Explore our comprehensive overview of ADHD, a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity. Learn about the symptoms, common co-occurring conditions like anxiety, depression, and learning disabilities, and the factors contributing to ADHD. Understand how ADHD affects children differently as they grow, and what is known about its genetic origins.

ADHD – Overview

What is ADHD?

Everybody can have difficulty sitting still, paying attention, or controlling impulsive behavior once in a while. For some people, however, the problems are so pervasive and persistent that they interfere with every aspect of their life: home, academic, social, and work.

ADHD is a neurodevelopmental disorder associated with an ongoing pattern of inattention, hyperactivity, and/or impulsivity. ADHD begins in childhood and can continue into the teen years and adulthood.

What are the symptoms of ADHD?

People with ADHD experience an ongoing pattern of the following types of symptoms:

·         Inattention—having difficulty paying attention

·         Hyperactivity—having too much energy or moving and talking too much

·         Impulsivity—acting without thinking or having difficulty with self-control

Some people with ADHD mainly have symptoms of inattention. Others mostly have symptoms of hyperactivity-impulsivity. Some people have both types of symptoms.

Signs of inattention may include:

·         Not paying close attention to details or making seemingly careless mistakes in schoolwork or during other activities

E.g. A child might write the wrong answer to a math problem even though they know how to solve it, misspell a word that they have learned before, or forget to put their name on their paper.

·         Difficulty sustaining attention in play and tasks, including conversations, tests, or lengthy assignments

E.g. A child might lose interest in a game after a few minutes and switch to something else, zone out during a class discussion and miss important information, or give up on a project that requires multiple steps and planning.

·         Trouble listening closely when spoken to directly

E.g., A child directly might not respond when their parent or teacher calls their name, nod along without really understanding what the other person is saying, or interrupts the speaker with irrelevant comments or questions.

·         Finding it hard to follow through on instructions or finish schoolwork or chores, or start tasks but losing focus and getting easily sidetracked

E.g. A child might leave their room messy even though they were told to clean it, or start doing their homework but then get distracted by a video or a toy, or begin a craft activity but then abandon it halfway.

·         Difficulty organizing tasks and activities, such as doing tasks in sequence, keeping materials and belongings in order, managing time, and meeting deadlines

E.g. A child might forget the order of the steps in a recipe or a science experiment, lose their backpack or jacket at school, procrastinate on a big assignment until the last minute, or miss the due date for a library book or a permission slip.

·         Avoiding tasks that require sustained mental effort, such as homework

E.g. A child complain that they are too tired or bored to do their work, makes excuses to avoid doing it, pretends that they have already done it, or does it hastily and carelessly.

·         Losing things necessary for tasks or activities, such as school supplies, books, eyeglasses, and cell phones

E.g. A child might have to borrow a pencil or a calculator from their classmates, not be able to find the book they need for their report, misplace their glasses and have trouble seeing the board, or forget where they left their phone and miss important calls or messages.

·         Being easily distracted by unrelated thoughts or stimuli

E.g. A child might daydream about something else while they are supposed to be paying attention, look out the window and watch the birds or the cars,  notice a sound or a smell that has nothing to do with what they are doing, or get caught up in their fantasies or imaginations.

·         Being forgetful during daily activities, such as chores, errands, and keeping appointments

E.g. A child might forget to brush their teeth or comb their hair, leave their lunch or homework at home, or not remember to feed their pet or water their plants, or show up late or not at all for a playdate or a doctor’s appointment.

Signs of hyperactivity and impulsivity may include:

·         Fidgeting and squirming while seated

E.g. A child might wiggle their legs or feet, twist and turn their body, tap their fingers or toes, play with their hair or clothes, bite their nails or lips, or rock their chair or desk.

·         Getting up and moving around when expected to stay seated, such as in a classroom

E.g. A child might stand up and walk to the door or the window, go to the bathroom or the water fountain, visit another student or the teacher, wander around the room or the hall, or run out of the class or the school.

·         Running, dashing around, or climbing at inappropriate times or, in teens, often feeling restless

E.g. A child might sprint across the street or the playground, jump over fences or walls, climb trees or furniture, swing from branches or bars, crawl under tables or beds, pace back and forth, or bounce up and down.

·         Being unable to play or engage in hobbies quietly

E.g., A child might make loud noises or sounds, sing or shout, laugh or scream, bang or slam, crash or smash, whistle or hum, or talk or chatter.

·         Being constantly in motion or on the go and/or acting as if driven by a motor

E.g., A child might run or jump, skip or hop, dance or spin, roll or tumble, kick or throw, catch or hit, push or pull, or shake or stir.

·         Talking excessively

E.g. A child might tell long stories or jokes, ask any questions or comments, repeat themselves or others, say whatever comes to their mind or mouth, talk to themselves or their toys, narrate their actions or thoughts, or speak very fast or loud.

·         Answering questions before they are fully asked or finishing other people’s sentences

E.g. A child might blurt out the answer or the word, guess what the other person is going to say or ask, interrupt the other person or the conversation, complete the other person’s sentence or question, or correct the other person or the mistake, or agree or disagree with the other person or the opinion, or change the topic or the subject.

·         Having difficulty waiting one’s turn, such as when standing in line

E.g., A child might cut in front of others or push them aside, complain or whine, get angry or frustrated, leave the line or the place, do something else or lose interest, act impatient or bored, or demand attention or service.

·         Interrupting or intruding on others, for example, in conversations, games, or activities

E.g., A child might join in without asking or being invited, take over or dominate, interfere or disrupt, comment or criticize, tease or mock, argue or fight, ignore or disregard, or spoil or ruin.

Does ADHD look the same in all children?

ADHD symptoms can change over time as a child grows and moves into the preteen and teenage years. In young children with ADHD, hyperactivity and impulsivity are the most common symptoms. As academic and social demands increase, symptoms of inattention become more prominent and begin to interfere with academic performance and peer relationships.

ADHD and Co-occurring Conditions

More than two-thirds of children with ADHD have at least one other co-existing condition. Any disorder can co-exist with ADHD, but certain disorders seem to occur more often. These disorders include:

·         Oppositional defiant and conduct disorders: These are behavioral disorders that involve a pattern of angry, defiant, disobedient, or aggressive behavior towards authority figures. Children with these disorders may argue, lie, steal, bully, or harm others. They may also have trouble following rules, controlling their impulses, or accepting responsibility for their actions.

·         Anxiety and depression: These are mood disorders that involve persistent feelings of worry, fear, sadness, or hopelessness. Children with these disorders may have low self-esteem, poor concentration, difficulty sleeping, or loss of interest in activities. They may also experience physical symptoms, such as headaches, stomachaches, or fatigue.

·         Tic disorders or Tourette syndrome: These are neurological disorders that involve involuntary movements or sounds, such as blinking, twitching, sniffing, or grunting. Children with these disorders may have trouble suppressing or controlling their tics, which can interfere with their social, academic, or daily functioning.

·         Substance abuse: This is a disorder that involves the misuse of alcohol, drugs, or other substances. Children with this disorder may use substances to cope with their ADHD symptoms, to fit in with their peers, or to escape from their problems. They may also develop tolerance, dependence, or addiction to the substances, which can harm their health, safety, or well-being.

·         Sleep disorders: These are disorders that involve problems with falling asleep, staying asleep, or waking up. Children with these disorders may have insomnia, sleep apnea, restless legs syndrome, or narcolepsy. They may also have irregular sleep patterns, such as staying up late or sleeping too much. Sleep disorders can affect the quality and quantity of sleep, which can worsen ADHD symptoms, such as inattention, hyperactivity, or impulsivity.

·         Learning disabilities: These are disorders that involve difficulties with specific academic skills, such as reading, writing, or math. Children with these disorders may have trouble with decoding, spelling, comprehension, expression, or calculation. They may also have problems with memory, organization, or reasoning. Learning disabilities can affect the academic performance, achievement, or progress of children with ADHD. About 45% of children with ADHD have learning disabilities

What causes ADHD?

Despite multiple studies, researchers have yet to determine the exact causes of ADHD. However, scientists have discovered a strong genetic link since ADHD can run in families. More than 20 genetic studies have shown evidence that ADHD is strongly inherited. Yet ADHD is a complex disorder, which is the result of multiple interacting genes.

The following factors are NOT known causes, but can make ADHD symptoms worse for some children:

· Watching too much television

·         eating sugar

·         family stress (poverty, family conflict)

·         traumatic experiences