Attention Deficit Hyperactivity Disorder Symptoms & Causes
Attention-deficit/hyperactivity disorder, also called ADHD, is a long-term condition that affects millions of children. It often continues into adulthood. ADHD includes a mix of ongoing problems. These can include having a hard time paying attention, being hyperactive and being impulsive.
Children with ADHD also may have low self-esteem and troubled relationships and do poorly in school. Symptoms sometimes lessen with age. Some people never completely outgrow their ADHD symptoms but they can learn strategies to be successful.
While treatment won’t cure ADHD, it can help a great deal with symptoms. Besides giving education about ADHD, treatment can involve medicines and behavior therapies. Early diagnosis and treatment can make a big difference in results.
Symptoms
The main features of ADHD include not paying attention and being hyperactive and impulsive. ADHD symptoms usually start before age 12. In some children, they can be seen as early as 3 years of age. ADHD symptoms can be mild, moderate or severe. Symptoms need to be seen in two or more settings, such as at home and at school. The symptoms cause problems with development and daily life and may continue into adulthood.
ADHD occurs more often in boys than in girls. Behaviors can be different in boys and girls. For example, boys may be more hyperactive and girls may tend to quietly not pay attention.
There are three types of ADHD:
- Predominately inattentive. In this type, most symptoms fall under inattention. This means having trouble focusing and staying on a task. It also includes trouble getting and staying organized.
- Predominately hyperactive and impulsive. In this type, most symptoms involve being hyperactive and impulsive. Hyperactive means being too active and having too much energy. It may include disruptive behavior. Being impulsive means acting without thinking ahead about the results or effects of behavior.
- Combined. This type is a mix of inattentive symptoms and hyperactive and impulsive symptoms. The person meets the criteria for both predominately inattentive and predominately hyperactive and impulsive types of ADHD.
Inattentive symptoms
A child who shows a pattern of inattention may often:
- Fail to pay close attention to details or make careless mistakes in schoolwork.
- Have trouble staying focused in tasks or play.
- Seem not to listen, even when spoken to directly.
- Have a hard time following through on instructions and not finish schoolwork or chores.
- Have trouble organizing tasks and activities.
- Stay away from or not like tasks that need focused mental effort, such as homework.
- Lose items needed for tasks or activities, for example, toys, school assignments, pencils.
- Be easily distracted by other things, thoughts or activities rather than finishing a task.
- Forget to do some daily activities, such as forgetting to do chores.
Hyperactive and impulsive symptoms
A child who shows a pattern of hyperactive and impulsive symptoms may often:
- Fidget with or tap hands or feet, or squirm in the seat.
- Have a hard time staying seated in the classroom or in other situations.
- Be on the go, in constant motion.
- Run around or climb in situations when it’s not proper.
- Have trouble playing or doing an activity quietly.
- Talk too much.
- Blurt out answers, interrupting the questioner.
- Have trouble waiting for a turn.
- Interrupt others’ conversations, games or activities.
Typical development versus ADHD
Most healthy children are inattentive, hyperactive or impulsive at one time or another. It’s typical for preschoolers to have short attention spans and not be able to stick with one activity for long. Even in older children and teenagers, attention span often depends on the level of interest.
The same is true of hyperactivity. Young children are naturally energetic. They often are still full of energy long after they’ve tired their parents. And some children just naturally have a higher activity level than others do. Children should never be classified as having ADHD just because they’re different from their friends or siblings.
Children who have problems in school but get along well at home or with friends may likely have a concern other than ADHD. The same is true of children who are hyperactive or inattentive at home but whose schoolwork and friendships aren’t affected.
When to see a doctor
If you’re concerned that your child shows signs of ADHD, see your pediatrician or family healthcare professional. Your healthcare professional can do a medical evaluation to check for other causes of your child’s symptoms. Then if needed, your child may be referred to a specialist, such as a developmental-behavioral pediatrician, psychologist, psychiatrist or pediatric neurologist.
Causes
While the exact cause of ADHD is not clear, research efforts continue. Factors that may be involved in the development of ADHD include genetics, the environment or central nervous system conditions at key moments in development.
Risk factors
Risk factors for ADHD may include:
- Having a blood relative, such as a parent or sibling, with ADHD or another mental health condition.
- Being around environmental toxins such as lead, which is found mainly in paint and pipes in older buildings.
- Being born to a parent who used recreational drugs, alcohol or tobacco during pregnancy.
- Being born too early, also called premature birth.
Although many people seem to believe that sugar causes hyperactivity, there’s no proof of this. Many issues in childhood can lead to trouble paying attention, but that’s not the same as ADHD.
Complications
ADHD can make life hard for children. Children with ADHD:
- Often have trouble in the classroom, which can lead to failing grades and being judged by other children and adults.
- Tend to have more accidents and injuries of all kinds than do children who don’t have ADHD.
- Tend to have poor self-esteem.
- Are more likely to have trouble interacting with and being accepted by peers and adults.
- Are at higher risk of alcohol and drug misuse and other behavior that can cause problems with the law.
- Have a higher risk of suicidal thoughts and suicide.
- Have sleep disorders.
Conditions often linked with ADHD
ADHD does not cause other mental health or developmental problems. But children with ADHD are more likely than others to also have conditions such as:
- Oppositional defiant disorder. This condition is generally defined as a pattern of negative, defiant and hostile behavior toward people who are in authority.
- Conduct disorder. This involves antisocial behavior such as stealing, fighting, destroying property, and harming people or animals.
- Disruptive mood dysregulation disorder. This involves irritability and problems handling frustration.
- Learning disabilities. These can include problems with reading, writing, understanding and communicating.
- Substance use disorders. This involves misuse of drugs, alcohol, marijuana or nicotine.
- Anxiety. This results in constant worry and nervousness that affect daily life.
- Obsessive-compulsive disorder, also called OCD. OCD is a pattern of unwanted thoughts and fears that lead to repetitive behaviors. These get in the way of daily activities and cause a lot of distress.
- Mood disorders. These include depression and bipolar disorder. Bipolar disorder includes depression and manic behavior.
- Autism spectrum disorder. This condition is related to brain development. It impacts how a person thinks of and socializes with others.
- Tic disorders. These conditions involve repetitive movements or unwanted sounds, called tics, that can’t be easily controlled.
Prevention
To help lower your child’s risk of ADHD:
- During pregnancy, avoid anything that could harm your baby’s development before birth. For example, don’t drink alcohol, use drugs or smoke cigarettes.
- Protect your child from exposure to pollutants and toxins, including cigarette smoke and lead paint.
- Limit screen time. Although still not proved, it may be a good idea for young children to limit TV, video games and other screen time.
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