD?
• Should I speak to a specialist?
• What tests will my child be given?
• How can I help my child in school?
• Can I skip giving my child medicine in the summer?
• Will my child outgrow ADHD?
• Will my other children have ADHD?

Resources

Centers for Disease Control and Prevention: What is ADHD?

National Center for Complementary and Integrative Health: Attention-Deficit Hyperactivity Disorder at a Glance

National Institute of Mental Health: Attention-Deficit/Hyperactivity Disorder in Children and Teens: What You Need to Know