ADHD in Children

Recognizing the Signs and Symptoms and Getting Help

It’s normal for children to occasionally forget their homework, daydream during class, act
without thinking, or get fidgety at the dinner table. But inattention, impulsivity, and
hyperactivity are also signs of attention deficit hyperactivity disorder (ADHD or ADD).
ADHD can lead to problems at home and school and affect your child’s ability to learn and
get along with others. The first step to addressing the problem and getting your child the
help he or she needs is to learn to recognize the signs and symptoms of ADHD.

What is ADHD or ADD?

We all know kids who can’t sit still, who never seem to listen, who don’t follow instructions
no matter how clearly you present them, or who blurt out inappropriate comments at
inappropriate times. Sometimes these children are labeled as troublemakers, or criticized
for being lazy and undisciplined. However, they may have attention deficit hyperactivity
disorder (ADHD), formerly known as attention deficit disorder, or ADD. ADHD makes it
difficult for people to inhibit their spontaneous responses—responses that can involve
everything from movement to speech to attentiveness.

The signs and symptoms of ADHD typically appear before the age of seven. However, it can
be difficult to distinguish between attention deficit disorder and normal “kid behavior.” If
you spot just a few signs, or the symptoms appear only in some situations, it’s probably not
ADHD. On the other hand, if your child shows a number of ADHD signs and symptoms that
are present across all situations—at home, at school, and at play—it’s time to take a closer
look.

Once you understand the issues your child is struggling with, such as forgetfulness or
difficulty paying attention in school, you can work together to find creative solutions and

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capitalize on strengths.

Myths & Facts about Attention Deficit Disorder

Myth: All kids with ADHD are hyperactive.
Fact: Some children with ADHD are hyperactive, but many others with attention problems
are not. Children with ADHD who are inattentive, but not overly active, may appear to be
spacey and unmotivated.
Myth: Kids with ADHD can never pay attention.
Fact: Children with ADHD are often able to concentrate on activities they enjoy. But no
matter how hard they try, they have trouble maintaining focus when the task at hand is
boring or repetitive.
Myth: Kids with ADHD could behave better if they wanted to.
Fact: Children with ADHD may do their best to be good, but still be unable to sit still, stay
quiet, or pay attention. They may appear disobedient, but that doesn’t mean they’re acting
out on purpose.
Myth: Kids will eventually grow out of ADHD.
Fact: ADHD often continues into adulthood, so don’t wait for your child to outgrow the
problem. Treatment can help your child learn to manage and minimize the symptoms.

Myth: Medication is the best treatment option for ADHD.

Fact: Medication is often prescribed for attention deficit disorder, but it might not be the
best option for your child. Effective treatment for ADHD also includes education, behavior
therapy, support at home and school, exercise, and proper nutrition.

The primary characteristics of ADHD

When many people think of attention deficit disorder, they picture an out-of-control kid in
constant motion, bouncing off the walls and disrupting everyone around. But this is not the
only possible picture. Some children with ADHD are hyperactive, while others sit
quietly—with their attention miles away. Some put too much focus on a task and have
trouble shifting it to something else. Others are only mildly inattentive, but overly impulsive.

The three primary characteristics of ADHD are inattention, hyperactivity, and impulsivity.
The signs and symptoms a child with attention deficit disorder has depend on which
characteristics predominate.

Which one of these children may have ADHD?

A. The hyperactive boy who talks nonstop and can’t sit still.
B. The quiet dreamer who sits at her desk and stares off into space.
C. Both A and B

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The correct answer is “C.”

Children with ADHD may be:

Inattentive, but not hyperactive or impulsive.

Hyperactive and impulsive, but able to pay attention.
Inattentive, hyperactive, and impulsive (the most common form of ADHD).

Children who only have inattentive symptoms of ADHD are often overlooked, since they’re
not disruptive. However, the symptoms of inattention have consequences: getting in hot
water with parents and teachers for not following directions; underperforming in school; or
clashing with other kids over not playing by the rules.

Because we expect very young children to be easily distractible and hyperactive, it’s the
impulsive behaviors—the dangerous climb, the blurted insult—that often stand out in
preschoolers with ADHD. By age four or five, though, most children have learned how to pay
attention to others, to sit quietly when instructed to, and not to say everything that pops
into their heads. So by the time children reach school age, those with ADHD stand out in all
three behaviors: inattentiveness, hyperactivity, and impulsivity.

Inattentiveness signs and symptoms of ADHD

It isn’t that children with ADHD can’t pay attention: when they’re doing things they enjoy or
hearing about topics in which they’re interested, they have no trouble focusing and staying
on task. But when the task is repetitive or boring, they quickly tune out.

Staying on track is another common problem. Children with ADHD often bounce from task
to task without completing any of them, or skip necessary steps in procedures. Organizing
their schoolwork and their time is harder for them than it is for most children. Kids with
ADHD also have trouble concentrating if there are things going on around them; they
usually need a calm, quiet environment in order to stay focused.

Symptoms of inattention in children:

1. Has trouble staying focused; is easily distracted or gets bored with a task before it’s
completed
2. Appears not to listen when spoken to
3. Has difficulty remembering things and following instructions; doesn’t pay attention to
details or makes careless mistakes
4. Has trouble staying organized, planning ahead, and finishing projects
5. Frequently loses or misplaces homework, books, toys, or other items

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Hyperactivity signs and symptoms of ADHD
The most obvious sign of ADHD is hyperactivity. While many children are naturally quite
active, kids with hyperactive symptoms of attention deficit disorder are always moving. They
may try to do several things at once, bouncing around from one activity to the next. Even
when forced to sit still, which can be very difficult for them, their foot is tapping, their leg is
shaking, or their fingers are drumming.

Symptoms of hyperactivity in children:

1. Constantly fidgets and squirms

2. Has difficulty sitting still, playing quietly, or relaxing
3. Moves around constantly, often runs or climbs inappropriately
4. Talks excessively
5. May have a quick temper or “short fuse”

Impulsive signs and symptoms of ADHD

The impulsivity of children with ADHD can cause problems with self-control. Because they
censor themselves less than other kids do, they’ll interrupt conversations, invade other
people’s space, ask irrelevant questions in class, make tactless observations, and ask overly
personal questions. Instructions like, “Be patient” and “Just wait a little while” are twice as
hard for children with ADHD to follow as they are for other youngsters.

Children with impulsive signs and symptoms of ADHD also tend to be moody and to
overreact emotionally. As a result, others may start to view the child as disrespectful, weird,
or needy.

Symptoms of impulsivity in children:

1. Acts without thinking

2. Guesses, rather than taking time to solve a problem or blurts out answers in class
without waiting to be called on or hear the whole question
3. Intrudes on other people’s conversations or games
4. Often interrupts others; says the wrong thing at the wrong time
5. Inability to keep powerful emotions in check, resulting in angry outbursts or temper
tantrums

Is it really ADHD?
Just because a child has symptoms of inattention, impulsivity, or hyperactivity does not

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mean that he or she has ADHD. Certain medical conditions, psychological disorders, and
stressful life events can cause symptoms that look like ADHD. Before an accurate diagnosis
of ADHD can be made, it is important that you see a mental health professional to explore
and rule out the following possibilities:

Learning disabilities or problems with reading, writing, motor skills, or language.

Major life events or traumatic experiences (e.g. a recent move, death of a loved one,
bullying, divorce).

Psychological disorders including anxiety, depression, and bipolar disorder.

Behavioral disorders such as conduct disorder and oppositional defiant disorder.

Medical conditions, including thyroid problems, neurological conditions, epilepsy, and

sleep disorders.

Positive effects of ADHD in children

In addition to the challenges, there are also positive traits associated with people who have
attention deficit disorder:

Creativity – Children who have ADHD can be marvelously creative and imaginative. The
child who daydreams and has ten different thoughts at once can become a master problem-
solver, a fountain of ideas, or an inventive artist. Children with ADHD may be easily
distracted, but sometimes they notice what others don’t see.

Flexibility – Because children with ADHD consider a lot of options at once, they don’t
become set on one alternative early on and are more open to different ideas.

Enthusiasm and spontaneity – Children with ADHD are rarely boring! They’re interested
in a lot of different things and have lively personalities. In short, if they’re not exasperating
you (and sometimes even when they are), they’re a lot of fun to be with.

Energy and drive – When kids with ADHD are motivated, they work or play hard and strive
to succeed. It actually may be difficult to distract them from a task that interests them,
especially if the activity is interactive or hands-on.

Keep in mind, too, that ADHD has nothing to do with intelligence or talent. Many children
with ADHD are intellectually or artistically gifted.

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Helping a child with ADHD
Whether or not your child’s symptoms of inattention, hyperactivity, and impulsivity are due
to ADHD, they can cause many problems if left untreated. Children who can’t focus and
control themselves may struggle in school, get into frequent trouble, and find it hard to get
along with others or make friends. These frustrations and difficulties can lead to low self-
esteem as well as friction and stress for the whole family.

But treatment can make a dramatic difference in your child’s symptoms. With the right
support, your child can get on track for success in all areas of life. If your child struggles
with symptoms that look like ADHD, don’t wait to seek professional help. You can treat
your child’s symptoms of hyperactivity, inattention, and impulsivity without having
a diagnosis of attention deficit disorder. Options to start with include getting your child
into therapy, implementing a better diet and exercise plan, and modifying the home
environment to minimize distractions.

If you do receive a diagnosis of ADHD, you can then work with your child’s doctor, therapist,
and school to make a personalized treatment plan that meets his or her specific needs.
Effective treatment for childhood ADHD involves behavioral therapy, parent education and
training, social support, and assistance at school. Medication may also be used; however, it
should never be the sole attention deficit disorder treatment.

Parenting tips for children with ADHD

If your child is hyperactive, inattentive, or impulsive, it may take a lot of energy to get him
or her to listen, finish a task, or sit still. The constant monitoring can be frustrating and
exhausting. Sometimes you may feel like your child is running the show. But there are steps
you can take to regain control of the situation, while simultaneously helping your child make
the most of his or her abilities.

While attention deficit disorder is not caused by bad parenting, there are effective parenting
strategies that can go a long way to correct problem behaviors. Children with ADHD need
structure, consistency, clear communication, and rewards and consequences for their
behavior. They also need lots of love, support, and encouragement.

There are many things parents can do to reduce the signs and symptoms of ADHD without
sacrificing the natural energy, playfulness, and sense of wonder unique in every child.

Take care of yourself so you’re better able to care for your child. Eat right, exercise,
get enough sleep, find ways to reduce stress, and seek face-to-face support from family and
friends as well as your child’s doctor and teachers.

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Establish structure and stick to it. Help your child stay focused and organized by
following daily routines, simplifying your child’s schedule, and keeping your child busy with
healthy activities.

Set clear expectations. Make the rules of behavior simple and explain what will happen
when they are obeyed or broken—and follow through each time with a reward or a
consequence.

Encourage exercise and sleep. Physical activity improves concentration and promotes
brain growth. Importantly for children with ADHD, it also leads to better sleep, which in
turn can reduce the symptoms of ADHD.

Help your child eat right. To manage symptoms of ADHD, schedule regular healthy meals
or snacks every three hours and cut back on junk and sugary food.

Teach your child how to make friends. Help him or her become a better listener, learn to
read people’s faces and body language, and interact more smoothly with others.

School tips for children with ADHD

ADHD, obviously, gets in the way of learning. You can’t absorb information or get your work
done if you’re running around the classroom or zoning out on what you’re supposed to be
reading or listening to. Think of what the school setting requires children to do: Sit still.
Listen quietly. Pay attention. Follow instructions. Concentrate. These are the very things
kids with ADHD have a hard time doing—not because they aren’t willing, but because their
brains won’t let them.

But that doesn’t mean kids with ADHD can’t succeed at school. There are many things both
parents and teachers can do to help children with ADHD thrive in the classroom. It starts
with evaluating each child’s individual weaknesses and strengths, then coming up with
creative strategies for helping the child focus, stay on task, and learn to his or her full
capability.

Recommended reading
For Kids: What is ADHD? – Diagnosing and treating ADHD in children. (KidsHealth)

For Teens: What is ADHD? – Diagnosing and treating ADHD in teenagers. (TeensHealth)

Attention Deficit/Hyperactivity Disorder – Guide to ADHD for parents. (Center for Parent
Information & Resources)

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ADHD: The Basics – Signs, symptoms, causes, and treatment. (National Institute of Mental
Health)

Attention Deficit Hyperactivity Disorder: A Parent’s Guide to ADHD (PDF) – (Montana State
University)

Symptoms and Diagnosis – Including the signs of hyperactivity, impulsivity, and inattention.
(Centers for Disease Control and Prevention)

Authors: Melinda Smith, M.A., Lawrence Robinson, and Jeanne Segal, Ph.D. Last updated:
October 2018.

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