Attention Deficit Hyperactivity Disorder

What is attention deficit hyperactivity disorder (ADHD)?

ADHD is a neurodevelopmental disorder. It is usually first diagnosed in childhood and often lasts into adulthood. But some people don't get diagnosed with ADHD until they are adults. ADHD involves:

• Having trouble paying attention (inattention)
• Having trouble controlling impulsive behaviors (impulsivity)
• Being overly active (hyperactivity)

What are the types of attention deficit hyperactivity disorder (ADHD)?

There are three types of ADHD:

• Mostly Inattentive ADHD. People with this type of ADHD have trouble paying attention and are easily distracted. It's hard for them to organize or finish tasks. They may have trouble following instructions or conversations.
• Mostly Hyperactive-Impulsive ADHD. People with this type of ADHD have symptoms of both hyperactivity and impulsivity:
  • With hyperactivity, people feel a need to always be moving. They have trouble sitting still and may fidget and/or talk too much.
  • With impulsivity, people have trouble controlling their actions and words. They tend to act on sudden ideas or feelings without thinking about the possible results. They may interrupt others a lot or have trouble waiting their turn.
• Combined ADHD. People with this type of ADHD have a mix of inattentive and hyperactive-impulsive symptoms. Combined ADHD is the most common type.

It's normal to sometimes have trouble paying attention or sitting still, especially for children. But people with ADHD have more severe symptoms that can sometimes cause serious problems, for example, failing grades for a child or a job loss for an adult. The symptoms are ongoing and may affect family and social life, too.

What causes attention deficit hyperactivity disorder (ADHD)?

The exact cause of ADHD is unknown. ADHD probably results from a combination of factors, such as genetics and your environment. Researchers are looking at possible environmental factors that might raise the risk of developing ADHD. These factors include brain injuries, nutrition, and social environments.

What are the symptoms of attention deficit hyperactivity disorder (ADHD)?

The symptoms of ADHD depend on the type of ADHD a person has:

People with symptoms of attention problems may often:

• Miss details or make careless mistakes in schoolwork, at work, or in other activities
• Have trouble staying focused on play activities or work tasks
• Not seem to listen when spoken to directly
• Find it hard to follow instructions or finish tasks, or may start but get easily sidetracked
• Have trouble being organized, keeping belongings in order, and managing time
• Avoid doing tasks that require long periods of mental effort
• Lose important items, such as books, wallets, keys, eyeglasses, and cellphones
• Forget about doing daily activities

People with symptoms of hyperactivity-impulsivity may often:

• Fidget and squirm while seated
• Get up when staying seated is expected, such as at school or work
• Run around or climb when it's not appropriate (children) or feel restless (teens and adults)
• Have trouble doing quiet activities
• Be constantly moving or "on the go"
• Talk much more than is normal
• Blurt out answers before questions are completed
• Have trouble waiting for their turn
• Interrupt others for example during conversations or games

People with combined ADHD show a mix of inattention and hyperactivity-impulsivity symptoms

How is attention deficit hyperactivity disorder (ADHD) diagnosed?

There is no single test to diagnose ADHD. One step of the process for diagnosing ADHD involves having a physical exam, including vision tests, hearing tests (for children and adults), and other tests to rule out other problems with symptoms like ADHD. Other problems with similar symptoms include anxiety, depression, sleep problems, and certain types of learning disabilities.

The process also involves a thorough medical history and family history. And it usually includes using standardized ADHD symptom checklists, questionnaires, and/or interview questions. These tools have rating scales (scoring systems) that help the provider see if a person's symptoms and history fit a diagnosis of ADHD.

To make a diagnosis of ADHD, the provider needs to have found all of these things:

• Several symptoms of ADHD that began before age 12.
• Several symptoms of inattention and/or hyperactivity-impulsivity that have lasted for at least 6 months and cause serious problems:
• For children up to age 16, there must be at least 6 ongoing symptoms.
• For people 17 and older, there must be at least 5 ongoing symptoms.
• Symptoms that happen in 2 or more settings, for example, at home and at work or school.
• Symptoms that clearly get in the way of functioning well at school, work, and/or in social situations.
• Symptoms aren't caused by another mental health disorder.

What are the treatments for attention deficit hyperactivity disorder (ADHD)?

Although there is no cure for ADHD, treatments may help reduce symptoms and improve functioning. ADHD is commonly treated with:

• Medicines.
• Psychotherapy (talk therapy), including behavior therapy.
• Education or training for parents to give them the skills and strategies to help their child. This is especially important for younger children.
• A combination of these treatments.

Good treatment plans will include close monitoring, follow-ups, and making changes, if needed, along the way.

Having a healthy lifestyle, such as healthy eating and regular exercise, may also help manage symptoms.

For school-aged children, school support is important. This could include classroom-based behavioral interventions such as behavior management plans or teaching your child organizational and study skills. It may also include accommodations such as specific seating in the classroom, reduced classwork, or extended time on tests and exams.

NIH: National Institute of Mental Health