ADD & ADHD in Children

What is ADD / ADHD?

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, 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 ADHD.

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 and attentiveness.

The signs and symptoms of ADD / ADHD typically appear before the age of 7. However, it can be difficult to distinguish between ADHD and normal “kid behavior.” If you spot just a few signs, or the symptoms appear only in some situations, it’s probably not ADD / ADHD. On the other hand, if your child shows a number of disruptive ADD / ADHD signs and symptoms that are present across all situations – at home, at school, and at play – it’s time to take a closer look.

Is it really ADD / ADHD?

Just because a child has symptoms of inattention, impulsivity, or hyperactivity does not mean that he or she has ADD or ADHD. Many other things can cause symptoms that are identical to the symptoms of ADD / ADHD. Before an accurate diagnosis of ADD / ADHD can be made, it is important that you see a mental health professional to explore and rule out the following possible causes of the ADHD-like symptoms:

• Major life events or traumatic experiences that have caused stress (e.g. a recent move, death of a loved one, bullying, illness, divorce).
• Learning disabilities or problems with reading, writing, motor skills, or language.
• Psychological problems including anxiety, depression, and bipolar disorder.
• Behavioral disorders such as conduct disorder and oppositional defiant disorder.
• Medical conditions, including thyroid problems, neurological conditions, epilepsy, and sleep disorders.

Signs and symptoms of ADD & ADHD

When many people think of ADHD, they picture an out-of-control kid in constant motion, bouncing off the walls and disrupting everyone around. But this is not the only possible picture. Some children with ADD/ADHD are hyperactive, while others sit quietly (with their attention miles away). Some put too much focus on a task and have trouble shifting it to something else. Others are only mildly inattentive but overly impulsive.

The 3 primary characteristics of ADD / ADHD are inattention, hyperactivity, and impulsivity. The signs and symptoms a child with ADD / ADHD has depends on which characteristics predominate. Children with ADD / ADHD may be:

• Inattentive, but not hyperactive or impulsive.
• Hyperactive and impulsive, but able to pay attention.
• Inattentive, hyperactive, and impulsive (the most common form of 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; and clashing with other kids over not playing by the rules.

Inattentive signs and symptoms of ADD / ADHD

Children with ADD / ADHD can pay attention when they’re doing things they enjoy or hearing about topics in which they’re interested. But when the task is repetitive or boring, they quickly tune out.

Not paying close enough attention is another common problem. Children with ADD / ADHD often bounce from task to task without completing any of them, or skip necessary steps in procedures. Organizing their schoolwork and their time is harder for them than it is for most children. Kids with ADD / ADHD also have trouble concentrating if there are things going on around them; they usually need a calm, quiet environment in order to sustain attention.

Hyperactive signs and symptoms of ADD / ADHD

The most obvious sign of ADD / ADHD is hyperactivity. While many children are naturally quite active, kids with hyperactive symptoms of ADD / ADHD are always moving.

They may try to do several things at once, bouncing around from one activity to the next. Even when forced to sit still – which can be very difficult for them – their foot is tapping, their leg is shaking, or their fingers are drumming.

Impulsivity signs and symptoms of ADD / ADHD

The impulsivity of children with ADD / ADHD can cause problems with self-control. Because they censor themselves less than other kids do, they’ll interrupt conversations, invade other people’s space, ask irrelevant questions in class, make tactless observations, and ask overly personal questions.

Children with impulsive signs and symptoms of ADD / ADHD also tend to be moody and to overreact emotionally. As a result, others may start to view the child as disrespectful, weird, or needy.

Positive effects of ADD & ADHD in children

In addition to the challenges, there are also some positive traits associated with people who have ADD or ADHD:

• Creativity – Children who have ADD / ADHD can be marvelously creative and imaginative. The child who daydreams and has ten different thoughts at once can become a master problem-solver, a fountain of ideas, or an inventive artist. Children with ADD may be easily distracted, but sometimes they notice what others don’t see.
• Flexibility – Because children with ADD / ADHD consider a lot of options at once, they don’t become set on one alternative early on and are more open to different ideas.
• Enthusiasm and spontaneity – Children with ADD / ADHD are rarely boring! They’re interested in a lot of different things and have lively personalities. In short, if they’re not exasperating you (and sometimes even when they are), they’re a lot of fun to be with.
• Energy and drive – When kids with ADD / ADHD are motivated, they work or play hard and strive to succeed. It actually may be difficult to distract them from a task that interests them, especially if the activity is interactive or hands-on.

Keep in mind, too, that ADD/ADHD has nothing to do with intelligence or talent. Many children with ADD/ADHD are intellectually or artistically gifted.

Diagnosing ADD / ADHD in children

At present, no laboratory or imaging test exists to determine if your child has ADD / ADHD. Clinicians base their diagnosis on the signs and symptoms they observe and by ruling out other disorders. In order to get an accurate diagnosis, it is important to have a full medical and psychological evaluation. The doctor should interview you, your child, and any adults who can provide insight, such as teachers or nannies.

When choosing a specialist to diagnose your child, it’s a good idea to get recommendations from other doctors, therapists, and parents. You can also call your insurance company for referrals and information about what is covered by your insurance plan. Mental health professionals who can diagnose ADD / ADHD include psychologists, pediatricians, and psychiatrists.

Helping a child with ADD / ADHD

Whether or not your child’s symptoms of inattention and hyperactivity are due to ADD / ADHD, they can  cause many problems if left untreated. Children who can’t focus and control themselves may struggle in school, get into frequent trouble, and find it hard to get along with others or make friends. These frustrations and difficulties can lead to low self-esteem – as well as friction and stress for the whole family.

But treatment can make a dramatic difference in your child’s symptoms. With the right support, your child can get on track for success in all areas of life.

Parenting tips

If your child is hyperactive, inattentive, or impulsive, it takes a lot of energy to get him or her to listen, finish a task, or sit still. The constant monitoring can be frustrating and exhausting. Sometimes you may feel like your child is running the show. But there are steps you can take to regain control of the situation, while simultaneously helping your child make the most of his or her abilities.

While ADD / ADHD is not caused by bad parenting, good parenting strategies can go a long way in correcting problem behaviors. Children with ADHD need structure, consistency, clear communication, and rewards and consequences for their behavior. They also need lots of love, support, and encouragement.

There are many things parents can do to reduce the signs and symptoms of ADHD – without sacrificing the natural energy, playfulness, and sense of wonder unique in every child.

Treatment for ADD or ADHD

If your child struggles with ADHD-like, don’t wait to seek professional help. You can treat your child’s symptoms of hyperactivity, inattention, and impulsivity without having a diagnosis of ADD / ADHD. Options to start with include getting your child into therapy; implementing a better diet and exercise plan; and modifying the home environment to minimize distractions.

If you receive a diagnosis of ADD / ADHD, you can work with your child’s doctor, therapist, and school to make a personalized treatment plan that meets his or her specific needs. Effective treatment for childhood ADD / ADHD involves behavioral therapy, parent education and training, social support, and assistance at school. Medication is sometimes used, however, it should never be the sole ADD / ADHD treatment.

Related links for ADD / ADHD in children

General information about ADD / ADHD in children

Attention Deficit Hyperactivity Disorder – Overview of ADHD, including its signs, symptoms, causes, and treatment options. (National Institute of Mental Health)

ADHD: What Parents Should Know - Includes signs, symptoms and treatment of ADHD in children (Family Doctor)

Signs and symptoms ADD / ADHD in children

ADHD: What are the Signs? – Detailed look at the signs and symptoms of inattention, impulsivity, and hyperactivity in children with ADHD. (Family Education Network)

Attention Deficit Hyperactivity Disorder – Describes the signs, symptoms and diagnosis of ADD / ADHD in Children. (University of Maryland Medical Center)

A Look at Attention Deficit Hyperactivity Disorder (PDF) - Illustrated booklet detailing the signs and symptoms commonly associated with ADD / ADHD and action steps you can take. (National Institute of Mental Health)

Signs and symptoms of ADD / ADHD in teens

ADHD – A clear, simple, teen-oriented article that provides information about teens who have ADHD, with links to topics of interest to teenagers: driving, getting along with teachers, organizing homework. (KidsHealth.org)

Jeanne Segal, Ph.D., Melinda Smith, M.A., Ellen Jaffe-Gill, and Deborah Cutter, Psy.D., contributed to this article. Last modified on: August 08.