Attention Deficit Hyperactivity Disorder and Attention Deficit Disorder
(ADHD and ADD; Hyperkinetic Syndrome; Hyperkinetic Impulse Disorder)
Attention deficit hyperactivity disorder (ADHD) is a change in the brain that can affect how you behave. It can make it hard to be still or pay attention. It can also make it hard to control some behavior. There are 3 types of ADHD:
- Inattentive (classic "ADD")
- Combined inattentive and hyperactive—the most common type
The exact cause of ADHD is not known. Changes may happen as the brain develops. Genes or events in the world around you may both play a role.
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Things that increase the risk of ADHD include:
ADHD is often first noticed when you are a child. Some with mild symptoms may not be aware they have ADHD until they are older. Symptoms are always present. They occur in home, school and work. Symptoms that are only present in 1 area may not be ADHD.
Symptoms based on type of ADHD are:
Inattentive (classic "ADD")
- Easily distracted by sights and sounds
- Little or no attention to detail
- Does not seem to listen when spoken to
- Careless mistakes are common
- Problems with follow-through on instructions or tasks
- Does not like activity that needs longer periods of mental effort
- Loses or forgets things needed for tasks
- Forgetful in day-to-day activities
- Restless, tends to fidget and squirm
- Not able to stay seated, prefers to run and climb
- Blurts out answers before hearing the entire question
- Hard time playing quietly
- Talks more than needed
- Interrupts others
- Has difficulty waiting in line or waiting for a turn
- Combined ADHD—mix of the symptoms above.
All children have some of these problems at some point. Children with ADHD have more severe symptoms. They will also occur more often.
In adults, these symptoms can cause problems with relationships and work. They can make it difficult to do a job well or keep a job.
Other health or behaviors that are more common in those with ADHD include:
- Conduct disorder —hard time following social rules
- Oppositional defiant disorder —negative, angry, and defiant behaviors
- Learning and language disorders
- Physical conditions such as sleep apnea
- Trouble sleeping
- Substance abuse —common in those that have untreated ADHD
- Cigarette use
There is no standard test for ADHD. A trained health professional will make a diagnosis. They will observe you or your child and talk to family, caregivers, and teachers.
A doctor will also rule out any other health issues that may be causing problems.
ADHD is a lifelong condition. The effects of ADHD can be managed with treatment. The goal of treatment is to improve ability to grow or succeed, and have healthy relationships. Doctors should work together with parents, school staff, and other health professionals. Together, they can set realistic goals and keep an eye on the child's response. Proper treatment can prevent problems later in life.
Children who do not sleep enough may suffer from worse behavioral problems. A key part of treatment is to ensure that children with ADHD get plenty of sleep.
Medicine may be used alone or with therapy in people over 6 years of age. It can help to control behavior and increase focus.
Stimulants are the most common type of medicine used to treat ADHD. They increase activity in parts of the brain that seem to be less active in those with ADHD. There are different types of medicine. The medical team will work with patients to find what works best. They will also work to balance the benefits and risks of each medicine.
Other medicine choices are:
- Selective norepinephrine reuptake inhibitors—to improve attention and decrease impulsiveness and hyperactivity
- Antidepressants—to manage depression symptoms
- Antipsychotics—to treat aggressive behavior
- Certain blood pressure lowering medication—to treat impulsivity
Therapy may be all that is needed for younger children. Therapy can also help children who take medicine do better.
Therapy will help by teaching new social and problem solving skills. Parents and teachers will also be shown ways to help their children adapt. This may include changes in the classroom, as well as changes to how they parent. For example, an air cushion on a child's seat at school allows the child to move their body without distracting other students. Moving their body may help them increase their attention span.
ADHD coaching can also be helpful for older children and adults. Coaches work with people to help them organize and be more successful.
There are no current guidelines to prevent ADHD because the cause is unclear.
Attention Deficit Disorder Association
Children and Adults with Attention-Deficit/Hyperactivity Disorder
About Kids Health—The Hospital for Sick Children
Canadian Psychiatric Association
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Last reviewed January 2021 by EBSCO Medical Review Board Adrian Preda, MD Last Updated: 01/05/2021