What is ADHD?

Attention deficit hyperactivity disorder (ADHD) in children is a difference in brain development that can affect the ability to pay attention and exercise impulse control. ADHD is one of the most common mental health conditions, affecting nearly 10% of all children and adolescents in the U.S. Although typically seen in children, ADHD can last into adulthood and can also develop later in life.

Our understanding of ADHD has improved from when it was once considered as a separate condition from Attention Deficit Disorder (ADD). Children who may present as primarily inattentive are still diagnosed with ADHD even though they may not display any hyperactivity.

Though the symptoms vary for each child, there are 3 categories of symptoms that affect children and adolescents with ADHD:

1. Inattention: when your child has trouble paying attention or is easily distracted.
2. Impulsivity: your child may act without thinking, such as by chronically interrupting others. 
3. Hyperactivity: your child may exhibit signs of excessive fidgeting, motion, restlessness, or talking too much.

Based on these symptoms, children will be diagnosed as fitting one of these 3 ADHD profiles:

• Predominantly inattentive: this is the category that was once referred to as ADD. Children in this category will have trouble paying attention. Symptoms may not be as easily recognizable for children with this type of ADHD.
• Predominantly hyperactive-impulsive: children in this category show both hyperactive and impulsive behavior.
• Combined type (inattentive and hyperactive/impulsive): children in this category demonstrate behavior from both of the types described above. This is the most common form of ADHD. 

Prevalence of ADHD in Children

ADHD is a common condition that affects both children and adults, with a varying degree of prevalence across different age groups. Moreover, the age at which children are typically diagnosed plays a crucial role in understanding and managing this condition.

ADHD is more prevalent than most people think, and affects individuals across diverse backgrounds. According to the CDC, around 11.4% of children ages 3 to 17 in the United States have been diagnosed with ADHD. However, these numbers might be even higher due to underdiagnosis or misdiagnosis. ADHD is characterized by symptoms of inattention, hyperactivity, and impulsivity, which can significantly impact academic, occupational, and social functioning.

The prevalence of ADHD varies across different age groups. In children, the condition is most commonly diagnosed during early school years, typically around ages 6 to 12. This is a critical period as the demands of structured learning environments often bring out the challenges associated with ADHD. 

As children transition into adolescence, the presentation of ADHD symptoms can change. Hyperactivity may decrease, but inattention and impulsivity may persist. Adolescents with ADHD might face additional challenges related to organization, time management, and emotional regulation. The prevalence of ADHD among adolescents is highest among the age groups, with roughly 13% of adolescents aged 12 to 17 having been diagnosed.

Common Misconceptions About ADHD

ADHD is a complex neurodevelopmental condition that often comes with a range of misconceptions and misunderstandings. These misconceptions can contribute to stigma and make it challenging for individuals with ADHD to receive appropriate support and understanding. Some common misconceptions about ADHD include:

ADHD is just a lack of discipline or laziness

One of the most damaging misconceptions is that ADHD is simply a result of laziness or a lack of discipline. In reality, ADHD is a neurobiological condition that affects the brain’s executive functions, making it challenging for individuals to regulate attention, impulses, and emotions. Children with ADHD often struggle despite their genuine efforts to focus and stay organized.

Every child with ADHD is hyperactive

While hyperactivity is a well-known symptom of ADHD, not every child with the disorder exhibits this behavior. There are three main types of ADHD: predominantly inattentive presentation, predominantly hyperactive-impulsive presentation, and combined presentation. Some individuals primarily struggle with inattention and may not exhibit noticeable hyperactivity.

Only boys have ADHD

Historically, ADHD has been associated more with boys due to the stereotype of hyperactive behavior. However, girls and women also have ADHD, although their symptoms may manifest differently. Girls tend to exhibit more internalizing symptoms like daydreaming and inattentiveness, which can lead to under diagnosis or misdiagnosis.

If a child is diagnosed with ADHD, they will have to be put on medication

Pharmacotherapy is just one of several strategies that can be selected as part of your child’s treatment plan. Medication can be a very helpful tool for many kids and families, especially when combined with behavioral modification and therapy. But, it is not a panacea. It is best to share all of your concerns and questions with your healthcare providers to create an individualized plan best suited to your child and your family.

Signs and Symptoms of ADHD in Children

Signs of Inattention

Children with ADHD who predominantly exhibit inattentive symptoms often struggle with maintaining focus and attention in various situations. Here are some common signs of inattention in children with ADHD:

• Difficulty Sustaining Attention: Children with inattentive ADHD may find it challenging to stay engaged in tasks that require sustained focus, such as completing school assignments or listening during class.
• Easily Distracted: They might become easily distracted by external stimuli or their own thoughts, causing them to lose track of what they were supposed to be doing.
• Frequent Careless Mistakes: Children with inattentive ADHD might make careless errors in their schoolwork or other activities, even when they are capable of performing well.
• Struggles with Organizing Tasks: They may have difficulty organizing their thoughts and tasks, leading to disorganized schoolwork, messy rooms, and difficulties planning out their day.
• Avoidance of Tasks Requiring Mental Effort: Tasks that demand sustained mental effort or attention can be particularly challenging for these children, leading them to avoid or procrastinate on them.
• Difficulty Following Instructions: Following multi-step instructions, especially if they’re complex or given orally, can be tough for children with inattentive ADHD.
• Losing Items: They might frequently misplace important items like school supplies, homework, or personal belongings due to their tendency to get distracted.
• Daydreaming: Children with inattentive ADHD often appear to be lost in thought or daydreaming, which can interfere with their ability to focus on the task at hand.
• Forgetfulness: Forgetfulness is a common symptom. They might forget to complete assignments, bring necessary materials to school, or remember appointments or commitments.
• Difficulty with Listening: When someone is speaking to them, children with inattentive ADHD might struggle to maintain active listening, leading to missed instructions or information.
• Lack of Attention to Details: They may overlook important details in tasks, assignments, or even conversations.
• Difficulty with Transitioning: Transitions between activities can be challenging, as children with inattentive ADHD may find it hard to shift their focus from one task to another.

Signs of Hyperactivity and Impulsivity

Children with ADHD who predominantly exhibit hyperactivity and impulsivity often display behaviors that are noticeable due to their high energy levels. Some common signs of hyperactivity and impulsivity in children with ADHD include:

• Excessive Fidgeting: Children with hyperactive ADHD may have difficulty sitting still and often engage in constant fidgeting, such as tapping their feet, wiggling in their seats, or moving their hands.
• Inability to Remain Seated: They might frequently get up from their seat when it’s expected for them to remain seated, even in situations where sitting is necessary.
• Running or Climbing in Inappropriate Situations: Children with hyperactivity might engage in running or climbing activities in situations where it’s not safe or socially appropriate to do so.
• Restlessness: They might have a general sense of restlessness and be constantly on the move, even when it’s not necessary.
• Talking Excessively: Children with ADHD might struggle to control the volume and frequency of their speech, often talking excessively or interrupting conversations.
• Difficulty Waiting Turns: Impulsivity can lead to difficulties waiting their turn in games, group activities, or in conversation. They might interrupt others or blurt out answers without being called upon.
• Impulsive Actions: Children with impulsivity might act on their immediate impulses without considering potential consequences. This can lead to risky behaviors or making hasty decisions.
• Difficulty Playing Quietly: Engaging in quiet, calm activities might be a challenge for children with hyperactivity. They might find it difficult to play or engage in tasks without being overly active.
• Interrupting Others: Children with ADHD might frequently interrupt conversations, even if the topic isn’t related to them, due to their struggle with impulse control.
• Difficulty Following Rules: Impulsivity can make it challenging for these children to follow rules consistently, leading to behavioral problems and misunderstandings with authority figures.
• Engaging in Dangerous Activities: Impulsive behavior might lead children to engage in potentially dangerous activities without considering the risks involved.
• Difficulty Planning and Organizing: Impulsivity can also affect their ability to plan and organize tasks, making it challenging to complete assignments or adhere to routines.

 

ADHD in Children Diagnosis and Evaluation

Diagnosing ADHD in children involves a comprehensive and multi-faceted assessment process conducted by qualified healthcare professionals. The diagnosis requires the presence of specific symptoms that significantly impact a child’s daily life and functioning. 

ADHD Assessment Process

The process often begins with an initial screening by a healthcare provider, such as a pediatrician or child psychologist. This involves discussing the child’s behavior, development, and any concerns raised by parents, teachers, or caregivers. 

The healthcare provider may use standardized screening tools or questionnaires to gather information about the child’s symptoms and behaviors. For doctors to diagnose ADHD, a child’s symptoms need to be present for at least 6 months and be inappropriate or disruptive for the standard developmental level of that age group. Children need to show several symptoms of ADHD to receive a diagnosis.

Evaluating Behavioral Patterns

Medical professionals use a careful process to understand if a child has ADHD. They talk to parents and teachers to learn about the child’s behavior, how they learn and grow, and if there are any other problems. 

They might ask questions or use forms to measure the child’s behavior. This helps them see if the child has trouble paying attention, being too active, or acting without thinking. The goal is to figure out if ADHD is the reason for the behavior and rule out other potential conditions such as sleep issues or learning or cognitive disorders.

Childhood ADHD Treatment Options and Management Strategies

A common misconception is that psychiatrists are focused only on medication treatment. The truth is that medication is only one of many treatment options that they consider in their recommendations. Their role is to weigh the risks and benefits of a variety of treatment options, discuss them with parents/guardians, and support families in making a decision that is best for their child and family. Most often, a combination of behavioral therapy and medications work better than medication alone.

Medication for ADHD

If after careful assessment it is determined that medication is warranted, medical professionals can use two main types of medicines to help kids with ADHD: ones that make them more alert and focused (such as Adderall), and non-stimulants that target different aspects of ADHD symptoms. The doctor, along with parents and caregivers, will decide which medicine is best based on the child’s needs and how they react to it.

Behavioral Therapy

Behavior therapy for children with ADHD is a way to teach them important skills to control their actions and make better choices. Through talking and learning with a therapist, kids can discover techniques like organizing tasks, following routines, and concentrating on tasks. They also learn how to manage their impulses and decide on the right actions. Sometimes, rewards or praise are used to motivate them and feel good about their improvements. 

Parenting Technique and Support

There are many effective techniques parents can use to support children with ADHD, including:

• Creating structured routines and schedules to help with organization and consistency.
• Breaking tasks into smaller, manageable steps to prevent children from feeling overwhelmed.
• Offering clear and simple instructions, using visual aids and reminders to aid focus and memory.
• Encouraging regular physical activity and exercise to help manage excess energy.
• Practicing positive reinforcement by rewarding desired behaviors.
• Maintaining open communication with teachers and healthcare professionals to ensure a coordinated and comprehensive approach to the child’s well-being and progress.

The Center for Children and Youth also offers Parent Management Training, which is an evidence-based program that equips parents with skills and practical steps to create lasting changes for their child.

Supporting Children with ADHD

Classroom Accommodations

In the classroom, various accommodations can be made to support children with ADHD, such as: 

• Providing a structured and organized environment with clear routines.
• Using visual aids like charts and schedules to enhance focus and understanding,
• Allowing for movement breaks to help release excess energy.
• Providing preferential seating near the front and away from distractions. 
• Breaking down assignments into smaller tasks. 
• Offering frequent reminders and check-ins to maintain engagement
• Utilizing noise-canceling headphones or quiet spaces for focused work
• Fostering a supportive atmosphere that values the child’s strengths and addresses their individual needs.

A psychological assessment could help identify the specific classroom accommodations to request in an Individualized Education Plan (IEP) that would assist a student with ADHD. Learn more about the assessment and diagnostic testing services provided by our team of child development experts and how to request a consultation.

Emotional Support Programs

Emotional support programs for children with ADHD aim to help them manage their emotions and build skills for better self-control and social interactions. These programs often involve teaching strategies to recognize and express feelings appropriately, develop problem-solving skills, and cope with frustration. 

Therapists or counselors work with the children to improve their self-esteem, reduce anxiety, and enhance their ability to handle challenges. Through activities like role-playing, discussions, and relaxation techniques, these programs create a safe space where children can learn to navigate their emotions, build resilience, and improve their overall emotional well-being.

Parent Management Training

Developed by Dr. Alan Kazdin at the Yale Parenting Center and Child Conduct Clinic, Parent Management Training (PMT) is proven to have a high success-rate in significantly reducing moderate to severe oppositional, defiant and explosive behaviors in children with Attention-deficit/hyperactivity disorder (ADHD) and other social, emotional, and behavioral challenges. 

Our PMT course takes place over 8 weekly meetings, delivered live via Zoom. Sessions are facilitated by our clinical staff who are experts in the diagnosis and treatment of children with ADHD and other social, emotional, or learning challenges. During these sessions, you will be trained to effectively deal with negative behavior and, more importantly, you will learn how to increase positive behavior in your child. Each week, you’ll practice new strategies at home and share successes while problem-solving challenges with other parents. These groups also offer emotional support and a sense of community, helping parents feel understood and less isolated in their challenges. 

When to Seek Professional Help

If you are wondering whether your child might benefit from an assessment for ADHD, or a therapeutic intervention, contact our knowledgeable Intake team to learn more about your options. Call us at 888-927-0839 or contact us online to learn more.