Attention Deficit Hyperactivity Disorder (ADHD) is a condition that affects people's behaviour. People with ADHD can seem restless, may have trouble concentrating and may act on impulse .
Symptoms of ADHD tend to be noticed at an early age and may become more noticeable when a child's circumstances change, such as when they start school. Most cases are diagnosed when children are 6 to 12 years old.
The symptoms of ADHD usually improve with age, but many adults who were diagnosed with the condition at a young age continue to experience problems.
People with ADHD may also have additional problems, such as sleep and anxiety disorders.
Many children go through phases where they're restless or inattentive. This is often completely normal and does not necessarily mean they have ADHD. But you should consider raising your concerns with your child's teacher, their school's special educational needs co-ordinator (SENCo) or a GP if you think their behaviour may be different from most children their age.
The GP cannot formally diagnose ADHD, but they can discuss your concerns with you and refer you for a specialist assessment, if necessary.
When you see a GP, they may ask you:
- about your symptoms or those of your child
- when these symptoms started
- where the symptoms occur – for example, at home or in school
- whether the symptoms affect your or your child's day-to-day life – for example, if they make socialising difficult
- if there have been any recent significant events in your or your child's life, such as a death or divorce in the family
- if there's a family history of ADHD
- about any other problems or symptoms of different health conditions you or your child may have
If the GP thinks your child may have ADHD, they may first suggest a period of "watchful waiting" – lasting around 10 weeks – to see if your child's symptoms improve, stay the same or get worse.
They may also suggest starting a group-based, ADHD-focused parent training or education programme. Being offered a parent training and education programme does not mean you have been a bad parent – it aims to teach you ways of helping yourself and your child.
If your child's behaviour does not improve, and both you and the GP believe it's affecting their day-to-day life, the GP should refer you and your child to a specialist for a formal assessment.
There are a number of different specialists you or your child may be referred to for a formal assessment, including:
- a child or adult psychiatrist
- a paediatrician – a specialist in children's health
- a learning disability specialist, social worker or occupational therapist with expertise in ADHD
Who you're referred to depends on your age and what's available in your local area.
There's no simple test to determine whether you or your child has ADHD, but your specialist can make an accurate diagnosis after a detailed assessment. The assessment may include:
- a physical examination, which can help rule out other possible causes for the symptoms
- a series of interviews with you or your child
- interviews or reports from other significant people, such as partners, parents and teachers
The criteria for making a diagnosis of ADHD in children, teenagers and adults are outlined below.
Diagnosis in children and teenagers
Diagnosing ADHD in children depends on a set of strict criteria. To be diagnosed with ADHD, your child must have 6 or more symptoms of inattentiveness, or 6 or more symptoms of hyperactivity and impulsiveness.
Read more about the symptoms of ADHD.
To be diagnosed with ADHD, your child must also have:
- been displaying symptoms continuously for at least six months
- started to show symptoms before the age of 12
- been showing symptoms in at least two different settings – for example, at home and at school, to rule out the possibility that the behaviour is just a reaction to certain teachers or to parental control
- symptoms that make their lives considerably more difficult on a social, academic or occupational level
- symptoms that are not just part of a developmental disorder or difficult phase, and are not better accounted for by another condition
The exact cause of ADHD is unknown, but the condition has been shown to run in families. Research has also identified a number of possible differences in the brains of people with ADHD when compared with those without the condition.
Other factors suggested as potentially having a role in ADHD include:
- being born prematurely (before the 37th week of pregnancy)
- having a low birthweight
- smoking or alcohol or drug abuse during pregnancy
ADHD can occur in people of any intellectual ability, although it's more common in people with learning difficulties.
The symptoms of Attention Deficit Hyperactivity Disorder (ADHD) can be categorised into two types of behavioural problems: inattentiveness, and hyperactivity and impulsiveness.
Most people with ADHD have problems that fall into both these categories, but this is not always the case.
For example, some people with the condition may have problems with inattentiveness, but not with hyperactivity or impulsiveness.
This form of ADHD is also known as Attention Deficit Disorder (ADD). ADD can sometimes go unnoticed because the symptoms may be less obvious.
Symptoms in children and teenagers
The symptoms of ADHD in children and teenagers are well defined, and they're usually noticeable before the age of six. They occur in more than one situation, such as at home and at school.
The main signs of inattentiveness are:
- having a short attention span and being easily distracted
- making careless mistakes – for example, in schoolwork
- appearing forgetful or losing things
- being unable to stick to tasks that are tedious or time-consuming
- appearing to be unable to listen to or carry out instructions
- constantly changing activity or task
- having difficulty organising tasks
Hyperactivity and impulsiveness
The main signs of hyperactivity and impulsiveness are:
- being unable to sit still, especially in calm or quiet surroundings
- constantly fidgeting
- being unable to concentrate on tasks
- excessive physical movement
- excessive talking
- being unable to wait their turn
- acting without thinking
- interrupting conversations
- little or no sense of danger
These symptoms can cause significant problems in a child's life, such as underachievement at school, poor social interaction with other children and adults, and problems with discipline.
Although not always the case, some children may also have signs of other problems or conditions alongside ADHD, such as:
- anxiety disorder – which causes your child to worry and be nervous much of the time; it may also cause physical symptoms, such as a rapid heartbeat, sweating and dizziness
- Oppositional Defiant Disorder (ODD) – this is defined by negative and disruptive behaviour, particularly towards authority figures, such as parents and teachers
- conduct disorder – this often involves a tendency towards highly antisocial behaviour, such as stealing, fighting, vandalism and harming people or animals
- sleep problems – finding it difficult to get to sleep at night, and having irregular sleeping patterns
- autistic spectrum condition (ASC) – this affects social interaction, communication, interests and behaviour
- epilepsy – a condition that affects the brain and causes repeated fits or seizures
- Tourette's syndrome – a condition of the nervous system, characterised by a combination of involuntary noises and movements (tics)
- learning difficulties – such as dyslexia
Although there's no cure for ADHD, it can be managed with appropriate educational support, advice and support for parents and affected children, alongside medicine, if necessary.
Medicine is often the first treatment offered to adults with ADHD, although psychological therapies such as cognitive behavioural therapy (CBT) may also help.
Looking after a child with ADHD can be challenging, but it's important to remember that they cannot help their behaviour.
Some issues that may arise in day-to-day life include:
- getting your child to sleep at night
- getting ready for school on time
- listening to and carrying out instructions
- being organised
- social occasions