Attention Deficit Hyperactivity Disorder (ADHD) begins before a child is 7 years old. Symptoms are usually noticed by the time a child starts school. One out of 12 children have ADHD. It occurs more often in boys than in girls. Children with ADHD may be bright and creative but may have difficulty with learning or behavior.
Symptoms of ADHD
There are many symptoms of ADHD (Picture 1). Not all the symptoms listed are present in every child.
- Is easily distracted and forgetful
- Has trouble following directions, needs much supervision
- Often seems not to hear when spoken to directly
- Has trouble concentrating
- Notices everything but cannot focus on a task
- Is unable to "tune out" background noise
- Has trouble sticking to an activity
- Makes careless mistakes
- Has trouble organizing work
- Will not go back over his or her work to check it
- Does not finish tasks
- Has trouble shifting from one task to another
- Is messy, disorganized and loses things
- Acts before thinking
- Shifts activities rapidly
- Calls out in class
- Has trouble waiting his turn
- Runs or climbs excessively
- Is always "on the go"
- Has trouble sitting still
- Gets out of his seat in school
Other Problems That May Go Along with ADHD
- Is easily frustrated
- Deals poorly with a change in routine
- Overreacts and is quick-tempered
- Cries easily
- Has difficulty making and keeping friends
- Can develop poor self-esteem
- Is socially immature
Possible Causes and Diagnosis of ADHD
No one knows the cause of ADHD but it seems to run in families. There are no blood tests or other medical tests to diagnose ADHD. The diagnosis is made using a variety of tools to gather information about how the child behaves and performs with others at home and at school. You, caregivers and teachers may fill out questionnaires. A specialist may observe your child in the classroom.
Some additional testing may be needed to rule out learning disabilities or problems with vision and hearing. Your child’s health care provider will do a medical exam to find out if other problems are present.
Treatment of ADHD
Your child's health care provider will work closely with you to help you and him cope with ADHD. Family or individual counseling may be needed. Medicines may be prescribed.
Medicines can help reduce the symptoms of ADHD but may also have side effects. The most common medicines used are Ritalin®, Dexedrine®, Adderall®,Vyvanse®, Concerta® and Strattera®. It may take a few tries to find which one and what dose works best for your child. Also, the amount may need to be readjusted from time to time. These medicines are “controlled” and cannot be refilled automatically. You will have to get a new prescription from your child’s doctor each month.
Things You Can Do to Help Your Child
- You may need to talk with the teacher, principal, guidance counselor and nurse to be sure your child's learning needs are met.
- Let the teacher know what things help him to stay focused. For example, ask that your child be seated close to the front of the class and away from windows or other distractions.
- Your child may have behavior problems in the classroom. The school may need to offer him counseling or other support.
- Your child may need special tutoring. Do not be afraid to ask for that help, if it is needed.
- Encourage activities your child can excel in, such as sports, art, music or hobbies.
- Supervise homework time. Clear your child's desk and reduce distractions, such as radio or TV.
- Help your child create a system of organizing what he needs to do. For example, teach him to use an assignment book or to make a “to do” list with due dates.
- Set up daily routines. They will give your child structure and a feeling of security.
- Increase your child's self-esteem. Accept him for who he is. Focus on his abilities, strengths and good traits rather than on his shortcomings (Picture 2). Praise him for good behavior.
- Expect your child to succeed rather than to fail. Give him tasks that he can handle, a little at a time. A job well done boosts the child's self-esteem.
- Work on changing only one or two negative behaviors at a time.
- Explain rules clearly and be consistent. Tell your child what will happen if the rules are broken. Write down the rules or have him repeat them to you.
- Have fun with your child. Play with him. Love him.
- Take care of yourself. If you start to lose patience, take a break.
Long-Term Effects of ADHD
By working closely with your child's doctor and teachers, you can help your child adjust to ADHD. Most children do not "outgrow" ADHD. But with your help, your child can learn skills that help him cope, develop positive self-esteem and succeed in life.
CHADD (Children and Adults with Attention Deficit/Hyperactivity Disorder) is a national organization that gives support through advocacy and education. Their website, www.chadd.org, has many useful materials, including information on educational rights of children with ADHD.
HH-I-157 1/92, Revised 5/18 Copyright 1992-2011, Nationwide Children's Hospital