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ADHD in Children and Teenagers

15 July 2015

Attention deficit hyperactivity disorder (ADHD) is a group of behavioural symptoms that include inattentiveness, hyperactivity and impulsiveness.

small boy in school

ADHD can occur in people of any intellectual ability, although it is more common in people with learning difficulties. People with ADHD may also have additional problems, such as sleep and anxiety disorders. Symptoms of ADHD tend to be first 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 in children between the ages of 6 and 12.

The symptoms of ADHD usually improve with age, but many adults who are diagnosed with the condition at a young age will continue to experience problems.

Symptoms in Children and Teenagers

The symptoms of ADHD in children and teenagers are well defined, and they are 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 each behavioural problem are detailed below:

Inattentiveness

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 at 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.

Related Conditions in Children and Teenagers

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,
  • depression,
  • sleep problems – finding it difficult to get to sleep at night, and having irregular sleeping patterns,
  • autistic spectrum disorder (ASD) – 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 called tics,
  • learning difficulties – such as dyslexia.

Diagnosing ADHD

If you are worried about your child, it may help to speak to their teachers before seeing your GP, to find out if they have any concerns about your child’s behaviour. Your GP can’t formally diagnose ADHD, but they can discuss your concerns with you and refer you for a specialist assessment, if necessary.

When you see your 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 is a family history of ADHD,
  • about any other problems or symptoms of different health conditions you or your child may have.

Next Steps

If your 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 parent training or education programme to teach you ways of helping your child (see ‘treating ADHD’ on the NHS Choices website for more information).

If your child’s behaviour doesn’t improve, and both you and your GP thinks it is seriously affecting their day-to-day life, your GP should refer you and your child to a specialist for a formal assessment (see below).

Diagnosing ADHD in children depends on a set of strict criteria. To be diagnosed with ADHD, your child must have six or more symptoms of inattentiveness, or six or more symptoms of hyperactivity and impulsiveness.

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 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.