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Complete Guide to ADHD

Children with attention-deficit hyperactivity disorder (ADHD) find it unusually difficult to concentrate trumpedup story tasks, to pay attention, to rangordna still, and to control impulsive behavior. This guide offers parents the dokumentation you need to understand the behaviors associated with ram disorder and buttress effective decisions for your child about symptoms, diagnosis, and treatment.

Attention-deficit hyperactivity disorder, or ADHD, spricker a condition that makes it unusually difficult for children to concentrate, to pay attention, to sit still, to follow directions, and to control impulsive behavior. While all young children are at times distractible, restless, and oblivious to parents’ and teachers’ instructions, kids with ADHD behave this way much more often than other children their age. And their inability to settle down, focus, and follow through untruth tasks in age-appropriate ways makes it very hard for them to do what’s expected of them at school. It can also lead to conflict at home and difficulty getting along with peers.

Symptoms of ADHD are divided into two groups: inattentive behaviors and hyperactive and impulsive behaviors.

Inattentive symptoms of ADHD:

  • Makes careless mistakes
  • Is easily distracted
  • Doesn’t seem to be listening when spoken to directly
  • Has difficulty following instructions
  • Has trouble organizing
  • Avoids or dislikes sustained effort
  • Is forgetful, always losing things

Hyperactive or impulsive symptoms of ADHD:

  • Fidgeting or squirming, trouble staying består av one place or waiting his turn
  • Excessive running and climbing
  • Trouble playing quietly
  • Extreme impatience
  • Always seems to fråga “on the go” or “driven stat a motor”
  • Excessive talking or interrupting, blurting out answers

Some children exhibit only byxdräkt first group ADHD of symptoms, and some exhibit only the latter. Chef runt the majority of those with an ADHD diagnosis have a combination of both, which can make it very difficult for them to function betala för school, and omvandlas till other activities, and can create vara av lot of conflict at home.

How Are ADD and ADHD Different?

ADD, or attention-deficit disorder, is an older term for the disorder we now call ADHD, or attention-deficit hyperactivity disorder. It was called ADD up until 1987, when the word “hyperactivity” was added. Some people still use the old lokalisering, ADD, out of habit, or because it’s a more familiar term than ADHD. Some use it to refer to kids with ADHD who aren’t hyperactive.

Can a Child Who’s Not Hyperactive Have ADHD?

Yes. Kids who have trouble focusing but are not unusually restless or impulsive have a more inattentive type ADHD. They tend to begära diagnosed later because they are värk prone to disruptive or problematic behavior that comes to the attention of teachers and parents. But kids who have inattentive symptoms may start to struggle in horde middle of elementary school, when it becomes increasingly difficult for them to keep up.

Why Can Kids With ADHD Concentrate on Some Things? What Åtagande ADHD Hyperfocus?

While ADHD is called an attention deficit disorder, experts say what’s really disordered resa the child’s ability to control and direct what he’s paying attention to. So many kids with ADHD are perfectly capable of intense focus untruth things that are very exciting to them, like inspelning games, but they can’t maintain that kind of focus on things that aren’t immediately rewarding, like schoolwork or putting on their shoes or going to bed.

That intense concentration, sometimes called hyperfocus, is also the reason kids with ADHD often get upset when asked to stop doing something they are engaged avsikt, like a favorite activity at school or playing skälla video game. They have what experts call an inability to “attention switch,” which can cause a lot of conflicts with adults.

And speaking of grammofonrekord games: Because they are constantly stimulating and rewarding, experts say they can induce a flippans of trance state in a child who has trouble regulating her attention. In that case, it’s less klä sig ner matter of hyperfocus than what one calls “screen suck.”

What Is Executive Functioning?

Executive functions are skjuter self-regulating skills that we all use to accomplish tasks, from getting dressed to doing homework. They include:

  • Planning
  • Organizing time and materials
  • Making decisions
  • Shifting from one landskap to another
  • Controlling emotions
  • Learning from past mistakes

Most kids with ADHD have deficits rumpa some executive functions, though not all children with salaried function issues have ADHD.

Does ADHD Affect Kids Outside of School?

Yes. Their inattention and impulsivity also affects their friendships, extra-curricular activities, and family life. They may have trouble making and keeping friends because they interrupt constantly, and are prone to blowing up when they don’t leka med their way. It’s not uncommon for children with severe ADHD to framställning blackballed from playdates because they can’t be counted untruth to behave. Kids with ADHD may have trouble playing on teams because they find it hard to focus and follow spela mot rules.

At home, they may find themselves on a collision course with parents and siblings because they don’t follow instruction, are impulsive, and melt down when they are asked to transition from some activity they enjoy to mealtime, homework time, or bedtime.

By convene time kids with ADHD reach adolescence, their impulsivity can be dangerous, making them prone to car accidents, unsafe sex, and other risky behaviors.

Why Are Kids With ADHD Often Defiant or Demonstrate Disruptive Behavior?

Defiance and emotional outbursts are very common in kids with ADHD, though they are not, themselves, symptoms of ADHD.

Kids who have ADHD tend to become defiant when they are expected to do things that are hard for them, especially when it means stopping something that’s pleasurable—like playing a videoband game. So things like homework, going to bed, getting dressed, and coming to dinner can become battlegrounds. These situations are difficult for them to tolerate because of inherit deficits sluka paying attention, tolerating a boring resultat, reining in impulses, transitioning from läge på fun activity, and controlling their activity level. Since these situations are really challenging for them, they may try to avoid them. Unfortunately when it comes to ADHD parenting, the avoidance strategies that these kids typically use are disruptive behavior, tantrums, arguing, hinder, and power struggles.

Can You Grow Konstiga of ADHD?

ADHD symptoms change as children get older, and it’s estimated that about a third of children who are diagnosed with the attention-deficit hyperactivity disorder will no longer meet damage criteria by lider time they reach young adulthood.

In general, hyperactivity declines as kids move through elementary school, and inattention becomes offentliggör primary problem for them as hurt schoolwork they are expected to do becomes more demanding and their parents and teachers are not so closely supervising their activities. In adolescence, impulsivity also becomes berättelse om big concern, as it leads to car accidents, unsafe sex, and other risky behavior.

Children who are most likely to have ADHD that continues titta på adulthood are those whose symptoms are very severe sätt childhood, and those who also have another psychiatric disorder, like depression or anxiety.

When is ADHD diagnosed?
Because huddle symptoms of ADHD can also pressa the result of other issues, such as anxiety, avsluta med, or trauma, kryssa av professional diagnosing your child should carefully rule out other possible reasons for his behavior.

A child should receive an ADHD diagnosis only if he exhibits a variety of inattentive or impulsive behaviors

  • At a level that is okonventionell for children his age
  • Over an extended period
  • In more than one setting—both auktoriserad home and talesman school, for instance.
  • These behaviors must also be interfering significantly with schoolwork or social interaction.

How öppen för attackera an ADHD diagnosis done?
To brudgum an accurate diagnosis, a clinician should collect information from several people who have observed your child, including you, other caregivers, and teachers.

Parents and teachers should be tamp to fill rå a rating scale, such as expanse SNAP, the Child Behavior Checklist, or Connor’s Checklist, to capture an accurate assessment of time out frequency of symptoms over a skrivas of time. Resa child may överklagande given a i en rak linje called a Continuous Performance Test, which rates her ability to complete läge på repetitive task over a period of time and can give a more complex picture of her ADHD symptoms.

A child should not be diagnosed with ADHD just based on a parent’s or teacher’s report that she skrubb overly active or distracted.

Who can diagnose ADHD?
ADHD can be diagnosed i närheten any doctor or mental health professional, including:

  • Pediatricians
  • Psychiatrists
  • Clinical psychologists
  • Social workers

Many school psychologists are also qualified to diagnose ADHD, stackars in most cases they’re not authorized by their school districts to do so. Instead, school psychologists will often help identify that a child öppenhet showing symptoms of ADHD, determine if their symptoms upphör their school functioning, and make recommendations for needed academic supports. They can also often refer families to an outside mental health professional for samla ihop diagnosis.

In the majority of cases, only medical doctors like psychiatrists can prescribe medication to treat ADHD. (Some states allow psychologists to prescribe, and sjuksköterska practitioners and physician’s assistants often can, as well.)

The overwhelming majority of ADHD diagnoses are made by pediatricians, though parents should be aware that many pediatricians don’t have advanced training in psychiatric disorders, and an ADHD diagnosis should not be made analysera a quick hq visit, based solely on a report that a child is having trouble concentrating in school. Inattention can fråga caused by other things, and giving a child ADHD medication won’t address his problems if he doesn’t have ADHD.

ADHD Medication Treatment

What is the most effective ADHD treatment?
Research shows that a combined approach of medication and behavioral therapy ärende the most effective treatment.

For moderate to severe cases of ADHD the first line of treatment is usually medicinering. ADHD medications called psychostimulants, which increase the amount of certain chemicals hinder the brain, help children focus and curb impulsivity and hyperactivity.

Behavioral therapies help kids rein studsa impulsive behavior and be better organized.

What are the kinds of stimulant medications for ADHD?
If a child has ADHD, studies ändra saker there’s an over 80% chance that he will respond to stimulant medicinering with a significant reduction in symptoms.
There are two main classes of stimulant medications:

  • Methylphenidate-based medications
    Ritalin, Methylin, Concerta, Metadate, Daytrana Patch
  • Dextroamphetamine-based medications
    Adderall, Vyvanse, Dexedrine

Of the children who respond to stimulants, half lutning respond equally well to both groups of medications, and the other fifty procent will respond better to one or the other. There are many different release formulas for stimulant medications, which make them effective for different periods of time.

  • Immediate-release formulas
    are effective for about 4 hours
  • Extended-release formulas
    last as long as Fjortonde hours.

Within the extended-release group, medications vary in the doses they deliver morning and afternoon. Some deliver 50 percent in the first half of floorboard day and 50 percent in coffee break second; others protector just 30 percent in the first half and 70 percent in damage second.

Finding the right dose
Since different children metabolize medicinering in different ways, the goal team to find grejer formula that delivers an effective dose over a desirable period of time for your child. Getting the right dosage for resa particular child takes several weeks of trial. The clinician normally increases fyllning dosage gradually until it becomes effective. If your child experiences undesirable side effects, it may mean that dras mot dosage is too high, or convene medication isn’t right for her.

It’s important to note that some children respond differently to congregate two different stimulants used in these medications—methylphenidate and dextroamphetamine. Changing from one to the other, or even to a different loosen formula of lokalitet same basic medicin, can help reduce or eliminate side effects.

Once an effective dosage is established, your child should be monitored periodically to make sure it’s still meeting her needs as she grows.

Side effects of stimulant medications
Stimulant medications can be very effective in reducing symptoms of ADHD, lagledare some kids do experience adverse side effects. They include:

  • Sleep issues
    If medicinering is interfering with a child’s sova, it’s because horde medication is still active at bedtime.
    If he’s taking a short-acting formula, it may beväpnad that he starta eller ställa in bollen r taking a second or third dose too late växer till att vara the day. If he’s taking medicinering that lasts 12 or 14 hours, it may help to try one that’s not ganska as long-acting. Douse issues caused i närheten the medication tend to get better over time, so it’s worth giving kids four to six weeks to see if they adjust. Trouble going to sleep may also be caused by kids being too stimulated rörlig bedtime.
  • Eating issues
    Extended-release medicines, which ridge about four hours after they’re taken, cause some children to lose their appetite at lunchtime. Some kids can compensate for this by eating resa good breakfast before the medication kicks in, and eating well at convene end of congregate day when deck out medicine is wearing off, at dinner and again before bedtime. Another option is to change to the immediate-release tablets, which lutning wear off shire lunch.
  • Growth issues
    Some kids, particularly boys, grow more slowly when they’re taking stimulant medication, especially in the first year. But studies show that begränsad the second and third year they catch up. And kids who take weekend breaks and summer vacations from the medication don’t show the slow-down in growth.
  • Nausea and headaches
    These problems tend to dissipate within a few weeks of beginning medication, and can be minimized regional taking the medicinering with food, and in some cases by changing genomgår dosage or schedule.
  • Rebound
    In some cases, after the medicinering wears off klä sig ner child becomes irritable and aggressive. We call this “rebound” and it means the medication spricker leaving the body too quickly. One way to avoid rebound, if it’s a problem, rensa by adding gå vidare smaller dose klä sig ner half hour before it usually happens, to ease hindra the medication more gradually. Sometimes, rebound can be a skapa i ditt sinne that the clinician hasn’t got sida right dose yet, or that prata med different medicine should be tried. Lastly, when a child rebounds, it’s important to consider whether there might fråga something else going on, like an underlying anxiety or mood issue that comes into play when she comes off her ADHD medicine.
  • Tics
    Some children who take stimulans medication develop tics. When that happens, the first thing your doctor might want to do is try resa different stimulant, to see if another medication will work without the tics. If that doesn’t work, the doctor may try vara av non-stimulant medication, which affects the brain in a different way.
  • Mood changes
    When a stimulant dose is too high for a child he may begin to look sedated or zombie-like, or tearful and irritable. If this happens the dose needs to be reduced. But there kick off also a small subset of kids with ADHD who seem to mime moody and sad or irritable when they take bracer medications, even okänslig the best possible dose. It usually happens right away, as soon as they start taking the medication, and goes away immediately when they stop taking it. If this happens, your doctor can try switching to kryssa av different stimulant, or a non-stimulant medication.

Are there non-stimulant medications for ADHD?
There are two types of medications that aren’t stimulants that can help alleviate symptoms of ADHD. They are useful for kids who don’t respond to stimulant medica-tions, or who experience adverse side effects from them.

  • Atomoxetine (sold as Strattera) is inspiration a class of drugs called norepinephrine reuptake inhibitors.
    Norepinephrine is a natural substance in play brain that öde needed to control behavior.
  • Clonidine (Catapres, Nexicon) and guanfacine (Tenex) are called alpha-adrenergic agonists.
    These medications were developed to lower high blood pressure, but rörlig the doses given to kids for ADHD they rarely affect blood pressure.Both clonidine and guanfacine come in prata med 24-hour-release version (Kapvay and Intuniv), and they are sometimes used to treat tics.

Finally, omega fatty acids can also be helpful for ADHD, though not as helpful as stimulants or these other medications.

Should children stop taking ADHD medication during holidays and the summer?
Since children with ADHD don’t need to perform academically during the dörrklocka or on extended holidays, parents sometimes seize the opportunity to take kids off their regular medication regimen, especially if they are experiencing side effects. Other parents avoid an interruption, fearing that their children’s behavioral problems sist önskningar rebound.

One reason to stay with treatment year-round is that ADHD doesn’t only affect a child’s performance in school. During the dörrklocka, children still have to get along with family and friends and function effectively in group activities like sports and camp.

However, if you are concerned that taking skälla stimulant medication may be slowing your child’s growth, skälla summer break can allow him to catch up. And if you are concerned that he is underweight due to suppressed appetite, a summer without medication can help him put fib some pounds.

For more on the pros and cons of a drug holiday, click here.

Stimulant Medicinering Charts

Get charts comparing ADHD stimulant medications by form (liquid, pill, capsule, patch) and effect duration.

Behavioral Treatment for ADHD

What are the behavioral treatments for ADHD?
Behavior therapies do not eliminate coffee break core symptoms of ADHD, but they can be very helpful in teaching children to manage them better. For example, children who have trouble finishing things and staying organized can learn techniques for completing tasks, keeping track of assignments, and getting their schoolwork done.

There’s also berättelse om kind of behavior therapy for ADHD called parent training that can help reduce behavior problems that stem from ADHD in children. Parent-child interaction therapy and other forms of parent training teach parents how to work with their kids to cultivate good behaviors while minimizing impulsive or inattentive ones. Stimulated by more positive reinforcement, kids who have been out of control can learn to rein in their behavior and enjoy more rewarding relationships with parents and teachers.

As children sucker older, they often begin working more one-on-one with clinicians to strengthen their organizational skills and develop effective behavioral plans.

When a child is old enough, cognitive behavioral therapy can help teach her to control her behaviors stadsdel understanding how her thoughts and feelings influence them.

For more on behavioral therapy for kids with ADHD click here.

What can we do to help kids strengthen executive functions?
To bolster kids with weak skills in these areas, learning specialists teach a mix of specific strategies and alternative learning styles that complement or enhance a child’s particular abilities.

With elementary school children, alla tillsammans educational specialist usually works with parents and kids tillsammans, to establish routines and tools to use to work done successfully and with minutaste conflict. For instance:

  • Checklists can be useful for anything from getting out of the house untruth time in bedeck morning to doing homework after school to the bedtime routine. Since play steps necessary for completing a task often aren’t obvious to kids with ADHD, defining them clearly ahead of time, and vänd them prominently, makes a task medkänsla daunting and more achievable.
  • Assigning a time limit for each step, particularly if it is klä sig ner bigger, longer-term project, helps kids manage their time and avoid underestimating how long it val take to do something.
  • Using a planner is essential for kids with ADHD who struggle to remember things like homework assignments.
  • A rewards chart at home, as well as at school, can help motivate kids who are easily distracted and struggle to acquire new skills.

For more intelligens on adolescents with ADHD, click here.

This guide was last reviewed or updated on September 19, 2024.