- Defining ADHD
- ADHD Types, Symptoms, and Effects
- Diagnosing ADHD
- ADHD Causes & Treatment
- ADHD-Related Conditions
- ADHD at Different Ages
- Gender & ADHD
- ADHD Links
- Your Child & ADHD: ADHD Self Assessment
What Is ADHD?
Attention-Deficit/Hyperactivity Disorder, (ADHD), is a neuro-biological disorder that affects a specific portion of the brain that regulates Executive Functioning, more commonly referred to as the “operating system” of the brain. It is characterized by inattention and/or hyperactivity and impulsivity and often results in problems with organization, attention and working memory. People with ADHD often have difficulties functioning in interpersonal, social, academic, and professional realms. Depending upon the severity of the symptoms, ADHD can provide significant impairments in school, at work, in relationships and all other aspects of life.
ADHD Onset and Prevalence
ADHD typically becomes apparent in children when they reach preschool or elementary school age. Such children have trouble controlling their behavior and/or paying attention. Centers for Disease Control estimates that nearly 1 in 10 children in the U.S. have ADHD. It is not uncommon for classrooms to have three students with ADHD. People with ADHD can benefit from treatment, particularly if they are diagnosed and given help early on.
ADHD is prevalent at all socioeconomic levels, in all ethnic groups, and at all IQ levels. It affects girls in the same proportion that it affects boys.
ADHD Types, Symptoms, and Effects
Three types of ADHD have been identified:
- Predominantly inattentive type (frequently referred to as ADD)
- Predominantly hyperactive-impulsive type
- Combined inattentive and hyperactive-impulsive type
People with ADHD may have some or all of the following symptoms:
- Inability to regulate attention
- Difficulty completing tasks
- Poor time management and perception
- Lack of organization
- Difficulty following conversations
- Hyperactive behavior, such as excessive talking and restlessness
- Impulsive behavior, such as blurting and interrupting
- Short-term memory loss
Interpersonal Problems. According to the American Academy of Pediatrics, young people with ADHD may experience greater than normal “difficulty in academic, social, and personal realms.” Such difficulties can continue into adulthood and affect relationships with peers and family members as well as performance in school or at work.
Low Self-Esteem. Interpersonal and academic difficulties can lead to lower self-esteem, anxiety, and depression among children and teenagers with ADHD. Poor self-esteem can further aggravate the social and academic functioning of young people with ADHD, leading to higher than average high school and college dropout rates, substance abuse, risk taking, anti-social and criminal behavior.
Increased Accident and Injury Risk. Children and teenagers with ADHD have been found to be more prone to accidents and injuries. The Centers for Disease Control and Prevention (CDC) reports that “children with ADHD are significantly more likely to be injured as pedestrians or while riding a bicycle, to receive head injuries, injure more than one part of the body, and be hospitalized for accidental poisoning.” The CDC estimates that medical costs for children with ADHD are more than twice what they are for other children.
Is It ADHD?
Attention-Deficit/Hyperactivity Disorder can be difficult to diagnose. Since most children exhibit behavior characteristic of ADHD at times and to varying degrees, diagnosis should be approached thoughtfully. Stressful situations in a child’s life, such as loss or strife at home, can also bring about behavior that resembles ADHD. A comprehensive assessment of a child’s circumstances as well as behavior should therefore be undertaken before a diagnosis is given.
Childhood itself is characterized by a process of maturation and socialization in which children learn to govern their own behavior, focus, remember, complete tasks, and so on. Children develop these abilities at different rates. But overall the developmental level of children with ADHD is below that of most children of the same age in terms of attentiveness and/or self-control.
Parents may suspect a problem with their toddler or preschooler, but it is often teachers who first point out signs of ADHD because they typically have the best sense of what is normal or average behavior in children and what is not. However, even teachers can overlook inattention problems because children with this form of ADHD tend to be quieter and more cooperative than children with hyperactive/impulsive behavior.
A specialist such as a social worker, psychiatrist, neurologist or psychologist can assess whether a child has ADHD by interviewing parents and teachers and evaluating the child. He or she must first rule out possible alternative causes of behavior that resembles ADHD, such as loss or change at home. In addition he or she needs to be aware that 70 percent of young people with ADHD have a co-occurring condition such as a learning disability, substance abuse, or a psychiatric disorder.
The specialist should talk with and observe the child in different contexts to create a balanced and detailed profile of the child before reaching a diagnosis. For further help assessing your child’s likelihood of having ADHD, use our ADHD Assessment Tool.
ADHD Causes & Treatment
What Causes ADHD?
ADHD is highly genetic. If your father or mother has ADHD, there is an 80 percent probability that you or one of your siblings might also have ADHD.
Support for people with ADHD can make a big difference. While there is no “cure” for the condition, there are interventions and treatments that can be quite effective in helping people with ADHD overcome their unique challenges and fulfill their potential interpersonally, academically, and professionally. At the Edge Foundation, we believe that coaching can provide an invaluable support system of understanding, structure, and confidence-building for young people with ADHD making the transition from high school to college. Whether as a supplement to medicine, exercise, and therapy or as a primary intervention, coaching can make a world of difference in the life of someone with ADHD.
ADHD is commonly accompanied by other disorders, which can exacerbate its symptoms. Seventy percent of those with ADHD have a co-occurring condition. The National Institute of Mental Health identifies the following disorders that can accompany ADHD:
Learning Disabilities Twenty to 30 percent of children with ADHD also have learning disabilities. In the preschool years, these children may have trouble understanding or expressing themselves in words. As they get older, they can have difficulty writing, reading, spelling, and doing arithmetic.
Oppositional Defiant Disorder Approximately 30 to 50 percent of children with ADHD, mostly boys, have oppositional defiant disorder. This is characterized by defiance, belligerence, outbursts, stubbornness, and a refusal to obey.
Conduct Disorder About 20 to 40 percent of ADHD children may develop conduct disorder as older children or teenagers. These young people lie, steal, fight, and commit crimes. They are also more likely to become substance abusers.
Tourette Syndrome Tourette Syndrome is an uncommon neurological disorder that typically occurs in people with ADHD. People with this syndrome have nervous tics such as blinking, twitching, grimacing, throat-clearing, sniffing, snorting, or barking out words.
Anxiety and Depression Anxiety and depression can accompany ADHD and can be exacerbated by the personal, social, academic, and/or professional problems of ADHD.
Bipolar Disorder It is not clear how many children with ADHD also have bipolar disorder, and it can be difficult to distinguish between the two conditions among children. Bipolar disorder in children is characterized by erratic moods and a combination of elation, irritability, and depression.
Substance Abuse People with ADHD are six times more likely than other people to have a substance abuse problem.
ADHD at Different Ages
ADHD in Early Childhood
Because most young children are at times restless, inattentive, and impulsive, reliable signs of ADHD don’t usually emerge until children are at least six years old. Children who have ADHD tend to daydream, listen and focus poorly, forget things, fidget and talk excessively, and blurt and interrupt, and they have trouble taking turns. They may have trouble getting along with their peers and following the rules of a classroom environment. Their difficulty with following directions and completing tasks, along with social trouble, can cause them to lose confidence and perform poorly in school.
ADHD in Adolescence
For teenagers with ADHD, the typical challenges of adolescence can be exacerbated. Problems of identity, increased independence, and social and academic pressure can be heightened by the symptoms of ADHD. Teens with ADHD are six times more likely to experiment with drugs and alcohol. And according to the National Institute of Mental Health, ADHD teens have nearly four times as many car accidents and three times as many speeding tickets as teen drivers without ADHD.
ADHD in College
When students begin college, they are suddenly without the structure of high school and the support system of home, and the demands for organized, self-directed study are greater than ever before. These conditions can be particularly challenging for those with ADHD, who have inordinate difficulty focusing, staying on task, organizing their time, and interacting with professors and peers. For these reasons, some students with ADHD may discover the condition in college for the first time. They may find that their old academic and social coping mechanisms are no longer adequate for the rigors of college. In short, they desperately need an intervention that provides the structure, support and accountability that this new environment lacks.
ADHD in Adulthood
The National Institute for Mental Health reports that many adults with the condition are unaware they have it. They do not understand why they are restless, easily distracted, and impulsive and have trouble with day-to-day tasks such as getting dressed in the morning and getting to work on time. Often adults will discover their own ADHD when their child is diagnosed with the condition, bringing on an emotional reexamination of their personal identity and past. Having a better understanding of the source of their difficulties can be a relief, even as the realization that their problem went untreated can be painful or angering.
Gender & ADHD
Under Diagnosis of ADHD in Girls
Until recently it was believed that ADHD was more prevalent in males than in females. Because most ADHD studies focused on boys, the symptoms of ADHD in girls traditionally went unrecognized. It is estimated that the disorder is diagnosed three to nine times more often in boys than in girls. Yet in adults the disorder occurs with the same frequency among men and women, suggesting that ADHD may be as common in girls as it are in boys.
Gender Differences in ADHD Childhood Symptoms
Recent studies of girls with ADHD suggest that the higher rate of ADHD diagnosis in boys may be largely because they tend to exhibit more noticeable symptoms such as disruptive or oppositional behavior. Current findings on ADHD in girls indicate that girls with the condition more typically suffer from inattention and distractibility rather than hyperactivity and aggression. For this reason, their symptoms are often overlooked, and they remain undiagnosed or misdiagnosed. Whereas boys with ADHD often blurt out, interrupt, and show disruptive or aggressive behavior, girls with ADHD are more likely to be forgetful, timid, distracted, easily defeated, anxious, and depressed.
Gender Trends in Adults with ADHD
Among adults diagnosed with ADHD, women tend to show more pronounced long-term psychological problems stemming from their condition, including depression and anxiety. This may be because they are typically diagnosed later in life than boys are and therefore miss opportunities for early intervention. Recent studies indicate that girls with ADHD suffer more than boys from long-term effects of poor self-esteem. Such girls are at greater than normal risk for problems such as unwanted pregnancies, substance use disorder, divorce, financial trouble, eating disorders, incomplete education, and underemployment.
Need for Further Research
Researchers agree that further studies are needed to understand ADHD gender differences both in rate of incidence and in symptoms. What seems to be clear, however, is that gender differences exist, and ADHD appears to occur more often in girls than previously thought.
- Children and Adults with Attention Deficit Hyperactivity Disorder (CHADD)
- National Resource Center on ADHD
The Association on Higher Education and Disability (AHEAD)
- National Center for Girls and Women with ADHD
Answers to Your Questions About ADHD
- Attention Deficit Disorder Association (ADDA)
- ADD Resources
HEATH Resource Center (clearinghouse on postsecondary education for individuals with disabilities)
- Social Worker Help Starts Here
The National Association of Special Education Teachers (NASET)
ADHD Self Assessment Test
This ADHD Self Assessment Test is a guideline to help you assess whether you should pursue further evaluation and intervention for your child. Only a professionally trained ADHD specialist can accurately evaluate your child and diagnose ADHD. Please read Diagnosing ADHD before completing this assessment.
This assessment tool is based on the criteria for diagnosing ADHD provided in The Diagnostic & Statistical Manual for Mental Disorders, as summarized by the Centers for Disease Control and Prevention (CDC).
A. Check any of the following behaviors that you think apply to your child.
- Often does not pay close attention to details or makes careless mistakes in schoolwork, work, or other activities.
- Often has trouble keeping attention on tasks or play activities.
- Often does not seem to listen when spoken to directly.
- Often does not follow instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions).
- Often has trouble organizing activities.
- Often avoids, dislikes, or doesn’t want to do things that take a lot of mental effort for a long period of time (such as schoolwork or homework).
- Often loses things needed for tasks and activities (e.g., toys, school assignments, pencils, books, or tools).
- Often is easily distracted.
- Often is forgetful in daily activities.
B. Check any of the following behaviors that you think apply to your child.
- Often fidgets with hands or feet or squirms in seat.
- Often gets up from seat when remaining in seat is expected.
- Often runs about or climbs when and where it is not appropriate (adolescents or adults may feel very restless).
- Often has trouble playing or enjoying leisure activities quietly.
- Often is “on the go” or often acts as if “driven by a motor.”
- Often talks excessively.
- Often blurts out answers before questions have been finished.
- Often has trouble waiting his or her turn.
- Often interrupts or intrudes on others (e.g., butts into conversations or games).
If you checked six or more behaviors in category A and/or six or more behaviors in category B, continue with this assessment. If you did not, your child is not likely to be at high risk for ADHD.
If you did not check six or more behaviors in category A and/or six or more behaviors in category B, your child is not likely to be at high risk for ADHD.
After checking six or more behaviors in either category A or category B, you should pursue further evaluation for your child. Your pediatrician or family physician may be able to help your child by referring you to an ADHD specialist (usually a psychiatrist, psychologist, or social worker with experience in ADHD) who can diagnose. If you are unsure what applies to your child in this assessment, you may also want to seek a professional opinion.