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Attention deficit hyperactivity disorder (ADHD) is a condition in which
a person has trouble paying attention and focusing on tasks, tends to act
without thinking, and has trouble sitting still. It may begin in early
childhood and can continue into adulthood. Without treatment, ADHD can cause
problems at home, at school, at work, and with relationships. In the past, ADHD was
called attention deficit disorder (ADD).
The exact cause is not clear,
but ADHD tends to run in families.
The three types of ADHD
ADHD is often diagnosed
when a child is between 6 and 12 years old. Teachers may notice symptoms in
children who are in this age group.
First, the child will have tests to make sure that he or she doesn't have other problems such as
depression, or anxiety disorder. The doctor will use
guidelines from the American Psychiatric Association to diagnose ADHD. The
doctor may also look at written reports about the child's behavior. Parents,
teachers, and others who have regular contact with the child prepare these
There is no cure for ADHD, but
treatment may help control the symptoms. Treatment may include medicines and
behavior therapy. Parents and other adults need to closely watch children after
they begin to take medicines for ADHD. The medicines may cause side effects
such as loss of appetite, headaches or stomachaches, tics or twitches, and
problems sleeping. Side effects usually get better after a few weeks. If they
don't, the doctor can lower the dose.
Therapy focuses on making
changes in the environment to improve the child's behavior. Often, counseling
and extra support at home and at school help children succeed at school and
feel better about themselves.
Many adults don't
realize that they have ADHD until their children are diagnosed. Then they begin
to notice their own symptoms. Adults with ADHD may find it hard to focus,
organize, and finish tasks. They often forget things. But they also often are
very creative and curious. They love to ask questions and keep learning. Some
adults with ADHD learn to manage their lives and find careers that let them use
Learning about ADHD:
Living with ADHD:
Health Tools help you make wise health decisions or take action to improve your health.
The exact cause of
attention deficit hyperactivity disorder (ADHD) isn't
known. But it may run in families. Ongoing research
is focused on finding the
genes that cause a person to be likely to get
A mother's use of cigarettes, alcohol, or other drugs during pregnancy may increase the risk for ADHD. Also, exposure to lead may cause symptoms linked with
Although many parents believe
that foods with sugar and food additives make their children more hyperactive,
these foods haven't been shown to cause ADHD.footnote 2
These symptoms affect all people who have
ADHD. But typical behavior varies by age.
Attention deficit hyperactivity disorder (ADHD) may be hard to identify in a young child. It can be hard to tell the difference between normal behavior and ADHD symptoms in young children.
But after a child starts
school, ADHD becomes more noticeable. ADHD is most often diagnosed in children ages 6 to 12. During this time, ADHD
can disrupt many aspects of a child's life. Learning,
adjusting to change, sleeping, and getting along with others are all potential
About 60 to 85 out of 100 children with ADHD still have symptoms during the teen years.footnote 3 These children may be less mature than their peers. They may lag behind in reaching
milestones typical for the age group.
Teens with ADHD may also have more problems when they are
driving cars. They get more speeding tickets and have serious car accidents
more often. They should be watched closely by a licensed adult when they are
learning to drive.
Adults with ADHD may have trouble focusing, organizing, and
finishing tasks. But they are often able to adjust to the workplace better
than they did in the classroom as children.
People with ADHD often have one or more other
disorders. These include
oppositional defiant disorder,
Raising a child who has ADHD can
be a challenge. Parents must consistently watch their child. They must respond to
problem behavior in the right way. If other issues are causing stress within a
family (such as divorce, violence, or drug or alcohol abuse), it may be even
harder to deal with a child who has ADHD.
Treatment can help
control symptoms. It can allow a child to grow and develop normally.
The greatest risk factor for ADHD is
having an inherited tendency for the condition. Environmental factors, such as certain parenting
methods, may influence how symptoms of ADHD are expressed. But they don't
Call a doctor if:
Ask your doctor about his or her training
and experience related to ADHD. The doctor must be able to identify and distinguish behaviors that can be subtle and
complicated. Also, make sure that your doctor has enough time to
evaluate you or your child. Accurate diagnosis and successful treatment of ADHD
takes repeated office visits and observations. Your
doctor should also be able to coordinate between other health professionals,
family members, teachers, and caregivers.
Health professionals who can diagnose and treat
attention deficit hyperactivity disorder (ADHD) with medicine include:
Health professionals who do not prescribe medicines but
can provide behavior therapy or family counseling include:
To prepare for your appointment, see the topic Making the Most of Your Appointment.
A doctor relies on a combination of exams, tests, and other information to diagnose attention deficit hyperactivity disorder (ADHD). The doctor will look at guidelines created by the American Psychiatric Association
(APA). The diagnosis will be based on:
Before meeting with your doctor, think about at what age your child's
symptoms began. You and other caregivers should record when the
behavior occurs and how long it lasts. An important part of evaluation for
ADHD is thinking about the kinds of problems caused by the behaviors. How much do they affect schooling and social behavior?
Your child may have verbal and written tests to find out if behavior problems are caused by other conditions with similar symptoms.
For example, children with
ADHD may have a hard time learning to read, write, or do math problems. Testing
these learning disabilities will help teachers form the
best plan for a child with these problems.
If you are concerned about how your child's temperament, learning skills, and
behavior are developing, talk with your doctor during your next visit.
attention deficit hyperactivity disorder (ADHD) relies on a combination of medicines and behavior therapy. Treatment with medicine depends on the age of your child. The first step is an accurate diagnosis of ADHD and an understanding of your child's strengths and weaknesses. Learning about ADHD will help you and your child's siblings better
understand how to help your child.
The following medicines may be used for ADHD:
Through behavior therapy, parents
learn strategies, such as positive reinforcement, to improve a child's
behaviors. Children learn skills for problem solving, communication, and
self-advocacy. Behavior therapy is more helpful when used with medicine
than when used by itself.
Some children with ADHD also have other
conditions, such as
oppositional defiant disorder. Behavior therapy can
help treat some of these conditions.
Counseling may help children and
adults who have ADHD recognize problem behaviors and learn ways to deal with them.
For both parents and children, counseling can be a place to air frustrations
and deal with stress. To learn more, see Other Treatment.
There are many things you can do to help your child at home and at school. To learn more, see Home Treatment.
Many adults don't
realize that they have ADHD until their children are diagnosed. Then they begin
to recognize their own symptoms. Some adults with ADHD learn to manage their
lives and find careers in which they can use their intellectual
curiosity and creativity to their advantage. But many adults have difficulties
at home and work.
Like children with ADHD,
adults may benefit from medicine combined with psychological support. This support includes education about the disorder, support groups and/or counseling, and skills
training. Skills training may include:
Medicines that may be used for ADHD in adults include:
Certain antidepressants are sometimes also recommended. These include
bupropion (for example, Wellbutrin) and tricyclics (for example, desipramine, imipramine,
There are several
myths that can get in the way of understanding ADHD. It is important to understand that ADHD is a medical problem that
is best managed with treatment. Your child is more likely to control symptoms when he or she
actively takes part in treatment, such as taking medicines on time.
There is no known way to prevent
attention deficit hyperactivity disorder (ADHD).
But use of cigarettes, alcohol, or other drugs during pregnancy may increase the risk for ADHD.
There are many things you can do at home to help your child who has attention deficit hyperactivity disorder (ADHD)-and to help yourself.
In the classroom, more demands are placed on children to sit still, pay
attention, listen, and follow class rules. So elementary school teachers are often the first to recognize ADHD symptoms. Many times teachers advise
parents to have their child tested or to see a doctor.
children with ADHD qualify for
educational services within the public schools. If
your child qualifies, you will meet with school personnel to identify goals and
plan an individualized education program (IEP). This usually
means that your school will try to accommodate your child's extra needs. This may
be as minor as placing your child at the front of the class. Or it may be as involved as
providing classroom staff to help your child.
Your doctor will
talk with you about setting realistic and measurable goals for your child's
behavior at school and at home. Your child's specific problems and needs will be taken into account.
Regular communication among
parents, teachers, and doctors benefits a teen who has
You'll need to stay closely involved with your teen. The teen years present many challenges, such as
increased schoolwork and the need to be more attentive and organized. Making
good decisions becomes especially important during these years when peer
pressure, emerging sexuality, and other issues surface.
Use consequences that
are meaningful to your teenager. These may include losing privileges or having increased
chore assignments. Parents and teens can work together to establish reasonable,
obtainable goals. And they can negotiate rewards when those goals are
Medicines are used to help control the
attention deficit hyperactivity disorder (ADHD):
impulsivity, and inattention. The American Academy of
Pediatrics (AAP) guidelines recommend medicine and/or behavior therapy to treat
children who have ADHD.footnote 4
Children should be closely watched after they start
medicines. The doctor can assess whether your child is receiving the correct dose. Side
effects usually decrease after a few weeks on the medicines. Or the dosage can
be lowered to offset side effects.
Be sure that medicine for ADHD is taken consistently. You will also need to
keep track of the effects of the medicine and communicate closely with your
Medicines to treat ADHD include:
Most often, stimulant
medicines are used to treat ADHD. These medicines are effective for people of
all ages. But more research is needed on how adults respond. In general,
stimulant medicines improve symptoms. There are often quick and dramatic improvements
If stimulant medicines have bothersome side effects or aren't effective, your child's doctor might recommend
a nonstimulant medicine such as atomoxetine (Strattera), clonidine (Kapvay), or guanfacine (Intuniv). These medicines may be used alone or in combination with stimulant medicines.
Medicines may also be used to treat other mental health
conditions that often occur along with
ADHD. One condition is anxiety disorders.
If your child is taking medicine for ADHD, consider:
Treatment depends on the age of your child. Children ages 4 to 5 years are treated first with behavior therapy. Your child's doctor will talk to you about medicine if your child's symptoms do not improve. Children ages 6 to 11 years are treated with medicine or behavior therapy or both. Children ages 12 to 18 years are treated with medicine and usually also with behavior therapy.
therapy helps train parents, teachers, and other adults responsible for a
child who has ADHD. These programs focus on establishing routines and rules
for behavior and closely watching how a child responds.
consistently delivers rewards or consequences depending upon how the child
complies with the rules. This type of treatment has been shown to be more
Cognitive-based therapies depend more upon the child to self-direct changes in behavior. A child with ADHD isn't likely to have the
skills to change his or her behavior without help and guidance from adults.
Behavioral programs most often used to help treat ADHD in a
Behavioral intervention for adults focuses on
help with organizational skills and healthy relationships.
Complementary medicine is used by some
therapists and other health professionals. These therapies have not been proven effective in treating ADHD. But a person with ADHD may
benefit. For example, acupuncture or biofeedback may help relieve
stress and muscle tension and improve a person's overall well-being and quality
If you are thinking about using complementary therapy for ADHD, be open with your doctor about the
subject. He or she can help direct you to a method that is safe to use in
combination with proven techniques. Only those therapies that best help
control ADHD symptoms without causing physical or emotional harm should be
Greenhill LL, Hechtman LI (2009). Attention-deficit/hyperactivity disorder. In BJ Sadock et al., eds., Kaplan and Sadock's Comprehensive Textbook of Psychiatry, 9th ed., vol. 2, pp. 3560-3572. Philadelphia: Lippincott Williams and Wilkins. National Institute of Mental Health (2008). Attention Deficit Hyperactivity Disorder (NIH Publication No. 08-3572). Available online: http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder/adhd_booklet.pdf. American Academy of Child and Adolescent Psychiatry (2007). Practice parameter for the assessment and treatment of children and adolescents with attention-deficit/hyperactivity disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 46(7): 894-921. American Academy of Pediatrics (2011). ADHD: Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics, 129(5): 1023-1029.
Other Works Consulted
Cooper WO, et al. (2011). ADHD drugs and serious cardiovascular events in children and young adults. New England Journal of Medicine, 365(20): 1896-1904. Greenhill L, et al. (2006). Efficacy and safety of immediate-release methylphenidate treatment for preschoolers with ADHD. Journal of the American Academy of Child and adolescent Psychiatry, 45(11): 1284-1293. Greenhill LL, Hechtman LI (2009). Attention-deficit/hyperactivity disorder. In BJ Sadock et al., eds., Kaplan and Sadock's Comprehensive Textbook of Psychiatry, 9th ed., vol. 2, pp. 3560-3572. Philadelphia: Lippincott Williams and Wilkins. Molina BS, et al. (2009). The MTA at 8 years: Prospective follow-up of children treated for combined-type ADHD in a multisite study. Journal of the American Academy of Child and Adolescent Psychiatry, 48(5): 484-500. National Institute of Mental Health (2008). Attention Deficit Hyperactivity Disorder (NIH Publication No. 08-3572). Available online: http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder/adhd_booklet.pdf. Rappley MD (2005). Clinical practice: Attention deficit-hyperactivity disorder. New England Journal of Medicine, 352(2): 165-173. Sadock BJ, et al. ( 2007). Attention-deficit disorders. In Kaplan and Sadock's Synopsis of Psychiatry, Behavioral Sciences/Clinical Psychiatry, 10th ed., pp. 1206-1217. Philadelphia: Lippincott Williams and Wilkins. Stubbe D (2007). Attention deficit hyperactivity disorder. Child and Adolescent Psychiatry, pp. 57-68. Philadelphia: Lippincott Williams and Wilkins. Swanson J, et al. (2006). Stimulant-related reductions of growth rates in the PATS. Journal of the American Academy of Child and Adolescent Psychiatry, 45(1): 1304-1313. Wilens TE, et al. (2004). Attention-deficit/hyperactivity disorder in adults. JAMA, 292(5): 619-623.
ByHealthwise Staff Primary Medical Reviewer Adam Husney, MD - Family Medicine Kathleen Romito, MD - Family Medicine Specialist Medical Reviewer Louis Pellegrino, MD - Developmental Pediatrics
Current as ofMay 3, 2017
Current as of:
May 3, 2017
Adam Husney, MD - Family Medicine & Kathleen Romito, MD - Family Medicine & Louis Pellegrino, MD - Developmental Pediatrics
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