If so, your child may have attention deficit hyperactivity disorder (ADHD). Nearly everyone shows some of these behaviors at times, but ADHD lasts more than 6 months and causes problems in school, at home and in social situations.

 


ADHD is more common in boys than in girls. It affects 3-5 percent of all American children.

The main features of ADHD are

  • Inattention
  • Hyperactivity
  • Impulsivity

No one knows exactly what causes ADHD. It sometimes runs in families, so genetics may be a factor. There may also be environmental factors.

A complete evaluation by a trained professional is the only way to know for sure if your child has ADHD. Treatment may include medicine to control symptoms, therapy, or both. The structure at home and at school is important. Parent training may also help.


How is ADHD diagnosed?


Healthcare professionals use the guidelines in the American Psychiatric Association’s Diagnostic and Statistical Manual, to help diagnose ADHD. This diagnostic standard helps ensure that people are appropriately diagnosed and treated for ADHD.

Group of children

Using the same standard across communities can also help determine how many children have ADHD, and how public health is impacted by this condition.

Here are the criteria in shortened form. Please note that they are presented just for your information.

Only trained health care providers can diagnose or treat ADHD.


Criteria for ADHD


People with ADHD show a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development:


Inattention


Six or more symptoms of inattention for children up to age 16, or five or more for adolescents 17 and older and adults; symptoms of inattention have been present for at least 6 months, and they are inappropriate for developmental level:


 

  • Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or with other activities.
  • Often has trouble holding attention on tasks or play activities.
  • Often does not seem to listen when spoken to directly.
  • Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., loses focus, side-tracked).
  • Often has trouble organizing tasks and activities.
  • Often avoids, dislikes, or is reluctant to do tasks that require mental effort over a long period of time (such as schoolwork or homework).
  • Often loses things necessary for tasks and activities (e.g. school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones).
  • Is often easily distracted
  • Is often forgetful in daily activities.

Hyperactivity and Impulsivity


Six or more symptoms of hyperactivity-impulsivity for children up to age 16, or five or more for adolescents 17 and older and adults; symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for the person’s developmental level:

  • Often fidgets with or taps hands or feet, or squirms in seat.
  • Often leaves the seat in situations when remaining seated is expected.
  • Often runs about or climbs in situations where it is not appropriate (adolescents or adults may be limited to feeling restless).
  • Often unable to play or take part in leisure activities quietly.
  • Is often “on the go” acting as if “driven by a motor”.
  • Often talks excessively.
  • Often blurts out an answer before a question has been completed.
  • Often has trouble waiting his/her turn.
  • Often interrupts or intrudes on others (e.g., butts into conversations or games)

In addition, the following conditions must be met:


  • Several inattentive or hyperactive-impulsive symptoms were present before age 12 years.
  • Several symptoms are present in two or more sets, (such as at home, school or work; with friends or relatives; in other activities).
  • There is clear evidence that the symptoms interfere with, or reduce the quality of, social, school, or work functioning.
  • The symptoms are not better explained by another mental disorder (such as a mood disorder, anxiety disorder, dissociative disorder, or a personality disorder).
  • The symptoms do not happen only during the course of schizophrenia or another psychotic disorder.

Based on the types of symptoms, three kinds (presentations) of ADHD can occur:


Combined Presentation


  • enough symptoms of both criteria inattention and hyperactivity-impulsivity were present for the past 6 months

Predominantly Inattentive Presentation


  • if enough symptoms of inattention, but not hyperactivity-impulsivity, were present for the past six months

Predominantly Hyperactive-Impulsive Presentation


  • if enough symptoms of hyperactivity-impulsivity, but not inattention, were present for the past six months.

Because symptoms can change over time, the presentation may change over time as well.


Diagnosing  ADHD in Adults


ADHD often lasts into adulthood. To diagnose ADHD in adults and adolescents age 17 or older, only 5 symptoms are needed instead of the 6 needed for younger children. Symptoms might look different at older ages. For example, in adults, hyperactivity may appear as extreme restlessness or wearing others out with their activity.

For more information about diagnosis and treatment throughout the lifespan, please visit the websites of the National Resource Center on ADHD and the National Institutes of Mental Health.


Behavior Therapy for Children with ADHD


Most experts recommends using both medication and behavior therapy to treat ADHD. This is known as a multimodal treatment approach
 

There are many forms of behavior therapy, but all have a common goal—to change the child's physical and social environments to help the child improve his behavior.

Under this approach, parents, teachers, and other caregivers learn better ways to work with and relate to the child with ADHD. You will learn how to set and enforce rules, help your child understand what he needs to do, use discipline effectively, and encourage good behavior. Your child will learn better ways to control his behavior as a result. You will learn how to be more consistent.


Medications


Medication can help children with ADHD in their everyday life, and medication treatment may be an effective way to manage ADHD symptoms. Medication is an option that may help control some of the behavior problems that have led to trouble in the past with family, friends and at school.


Several different types of medications are FDA-approved to treat ADHD in children:

  • Stimulants are the best-known and most widely used ADHD medications. Between 70-80 percent of children with ADHD have fewer ADHD symptoms when they take these fast-acting medications.
  • Nonstimulants were approved for treating ADHD in 2003.  Nonstimulants do not work as quickly as stimulants, but they can last up to 24 hours.

Medications can affect children differently. One child may respond well to one medication, but not another. The doctor may need to try different medications and doses, so it is important for parents to work with their child’s doctor to find the medication that works best for their child.

For more information on treatments, please click one of the following links:

National Resource Center on ADHD

National Institute of Mental Health

 

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