Ahmed Raza

Reviewed by Dr. Jessica DPN, RN, CEN, Dr. Jessica DPN, RN, CEN is a registered nurse and educator with 20 years of experience in critical care emergency nursing, specializing in patient care, education, and evidence-based practice. She holds multiple certifications and serves as a Patient Safety Coordinator.

Attention Deficit Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental condition often diagnosed in children. However, it is important to recognize that ADHD can persist into adulthood. Individuals with ADHD experience differences in brain development that impact their self-control, attention, and focus. This condition can influence various aspects of life, including home, school, work, and social relationships.¹

ADHD is more commonly diagnosed in males than females. Females with ADHD are more likely to initially exhibit signs and symptoms of inattention rather than hyperactivity or impulsivity. Many individuals with ADHD also experience comorbid conditions such as anxiety disorders, learning disabilities, depression, conduct disorders, and substance use disorders. It is estimated that ADHD affects approximately 2.5% of adults and 8.4% of children. Typically, it is first identified in school-aged children when they disrupt the classroom environment or struggle academically. ²

Causes of ADHD

Scientists are actively researching the risk factors for ADHD to find better ways to improve the health of individuals with ADHD and reduce the likelihood of developing the condition. While the exact causes and risk factors for ADHD remain unknown, current studies suggest that the condition is largely hereditary.

Recent research indicates a strong genetic component to ADHD, though specific causes have not yet been pinpointed. Studies reveal that about 75% of children with ADHD have a relative who also has the condition.

In addition to genetics, scientists are studying more possible causes and risk factors for ADHD, such as:

• Low birth weight
• Premature delivery
• Brain injury
• Alcohol and tobacco use during pregnancy
• Exposure to environmental risks at a young age or during pregnancy

Research and studies do not support the commonly held beliefs that ADHD is caused by too much screen time, excessive sugar consumption, poor parenting, or social and environmental factors such as family chaos or poverty. However, addressing some of these factors may help manage certain symptoms of ADHD. Nonetheless, the evidence does not strongly support these as primary causes of ADHD.

Diagnosis

Diagnosing ADHD involves multiple steps and is more complex than diagnosing many other conditions. A single test is not sufficient to diagnose ADHD because its symptoms can resemble those of other issues, such as depression, anxiety, sleep problems, and certain learning disabilities.

To diagnose ADHD, doctors gather information about a child’s behavior, health, and activities from parents and teachers. The diagnostic process also includes a medical examination, such as vision and hearing tests, to rule out other conditions with similar symptoms. Typically, the process involves using standardized checklists to rate ADHD symptoms and collecting a comprehensive history from parents, teachers, and the child.

After gathering all the necessary information, doctors diagnose ADHD if:

• A health check rules out other health or learning issues that could be causing the symptoms.
• The behaviors affect the individual in multiple settings, such as at home and school.
• The individual exhibits difficulties with hyperactivity, attention, or impulsivity that are beyond what is typical for their age.

Many children with ADHD also have learning difficulties, oppositional or defiant behaviors, or mood and anxiety issues. These can be treated alongside ADHD if identified.

For older individuals, it is necessary to confirm that the symptoms were present and noticeable when the person was a child.

Signs and Symptoms

Children with ADHD often struggle with focus and behavior, and these challenges do not typically diminish as they grow older. The symptoms can be severe, leading to difficulties at home, at school, and with friends.

A child with ADHD may:

• Forget to complete tasks or frequently lose things
• Daydream often
• Squirm, fidget, or be excessively talkative
• Have difficulty resisting temptations
• Make careless mistakes or take unnecessary risks
• Struggle to get along with others
• Get easily distracted by minor occurrences
• Have trouble taking turns or sitting still
• Find it hard to focus or concentrate on tasks
• Have difficulty waiting their turn
• Interrupt others during play, conversations, or tasks

Types

ADHD has three different types, depending on which types of symptoms are observed in a child:

• Predominantly Inattentive Presentation: Individuals find it challenging to complete tasks or maintain adequate attention to details, instructions, or conversations. They are easily distracted and often forget minor details of their daily routines. Children with the inattentive type of ADHD may not disrupt the classroom, making it less likely for them to receive an early diagnosis.

• Predominantly Hyperactive-Impulsive Presentation: In this type of ADHD, individuals often exhibit fidgeting and excessive talking. They struggle to remain seated for extended periods, such as during meals or while doing homework. Younger children with ADHD may engage in constant running, jumping, or climbing. Restlessness and impulsivity are common symptoms, with individuals frequently interrupting others, grabbing objects, or speaking at inappropriate times. They may find it challenging to wait their turn or follow directions, leading to a higher risk of accidents and injuries. People with predominantly hyperactive-impulsive ADHD may also experience difficulty focusing on tasks.

• Combined Presentation: The combined type of ADHD is the most common. Individuals with this type exhibit both hyperactive and inattentive symptoms. These symptoms include impulsiveness, difficulty focusing attention, and elevated levels of activity and energy.

Treatment

A combination of medication and behavior therapy is often considered the most effective treatment for ADHD. For children aged four to five years, behavior therapy, particularly parental training, is recommended as the initial approach before considering medication. This is crucial for both the child and their parents. Effective treatment plans should involve close monitoring, regular follow-ups, and adjustments as necessary throughout the course of treatment.

Maintaining overall health is essential for all children, especially those with ADHD. Alongside behavioral therapy and medication, adopting a healthy lifestyle can help both the child and the family better manage ADHD symptoms. Some healthy habits to consider include:

• Ensuring the child gets the recommended amount of sleep each night based on their age
• Encouraging daily physical activity appropriate for their age
• Promoting healthy eating habits, such as consuming plenty of vegetables, fruits, and whole grains while moderating protein intake
• Limiting daily screen time from television, computers, phones, and other electronic devices

Works Cited

• Centers for Disease Control and Prevention. What is ADHD? 2021.
• American Psychiatric Association. What is ADHD? 2017.
• Hasan, S. ADHD. 2020.

References

• Centers for Disease Control and Prevention. (2020). Attention-Deficit / Hyperactivity Disorder (ADHD): Diagnosis. CDC
• National Institute of Mental Health. (2021). Attention-Deficit/Hyperactivity Disorder. NIMH
• Mayo Clinic. (2021). ADHD diagnosis. Mayo Clinic