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What is attention deficit hyperactivity disorder (ADHD)?
If children have attention deficit hyperactivity disorder (ADHD), it means they have difficulties with:
- paying attention - for example, they find it hard to concentrate on tasks
- being hyperactive - for example, they find it hard to sit still for long
- controlling impulses - for example, they might do things before thinking them through.
In ADHD the different parts of the brain don't 'talk' to each other in a typical way. Because of this, children with ADHD might have more trouble than their peers with thinking, learning, expressing feelings or controlling behaviour.
Many children have these kinds of difficulties sometimes, but in children with ADHD, these difficulties happen most of the time and have a big effect on their daily lives.
We don't know the exact cause of ADHD. But we do know that ADHD isn't caused by bad parents or parenting. It's not because of inconsistent parenting or a lack of limits on behaviour.
Symptoms of ADHD
Attention deficit hyperactivity disorder (ADHD) symptoms fall into two groups.
This means that a child:
- doesn't pay close attention to details and makes 'careless' mistakes
- has difficulty following instructions and finishing tasks like homework or chores
- has difficulty keeping attention on things and is easily distracted
- is often distracted by little things
- has trouble remembering everyday things
- avoids tasks that require a lot of mental effort like schoolwork or homework
- doesn't seem to listen when spoken to
- has trouble getting things in order or doing things on time
- often loses things like schoolwork, pencils, books, wallets, keys or mobile phones.
Hyperactive and impulsive symptoms
This means that a child:
- fidgets a lot and can't sit still
- runs around and climbs on things in inappropriate situations
- is on the go all the time
- finds it hard to play or take part in activities quietly
- talks a lot
- has difficulty staying seated at school or the dinner table
- is impatient and doesn't wait for a turn
- blurts out answers before questions are finished
- interrupts other people's conversations or games or uses things without asking.
Even if your child has symptoms like the ones listed above, it doesn't always mean your child has ADHD. There are other problems that could cause behaviour that looks like ADHD - for example, problems with health, emotions, sleep or school. This is why your child needs to be properly assessed.
Diagnosing ADHD: what professionals look at
Children might be diagnosed with one of three types of attention deficit hyperactivity disorder (ADHD), depending on symptoms:
- ADHD combined type: children with this type have both hyperactive/impulsive and inattentive symptoms. They tend to have trouble concentrating, are fidgety or restless and are always on the go. They often act without thinking.
- ADHD inattentive type: children with this type mainly have inattentive symptoms. They tend to have trouble concentrating, remembering instructions, paying attention and finishing tasks.
- ADHD hyperactive/impulsive type: children with this type mainly have hyperactive/impulsive symptoms. They're always on the go, have trouble slowing down and often act without thinking.
When health professionals are working out whether a child has ADHD, they use careful guidelines to check the child's symptoms. They'll look at things like:
- Child's age: the child's symptoms must begin before the age of 12 years. Children are often at least five years old before ADHD is diagnosed because there might be lots of other reasons for difficult behaviour in younger children.
- Number of symptoms: the particular ADHD diagnosis depends on how many inattentive and hyperactive/impulsive symptoms a child has.
- Duration of symptoms: the child must have had symptoms for at least six months.
- Severity of symptoms: a child's symptoms must be worse than children of the same age and happen most of the time. Also, the symptoms must interfere with at least two areas of the child's life - for example, school, home or child care.
Diagnosing ADHD isn't easy, because ADHD can overlap with other medical and behaviour conditions. But the right diagnosis means a child can get the right therapies and management plan for his condition.
Getting an ADHD diagnosis
It's very important to diagnose and treat attention deficit hyperactivity disorder (ADHD) as early as possible. The earlier it's diagnosed, the earlier you and your child's health professionals can work on a plan to manage your child's symptoms.
If you're concerned about your child's behaviour, your GP is a good place to start. Your GP might refer your child to a paediatrician, a psychologist or a child psychiatrist, who can look at your child's symptoms and consider possible diagnoses.
The diagnosis process might include most, if not all, of the following:
- an interview with you and other primary carers of your child
- an interview with your child
- behaviour checklists that you and/or your child's carers and teachers fill out
- discussions with your child's teachers or carers.
Your child might also have other tests, including:
- developmental, learning, educational or IQ checks
- language, speech and movement checks
- general health checks
- vision and hearing tests.
Sometimes ADHD isn't diagnosed until later childhood or the teenage years. This is when children have more schoolwork and go through social and emotional changes. Symptoms that you hadn't noticed before might become more obvious because of these challenges.
ADHD and teenagers
Your child with attention deficit hyperactivity disorder (ADHD) might find the teenage years bring extra challenges. On the other hand, your child might also have built up some strategies to manage her symptoms more effectively.
As your child with ADHD gets older, his ADHD symptoms might change or tone down. For example, your child might still have trouble focusing, remembering things and thinking before he acts, but he might be less obviously hyperactive.
Some children with ADHD don't have symptoms any more when they're adults.
Everyday life for children with ADHD
Children with attention deficit hyperactivity disorder (ADHD) can be highly creative and can spend lots of time doing things they love. They might also be more open to trying new things than other children.
But life with ADHD can sometimes be challenging for children and their families.
For example, some children with ADHD can have trouble falling asleep and staying asleep overnight.
Also, children with ADHD often have problems at school, including learning disabilities, language impairment and movement difficulties.
And some children with ADHD also develop oppositional defiant disorder and conduct disorder, childhood anxiety, teenage anxiety and/or teenage depression.
But ADHD is manageable. Your child's health professionals can work with you to develop strategies to help your child manage her ADHD at home and at school.
Some children with ADHD might enjoy using their energy on sport or dancing. Finding positive ways for your child to use his energy can be good for his self-esteem and help protect him against mental health problems.
Risk factors for ADHD
A combination of genes and environmental factors might increase the risk for attention deficit hyperactivity disorder (ADHD).
There's no evidence that food intolerances cause children to develop ADHD symptoms.
Some artificial food colourings might make children with ADHD more cranky, and their ADHD symptoms might seem worse. These colourings include tartrazine (lemon yellow) (102), quinoline yellow (104), sunset yellow FCD (110), carmoisine (red) (122), ponceau 4R (red) (124) and allura red AC (129).
There are some conditions that don't necessarily cause ADHD but do cause behaviour that looks like ADHD or makes ADHD symptoms worse. These include various genetic syndromes, seizures and hydrocephalus. Conditions like intellectual disability and cerebral palsy also affect the way the different parts of the brain talk to each other.
If you're worried that your child's behaviour might be caused by other developmental problems, make an appointment to see your GP or paediatrician.