ADD / ADHD

What Is ADHD?

Attention-deficit/hyperactivity disorder (ADHD) is a problem of not being able to focus, being overactive, not being able to control behavior, or a combination of these. For these problems to be diagnosed as ADHD, they must be out of the normal range for a person's age and development.

ADHD usually begins in childhood but may continue into the adult years. It is the most commonly diagnosed behavioral disorder in children, and is diagnosed much more often in boys than in girls. It is not entirely clear what causes ADHD — a combination of genes and environmental factors likely play a role, and imaging studies suggest that the brains of children with ADHD develop differently from those without ADHD.

Symptoms

Symptoms of ADHD fall into three groups:

1. Not being able to focus (inattentiveness)
2. Being extremely active (hyperactivity)
3. Not being able to control behavior (impulsivity)

Some people with ADHD have mainly inattentive symptoms. Some have mainly hyperactive and impulsive symptoms. Others have a combination of different symptom types. Those with mostly inattentive symptoms are sometimes said to have attention deficit disorder (ADD) — they tend to be less disruptive and are more likely to go undiagnosed.

Inattentive Symptoms

• Fails to give close attention to details or makes careless mistakes in schoolwork
• Has difficulty keeping attention during tasks or play
• Does not seem to listen when spoken to directly
• Does not follow through on instructions and fails to finish schoolwork or chores
• Has problems organizing tasks and activities
• Avoids or dislikes tasks that require sustained mental effort (such as schoolwork)
• Often loses toys, assignments, pencils, books, or tools needed for tasks or activities
• Is easily distracted
• Is often forgetful in daily activities

Hyperactivity Symptoms

• Fidgets with hands or feet, or squirms in seat
• Leaves seat when remaining seated is expected
• Runs about or climbs in inappropriate situations
• Has problems playing or working quietly
• Is often "on the go," acting as if "driven by a motor"
• Talks excessively

Impulsivity Symptoms

• Blurts out answers before questions have been completed
• Has difficulty awaiting turn
• Interrupts or intrudes on others (butts into conversations or games)

Signs and Tests

If ADHD is suspected, the individual should be evaluated by a health care professional. There is no single test that can confirm or rule out a diagnosis of ADHD; the diagnosis is based on a pattern of the symptoms listed above. When the person with suspected ADHD is a child, parents and teachers are usually involved throughout the evaluation process. Most children with ADHD also have at least one other developmental or mental health concern, such as a mood disorder, anxiety disorder, substance use disorder, learning disability, or tic disorder — a thorough evaluation helps determine whether any of these conditions are present as well.

Treatment

Treating ADHD is a partnership between the health care provider and the patient. When the patient is a child, parents and often teachers are involved. For treatment to work, it's important to set specific, appropriate goals; begin medication and/or talk therapy; and follow up regularly to check on goals, results, and any side effects.

Medicine combined with behavioral treatment often works best. Several different ADHD medications may be used alone or in combination, and the health care provider will determine which is right based on symptoms and needs. Therapy — for both the patient and, where relevant, the family — can help everyone understand and gain control of the stressful feelings related to ADHD. A common type is behavioral therapy, which teaches children and parents healthy behaviors and how to manage disruptive behaviors; for mild cases, behavioral therapy alone (without medicine) can sometimes be effective. Support groups can also help patients and families connect with others who have similar challenges.

ADHD is a long-term, chronic condition. Left untreated, it may contribute to difficulty with substances, struggles in school, problems keeping a job, and trouble with the law. With the right evaluation and treatment plan, many of these outcomes can be avoided or minimized.

Frequently Asked Questions