What is attention deficit hyperactivity disorder (ADHD)?
Attention deficit hyperactivity disorder (ADHD) is a medical condition where children act before they think, have trouble focusing and can’t sit still a lot of the time.
Many children have trouble with some of these things. But in children with ADHD, this behaviour is extreme and has a big impact on children’s daily life.
With ADHD, the different parts of the brain don’t ‘talk’ to each other in a typical way. Because of this, children might have trouble thinking, learning, expressing their feelings or controlling their behaviour as well as other children of the same age.
There are three types of ADHD:
- ADHD inattentive type: children with this type tend to have trouble concentrating, remembering instructions, paying attention and finishing tasks.
- ADHD hyperactive/impulsive type: children with this type are always on the go, have trouble slowing down and can often act without thinking.
- ADHD combined type: children with this type tend to have trouble concentrating, are fidgety or restless and are always on the go. They often act without thinking.
Children diagnosed with ADHD whose symptoms aren’t managed effectively are at a higher risk of having learning difficulties, depression and anxiety, relationship problems, risky behaviour and injuries. That’s why it’s very important to identify and treat ADHD early.
Signs and symptoms of ADHD
If you think your child might have ADHD, first consider your child’s age. If your child is under five years, health professionals will be careful about diagnosing ADHD. That’s because there’s so much growing and developing going on in these years.
But if your child is five years or older, or if you’re very concerned even before this age, you should think about seeing a health professional.
ADHD red flags
Some ‘red flags’ for ADHD include behaviour problems that:
- are more severe than in other kids the same age
- go on for a long time – at least six months
- happen in, and have a negative impact on, at least two areas of your child’s life – for example, school, home, child care, playdates and so on.
Even if a child’s behaviour problems are severe, long-lasting and/or happen in two areas of life, they still might not be a sign of ADHD. For any behaviour problems to be signs or symptoms of ADHD, they also have to come from the following list, and there have to be at least six of them.
- doesn’t pay close attention to details and makes ‘careless’ mistakes in schoolwork or homework – for example, she overlooks or misses detail, or hands in inaccurate work
- jumps from one activity to another
- can’t get organised – for example, she has trouble getting things in order or doing things on time
- forgets things, particularly when trying to follow instructions to finish a task
- talks a lot or interrupts other people’s conversations
- acts restlessly – that is, she can’t sit still, doesn’t stay seated, fidgets, squirms or climbs on things
- can’t stay focused or is easily distracted
- doesn’t finish homework or chores around the house
- doesn’t seem to listen to instructions
- often loses things – for example, schoolwork, pencils, books, wallets, keys or mobile phones
- is too loud or noisy during play, leisure or social activities
- is on the go all the time and seems to have an endless supply of energy
- is impatient and doesn’t wait for a turn
- finds it hard to resist temptations or opportunities
- is uncomfortable doing things slowly, thoughtfully and for long periods of time.
If your child does have ADHD and it isn’t diagnosed and managed, it can cause long-term learning, behaviour and emotional difficulties. So it’s important to see a health professional if you’re concerned about your child’s behaviour.
But there are other problems that could cause behaviour that looks like ADHD – for example, problems with health, emotions, sleep or school. This is why your child needs careful diagnosis.
If you’re concerned about your child’s behaviour, your GP is a good place to start. Your GP might refer your child to a paediatrician, a psychologist or a child psychiatrist for an ADHD or other diagnosis.
Diagnosing ADHD involves looking closely at your child’s challenges in behaviour, learning and other areas of development. A thorough diagnosis might include most, if not all, of the following:
- an interview with you and other primary carers of your child
- an interview with your child
- behaviour checklists that you and/or your child’s carers and teacher fill out
- discussions with your child’s teacher or carers
- language, speech and movement checks
- learning and educational checks
- a hearing test.
Diagnosing ADHD isn’t quick and easy, because ADHD can overlap with many other medical and behaviour conditions. For example, you might say, ‘If he concentrated more, he would learn more at school’. But it might actually be the other way around – your child’s learning difficulties are causing concentration problems.
Careful diagnosis can pinpoint which – if any – symptoms belong to ADHD and which have other causes. And when your child gets the right diagnosis, she can also get the right therapies and management plan for her condition.
Although there’s no cure for ADHD, the good news is that ADHD is manageable with different therapies. You can read our articles on managing ADHD in children
and managing ADHD in teenagers
for tips and strategies for helping your child and looking after yourself.
Factors affecting ADHD
A combination of genes and environmental factors might increase the risk of an ADHD diagnosis, but we still don’t know what causes ADHD.
There are some conditions and situations that don’t necessarily cause ADHD – but they do cause behaviour that looks like ADHD or that makes ADHD behaviour worse.
For example, difficult family and social situations and other challenges such as illness can make ADHD behaviour more severe.
Some artificial food colourings might make children with ADHD more cranky, and their ADHD symptoms might seem worse. These colourings include tartrazine (lemon yellow) (102), quinoline yellow (104), sunset yellow FCD (110), carmoisine (red) (122), ponceau 4R (red) (124) and allura red AC (129).
For more information, see our article on reading food labels.
Extreme prematurity, various genetic syndromes, seizures, hydrocephalus and other conditions such as autism spectrum disorder, intellectual disability and cerebral palsy also affect the way the different parts of the brain talk to each other. These conditions might produce behaviour that looks like or is related to ADHD.
If you’re worried that your child’s behaviour might be caused by other developmental problems, make an appointment to see your GP or paediatrician.
What doesn’t cause ADHD
ADHD isn’t caused by bad parents or parenting. That is, it isn’t because of a lack of limits on behaviour or inconsistent parenting.
There’s no evidence that food intolerances cause children to develop ADHD symptoms.
Everyday life for children with ADHD
Children with ADHD often have academic difficulties and/or problems at school, including learning disabilities, language impairment and movement difficulties.
Sleep problems, such as having trouble falling asleep and staying asleep overnight, can often make school even more difficult.
Your child might have social difficulties – for example, he can’t concentrate or sit still long enough to enjoy a game with other children.
Other mental health difficulties might also develop, including oppositional defiance disorder and conduct disorder, anxiety in the younger years, anxiety in teenagers and/or depression in teenagers.
ADHD symptoms might put a strain on day-to-day family life, particularly if other family members also have ADHD or other learning difficulties.
Children with ADHD can be highly creative and can spend a long time doing activities they love. Some children might enjoy using their energy on sport or dancing. They might also be more open to trying new things than other children. Finding positive ways for your child to use his energy can be good for his self-esteem and help protect him against mental health problems.
ADHD and teenagers
Sometimes children don’t get diagnosed with ADHD until they’re teenagers. If you think your teenage child might have ADHD, it’s a good idea to seek professional advice.
Other times ADHD symptoms don’t cause problems until later childhood or the teenage years, when children have more schoolwork and go through social and emotional changes. These changes can add to your child’s social and academic difficulties.
On the other hand, as your child with ADHD gets older, her ADHD symptoms might change or tone down. For example, your child might still have trouble focusing, remembering things and thinking before she acts, but her behaviour might be less obviously hyperactive.
By the time he’s a teenager, your child might have built up some strategies to manage his symptoms more effectively. And some of the qualities and behaviour that made life hard for him at school can be strengths in later life, especially if he has good support as he develops.
For example, your child might be able to ‘think outside the box’ when it comes to problem-solving. Or she might be able to use her impulsiveness to help with creative or challenging situations.
Many children with ADHD don’t have symptoms any more when they’re adults.