Many children go through phases where they’re restless or inattentive. This is often completely normal and does not necessarily mean they have ADHD.
What causes attention deficit hyperactivity disorder (ADHD)?
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.
Symptoms of attention deficit hyperactivity disorder (ADHD)
The symptoms of attention deficit hyperactivity disorder (ADHD) can be categorised into 2 types of behavioural problems:
- inattentiveness (difficulty concentrating and focusing)
- hyperactivity and impulsiveness
Many people with ADHD have problems that fall into both these categories, but this is not always the case.
For example, around 2 to 3 in 10 people with the condition have problems with concentrating and focusing, 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.
ADHD is more often diagnosed in boys than girls. Girls are more likely to have symptoms of inattentiveness only, and are less likely to show disruptive behaviour that makes ADHD symptoms more obvious. This means girls who have ADHD may not always be diagnosed.
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 6. They occur in more than one situation, such as at home and at school.
Children may have symptoms of both inattentiveness and hyperactivity and impulsiveness, or they may have symptoms of just 1 of these types of behaviour.
Inattentiveness (difficulty concentrating and focusing)
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.
Talking to school
You can also discuss your concerns with your child’s teacher, their school’s special educational needs co-ordinator (SENCO) if you think their behaviour may be different from most children their age.
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 under 12 years old, but sometimes it’s diagnosed later in childhood.
Sometimes ADHD was not recognised when someone was a child, and they are diagnosed later as an adult.
The symptoms of ADHD may improve with age, but many adults who were diagnosed with the condition at a young age continue to experience problems.
Parents of children with ADHD
Looking after a child with ADHD can be challenging, but it’s important to remember that they cannot help their behaviour.
Some day-to-day activities might be more difficult for you and your child, including:
- getting your child to sleep at night
- getting ready for school on time
- listening to and carrying out instructions
- being organised
- social occasions
Ways to cope for parents of children with ADHD
Caring for a child with attention deficit hyperactivity disorder (ADHD) can be challenging. The impulsive, fearless and chaotic behaviours typical of ADHD can make everyday activities exhausting and stressful.
Although it can be difficult at times, it’s important to remember that a child with ADHD cannot help their behaviour. People with ADHD can find it difficult to suppress impulses, which means they may not stop to consider a situation, or the consequences, before they act.
If you’re looking after a child with ADHD, you may find this advice helpful.
Plan the day
Plan the day so your child knows what to expect. Set routines can make a difference to how a child with ADHD copes with everyday life.
For example, if your child has to get ready for school, break it down into structured steps, so they know exactly what they need to do.
Set clear boundaries
Make sure everyone knows what behaviour is expected, and reinforce positive behaviour with immediate praise or rewards. Be clear, using enforceable consequences, such as taking away a privilege, if boundaries are overstepped and follow these through consistently.
Give specific praise. Instead of saying a general: “Thanks for doing that,” you could say: “You washed the dishes really well. Thank you.”
This will make it clear to your child that you’re pleased and why.
If you’re asking your child to do something, give brief instructions and be specific. Instead of asking: “Can you tidy your bedroom?” say: “Please put your toys into the box and put the books back onto the shelf.”
This makes it clearer what your child needs to do and creates opportunities for praise when they get it right.
Set up your own incentive scheme using a points or star chart, so good behaviour can earn a privilege. For example, behaving well on a shopping trip will earn your child time on the computer or some sort of game.
Involve your child in it and allow them to help decide what the privileges will be.
These charts need regular changes or they become boring. Targets should be:
- immediate – for example, daily
- intermediate – for example, weekly
- long-term – for example, 3-monthly
Try to focus on just 1 or 2 behaviours at a time.
Watch for warning signs. If your child looks like they’re becoming frustrated, overstimulated and about to lose self-control, intervene.
Distract your child, if possible, by taking them away from the situation. This may calm them down.
Keep social situations short and sweet. Invite friends to play, but keep playtimes short so your child does not lose self-control. Do not aim to do this when your child is feeling tired or hungry, such as after a day at school.
Make sure your child gets lots of physical activity during the day. Walking, skipping and playing sport can help your child wear themselves out and improve their quality of sleep.
Make sure they’re not doing anything too strenuous or exciting near to bedtime.
Read our physical activity guidelines for children and young people, which includes information on getting active, and how much activity you and your child should be doing.
Keep an eye on what your child eats. If your child is hyperactive after eating certain foods, which may contain additives or caffeine, keep a diary of these and discuss them with a GP.
Stick to a routine. Make sure your child goes to bed at the same time each night and gets up at the same time in the morning.
Avoid overstimulating activities in the hours before bedtime, such as computer games or watching TV.
Sleep problems and ADHD can be a vicious circle. ADHD can lead to sleep problems, which in turn can make symptoms worse.
Many children with ADHD will repeatedly get up after being put to bed and have interrupted sleep patterns. Trying a sleep-friendly routine can help your child and make bedtime less of a battleground.
Help at school
Children with ADHD often have problems with their behaviour at school, and the condition can negatively affect a child’s academic progress.
Speak to your child’s teachers or their school’s special educational needs co-ordinator (SENCO) about any extra support your child may need.
Treatment of ADHD
Treatment for attention deficit hyperactivity disorder (ADHD) can help relieve the symptoms and make the condition much less of a problem in day-to-day life.
ADHD can be treated using medicine or therapy, but a combination of both is often best.
Treatment is usually arranged by a specialist, such as a paediatrician or psychiatrist, although the condition may be monitored by a GP.
There are 5 types of medicine licensed for the treatment of ADHD:
These medicines are not a permanent cure for ADHD but may help someone with the condition concentrate better, be less impulsive, feel calmer, and learn and practise new skills.
Some medicines need to be taken every day, but some can be taken just on school days. Treatment breaks are occasionally recommended to assess whether the medicine is still needed.
If you or your child is prescribed one of these medicines, you’ll probably be given small doses at first, which may then be gradually increased. You or your child will need to see a GP for regular check-ups to ensure the treatment is working effectively and check for signs of any side effects or problems. It’s important to let the GP know about any side effects and talk to them if you feel you need to stop or change treatment.
Your specialist will discuss how long you should take your treatment but, in many cases, treatment is continued for as long as it is helping.
Here are some of the therapies that may be used.
Psychoeducation means you or your child will be encouraged to discuss ADHD and its effects. It can help children, teenagers and adults make sense of being diagnosed with ADHD and can help you to cope and live with the condition.
Behaviour therapy provides support for carers of children with ADHD and may involve teachers as well as parents. Behaviour therapy usually involves behaviour management, which uses a system of rewards to encourage your child to try to control their ADHD.
If your child has ADHD, you can identify types of behaviour you want to encourage, such as sitting at the table to eat. Your child is then given some sort of small reward for good behaviour.
For teachers, behaviour management involves learning how to plan and structure activities, and to praise and encourage children for even very small amounts of progress.
Cognitive behavioural therapy (CBT)
CBT is a talking therapy that can help you manage your problems by changing the way you think and behave. A therapist would try to change how you or your child feels about a situation, which would in turn potentially change their behaviour.
CBT can be carried out with a therapist individually or in a group.
Tips for parents
If you’re the parent of a child with ADHD:
- be sure your GP or specialist helps you understand the difference between ADHD and any other problems your child may have
- think about who else needs to know about your child’s ADHD, such as their school or nursery
- find out the side effects of any medicine your child takes and what you need to look out for
- getting to know people at local support groups can stop you feeling isolated and help you to cope
- The charity AADD-UK has a list of support groups across the UK, including groups for adults, parents and carers.
The impact of ADHD on your child’s mental health
Any child or young person can struggle with their mental health and wellbeing, whether or not they have ADHD. This might be caused by things like family change, bullying, exam stress or a traumatic event.
But having ADHD may also mean your child has extra challenges – such as social difficulties, struggling to manage their emotions or getting into trouble at school – that leave them more vulnerable to low self-esteem, anxiety or depression.
Children and young people with ADHD frequently have other developmental or mental health conditions and it is important to ensure they have the appropriate support for these.
As a parent there is a lot you can do to support your child with their wellbeing and mental health:
encourage your child to talk about how they are feeling with you. Our starting a conversation guide has ideas for keeping communication open
if you feel your child may have a mental health problem or another condition alongside ADHD, discuss your concerns with their GP or ADHD specialist.