Attention deficit hyperactivity disorder
(ADHD and ADD; Hyperkinetic Syndrome; Hyperkinetic Impulse Disorder)
Attention deficit hyperactivity disorder (ADHD) is a disorder that affects behavior. It can cause hyperactive and impulsive behavior, and/or make it difficult to pay attention. These behavioral problems continue over a long period of time. ADHD affects children, adolescents, and adults.
There are three types of ADHD:
- Inattentive (classic "ADD")
- Combined—the most common type
A chemical imbalance in the brain may be responsible for ADHD.
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The cause of ADHD is unknown. It most likely is caused by a chemical imbalance in the brain. There also appears to be a genetic factor since ADHD can run in families.
This condition is more common in first-born males.
Factors that increase your chance of developing ADHD include:
- Premature birth
- Having a parent or sibling (especially an identical twin) with ADHD
- Having a mother who smoked cigarettes and/or drank alcohol, had a urinary tract infection, or had preterm labor during pregnancy
- Having a parent with certain conditions such as alcoholism and conversion disorder
- Other possible risk factors include:
All children display some of the symptoms of ADHD. Children with ADHD have symptoms that are more severe and consistent. They often have difficulty in school and with their family and peers.
ADHD can last into adulthood. It can cause problems with relationships, job performance, and job retention. Symptoms can vary according to the type of ADHD:
Inattentive (classic "ADD")
- Easily distracted by sights and sounds
- Doesn't pay attention to detail
- Doesn't seem to listen when spoken to
- Makes careless mistakes
- Doesn't follow through on instructions or tasks
- Avoids or dislikes activities that require longer periods of mental effort
- Loses or forgets items necessary for tasks
- Is forgetful in day-to-day activities
- Is restless, fidgets, and squirms
- Runs and climbs; not able to stay seated
- Blurts out answers before hearing the entire question
- Has difficulty playing quietly
- Talks excessively
- Interrupts others
- Has difficulty waiting in line or waiting for a turn
- Combined ADHD—Combination of the symptoms above.
People with ADHD may also have:
There is no standard test to diagnose ADHD. It is done by a trained mental health professional. The diagnosis will also be based on feedback from family and teachers.
During diagnosis, the following information may be gathered from parents, caregivers, teachers, or other school professionals:
- Assessment of symptoms of ADHD in different settings—home and school
- Age at which symptoms started
- How much the behavior affects the child's ability to function
The goal is to improve the child's ability to function. Doctors should work together with parents and school staff. Together, they can set realistic goals and evaluate the child's response.
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.
Medications can help control behavior and increase attention span. Stimulants are the most common choice for ADHD. They increase activity in parts of the brain that appear to be less active in children with ADHD.
Talk to your doctor if you have any questions about ADHD medications. There are possible risks with these medications, including heart problems and psychiatric problems.
Other medications include:
- Selective norepinephrine reuptake inhibitors—to promote attention and decrease impulsiveness and hyperactivity
- Antipsychotics—to treat aggressive behavior
- Alpha-agonist hypotensive agents—to treat impulsivity
Children who take medication and go to therapy do better than those who just use medication. Therapy sessions focus on practicing social and problem-solving skills. Counselors will also teach parents and teachers to help the child through positive reinforcement. This could involve changes in the classroom, as well as in parenting style. Often, daily report cards are exchanged between parents and teachers.
Other tools, like the Disc'O'Sit cushion, may be helpful in improving children's attention in class. The Disc'O'Sit is a dome-shaped cushion filled with air that the child balances on.
ADHD coaching can also be helpful. These coaches work with individuals to help them organize and create strategies so that they can be more efficient and successful.
There are no guidelines for preventing ADHD because the cause is unknown. Proper treatment can prevent problems later in life.
Last reviewed August 2014 by Kari Kassir, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.