Attention deficit hyperactivity disorder (ADHD): what is it?

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 say or do things before thinking them through.

Many children have these kinds of difficulties from time to time. In children with ADHD, these difficulties happen most of the time and have a big effect on their daily lives.

ADHD is a neurodevelopmental disorder – that is, a problem with the way the brain or nervous system grows. In ADHD, the different parts of the brain don’t ‘talk’ to each other in a typical way. This is why children with ADHD might have more trouble than their peers with thinking, learning, expressing feelings or controlling behaviour.

We don’t know exactly what causes ADHD.

Symptoms of ADHD

ADHD symptoms fall into two groups.

Inattentive symptoms
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, like someone moving or a sound outside the window
• 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
• uses things without asking.

Even if your child has symptoms like the ones listed above, it doesn’t always mean your child has ADHD. Other conditions or problems can cause behaviour that looks like ADHD. This is why your child needs to be properly assessed. So if you’re worried about your child’s behaviour for any reason, make an appointment to see your GP or paediatrician.

Diagnosing ADHD: what professionals look at

Children might be diagnosed with one of three types of 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 and 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 guidelines to carefully check the child’s symptoms. They’ll look at things like the following:

• Age: the child’s symptoms must begin before the age of 12 years. Children are usually at least five years old before ADHD is diagnosed because there might be many 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 in other children of the same age and happen most of the time. Also, the symptoms must interfere with the child’s life both at home and at school.

Diagnosing ADHD isn’t easy, because ADHD can overlap with other conditions. But the right diagnosis means a child can get the right therapies and management plan for their condition.

Getting an ADHD diagnosis

It’s important to diagnose and treat 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, psychologist or 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 and changes.

ADHD and teenagers

Children with ADHD might find the teenage years bring extra challenges. On the other hand, your child might also have built up some strategies to manage their symptoms better.

Also, as your child with ADHD gets older, their ADHD symptoms might change or tone down. For example, your child might still have trouble focusing, remembering things and thinking before they act, but they might be less obviously hyperactive.

Some children with ADHD no longer have symptoms when they’re adults.

Everyday life for children with ADHD

Children with ADHD can be highly creative and can spend a lot of time doing things they love. They might be more open to trying new things than other children. And they often enjoy using their energy on sport or dancing. Finding positive ways for your child to use their energy can be good for their self-esteem and help protect them against mental health problems.

Life with ADHD can also be challenging for children and their families sometimes. For example, your child with ADHD might have trouble falling asleep and staying asleep.

Children with ADHD often have problems at school, including learning disorders, 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 their ADHD at home and at school.

Food intolerances and some artificial food colourings, flavourings and preservatives might make some children with ADHD more irritable, and their ADHD symptoms might seem worse. If you think certain foods are affecting your child’s behaviour, it’s a good idea to speak with a GP or dietitian.