Life demands a lot. It isn’t unusual to feel distracted, hyper, or scattered sometimes or to wonder, “Is my child unusual or is this just our life?”
But how do you know when that type of behavior is caused by attention deficit hyperactivity disorder (ADHD) and requires treatment?
ADHD is a combination of symptoms including trouble focusing, paying attention, exercising self-control, and sitting still. These difficulties usually rise to a level that interferes with performance at school or work or in social relationships.
ADHD symptoms present in 3 different ways:
ADHD has three primary characteristics, which present to varying degrees in different people:
- Inattention: easy distraction and trouble concentrating and staying organized
- Impulsivity: frequent interrupting and risky behavior
- Hyperactivity: constant moving, talking, and fidgeting
ADHD isn’t one-size-fits-all
Symptoms can vary by age and gender. Boys are generally more hyperactive, while girls tend to be more quiet and inattentive.
Ground control to Major Tom: With this type of ADHD symptoms, you’re more “spaced out” than hyperactive or impulsive.
Difficulty staying focused, completing tasks, and meeting expectations at home, school, or work can lead to a diagnosis of inattentive ADHD.
People who exhibit inattentive symptoms may:
- have difficulty paying attention to details in homework or other tasks
- have trouble staying focused while working on tasks or interacting and talking with others
- appear to drift off or be uninterested in others
- have trouble following directions and following through on commitments
- tend not to finish what they start
- have poor time management and organizational skills or miss deadlines
- produce sloppy work or have disorganized work or living spaces
- have trouble keeping track of possessions or the tools necessary to complete assignments
- be frequently attracted to unrelated stimuli, topics, or activities
- appear forgetful, careless, or willful in avoiding tasks that require sustained focus or effort
Basically, this describes your friend who’s kind of a space cadet. They make the dinner plans and then forget to show up.
Stop hitting your brother! People with this type of ADHD symptoms are more hyperactive and impulsive than inattentive.
That means they’re likely to move constantly or fidget, and they tend to act without thinking first.
People with hyperactive-impulsive symptoms may:
- have difficulty staying seated
- seem to be in constant motion
- blurt out, interrupt, or change topics inappropriately
- speak, act, or react without thinking about the consequences
- have trouble controlling their emotions
So, like your BFF in kindergarten who thought recess meant WWE smackdown.
When both inattentive and hyperactive symptoms are present, the combination form of ADHD is diagnosed.
According to The National Institutes of Health, this is the most common type of ADHD in children, and hyperactivity is the most common symptom in preschool-age children.
So that means everyone has ADHD, right? Not quite: It’s common for our attention to wander, but people with ADHD have more frequent, more severe symptoms that impact their day-to-day life.
Difficulties in school often trigger the diagnostic process for children. A clinical professional such as a psychiatrist or psychologist can diagnose ADHD.
A combination of family history, behavior testing, and clinical observations are used to determine the diagnosis. Your doctor or your child’s pediatrician should be able to refer you to an appropriate clinician.
The Diagnostic and Statistical Manual of Mental Disorders (DSM–5) defines and classifies mental disorders to improve diagnosis, treatment, and research. It outlines specific criteria for the three forms of ADHD.
To be diagnosed with ADHD according to the DSM-5, a person must have symptoms that:
- disrupt everyday life
- last at least 6 months
- appear before age 12 (although diagnosis can happen at a later age)
- are present in more than one setting (such as at home and school)
- can’t be explained by another mental condition (in some cases, other diagnoses such as depression or anxiety accompany ADHD)
Signs of inattentiveness and hyperactivity can be diagnosed in children between the ages of 3 and 6. According to the CDC, the average age of diagnosis is 7.
ADHD symptoms can change over time, and you may need to be reevaluated later on.
There’s no cure for ADHD, so the focus of treatment is to manage symptoms, improve quality of life, and aid professional or academic performance.
Treatment is often a team approach that includes families, school personnel, therapists, coaches, and healthcare providers.
Several treatment options are commonly used in combination.
Behavioral therapy is often the first course of treatment recommended by a doctor to manage symptoms. It’s relatively free of side effects and is the first form of treatment recommended for children ages 4 to 5.
Therapy can help changes problematic behavior patterns and responses to anger or anxiety.
It takes a village!
Both parents and children attend therapy sessions to learn strategies to cope with symptoms, anticipate difficulties, and solve problems.
The goal of therapy is to:
- increase positive behaviors while reducing or eliminating negative ones
- replace negative expressions of feelings with productive emotional responses
The American Academy of Pediatrics recognizes four effective programs, including:
- Triple P (Positive Parenting Program)
- Incredible Years Parenting Program
- Parent-Child Interaction Therapy
- New Forest Parenting Programme — developed specifically for parents of children with ADHD
Therapy can help parents learn to do the following:
- Follow a routine. Consistency leads to better control of symptoms.
- Use organizational strategies. Help your child learn to keep track of school supplies and personal belongings.
- Manage distractions. Keep TV, background noise, and visual clutter to a minimum when your child is doing homework.
- Incorporate movement. Moving, listening to background music, or scheduling breaks may help with homework stress.
- Limit choices. This will prevent your child from becoming overwhelmed and overstimulated.
- Use clear and specific language. When you talk with your child, repeat back to them what you heard them say. Use clear, brief directions when they need to do something.
- Help kids plan. Break down complicated tasks into simpler, shorter steps.
- Use goals, praise, or rewards. Develop a chart to list goals and track positive behaviors, and provide appropriate positive feedback and rewards.
- Discipline effectively. Replace yelling or spanking with time-outs or limiting privileges as consequences.
- Create positive opportunities. Encourage your child and highlight the things they do well. Investigate art, music, or exercise opportunities, where kids with ADHD often thrive.
- Provide a healthy lifestyle. Nutrition, sleep, stress reduction, and downtime are important.
For older children, behavioral therapy is often recommended in combination with medication.
Prescription medications can be very effective for both kids and adults with ADHD. A healthcare provider will ensure proper dosage and monitor the medication’s effectiveness and potential side effects.
The two types of medication primarily used to treat ADHD are:
- Stimulants. These are the best-known and most widely used ADHD medications. They’re fast-acting and have been shown to be effective in 70 to 80 percent of children with an ADHD diagnosis.
- Nonstimulants. These are slower-acting but can last up to 24 hours. They’re believed to cause fewer long-term side effects than stimulant medications.
If medication is necessary, a healthcare provider can determine the best type and dosage for your child. Be patient, though, because there’s often a period of trial and adjustment to find the right balance.
Adults with ADHD usually benefit from a combination approach using medication, psychotherapy, and/or behavioral support.
ADHD symptoms may persist throughout life, but most kids no longer show significant symptoms by the time they hit their mid-20s.
Many people with ADHD lead productive, successful lives. Identifying and treating the condition early can lessen the negative effects on education and work-related performance, leading to a brighter future and happier families.