Attention Deficit and Hyperactivity Disorder (ADHD) | Symptoms & Causes
What are the symptoms of ADHD?
Symptoms of attention deficit and hyperactivity disorder (ADHD) fall into three categories:
Inattention
- short attention span for their age
- frequent careless mistakes
- trouble listening or following instructions
- trouble organizing activities
- losing or forgetting things repeatedly and often
- easily distracted
- forgetfulness and poor study skills for their age
Impulsivity
- habit of interrupting others
- difficulty waiting for their turn in school and with friends
- tendency to blurt out answers instead of waiting to be called on
- inclination to risky behaviors, often without thinking first
Hyperactivity
- constant need to run or climb, often with no apparent destination
- fidgeting or squirming when forced to sit still
- excessive talking
- difficulty engaging in quiet activities
- shifting from one task to another without finishing any of them
What causes ADHD?
While researchers have not been able to identify a single cause, many studies indicate that ADHD runs in families. Other possible risk factors under investigation include:
- traumatic brain injury
- alcohol and tobacco use during pregnancy
- low birth weight
- premature delivery
- exposure to lead at an early age
Despite what some people think, there is no evidence that eating too much sugar, consuming certain food additives, watching too much TV, or growing up in a chaotic home environment cause ADHD.
Attention Deficit and Hyperactivity Disorder (ADHD) | Diagnosis & Treatments
How is ADHD diagnosed?
There is no single test to determine if a child has ADHD. Because the symptoms are similar for several other conditions, including anxiety disorders, depression, and certain learning disabilities, doctors usually conduct a series of physical, neurological, and psychological tests to rule out these other conditions. Criteria established by the American Psychiatric Association helps doctors determine if a child has ADHD. Psychological testing is also often needed to identify the conditions that frequently occur along with ADHD, such as learning disorders or other mental health disorders.
How is ADHD treated?
Treatment for ADHD includes three major components:
- behavior therapy
- medication
- educational intervention
For many children, the most effective approach combines aspects of all three types of treatment, although for children younger than 6 years old, specialists in ADHD recommend that families start with behavior therapy first and introduce medication later
Behavior therapy
Behavior therapy helps both children with ADHD and their parents. Not only can it help all members of a family develop effective coping methods and ways to channel excess energy, it can also strengthen family bonds.
For parents, behavioral therapy is a way to learn strategies for responding to their children and reinforcing positive behaviors. The therapist will work with parents to identify and understand disruptive behaviors. Once parents learn what their children are getting out of problem behavior (usually attention or escape from activities they don’t like), they can then teach their children to substitute more effective ways to interact with others, express their emotions, and get their needs met. As children get older, they can start to take ownership of this process and recognize (and change) their own behavior patterns.
Medication
Two types of medication can be used to treat ADHD: stimulants and non-stimulants.
- Stimulant medications have proven effective in improving the basic symptoms of ADHD — including inattention, impulsivity, and hyperactivity. Doctors believe stimulant medications increase dopamine in the brain, a chemical that occurs naturally in the body and supports focus and attention. Stimulants can have side effects, including trouble getting to sleep, decreased appetite, headaches, and jitteriness. Most side effects are mild and decrease with regular use.
- Non-stimulants are available for children who cannot tolerate stimulant medications. Non-stimulants take longer to work than stimulants but can be effective in reducing impulsivity and increasing focus.
An important note: Children with any type of heart problem should always be examined and cleared by a cardiologist before beginning any new medication.
Educational intervention
Classrooms that require prolonged periods of sitting still and listening to a teacher can be especially challenging for a child with ADHD. Certain strategies in the classroom can help keep a child with ADHD engaged:
- making sure class assignments are clear
- assigning shorter assignments that are challenging but not discouraging
- rewarding good impulse control; for instance, not interrupting
- reducing distractions
- providing opportunities for physical activity during the day
- frequent communication between teachers and parents
- allowing extra time to complete work
- providing a variety of interesting approaches to learning
How we care for ADHD
The clinicians at the Boston Children’s Division of Developmental Medicine have years of experience assessing and providing ongoing, comprehensive treatment for children and adolescents with ADHD, including medication, behavioral therapy, and parent education and support. Our experts also work with parents and teachers to help them better understand the condition and develop strategies for interacting with children with ADHD most effectively.
