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Attention Deficit Hyperactivity Disorder, or ADHD. ADHD is defined by a persistent pattern of inattention, disorganization, and/or hyperactivity or impulsiveness, which negatively affects a child’s ability to function in multiple settings, such as school and home. Symptoms typically appear before age 12 and must be present for at least six months for a diagnosis.

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Children frequently make careless mistakes, have difficulty paying attention, seem not to listen to others, and fail to follow through on instructions. They struggle with organization, often avoid tasks requiring sustained effort, frequently lose or forget items, and are easily distracted.

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These children have great difficulty sitting still, often squirm or fidget, leave their seats inappropriately, and tend to engage in loud play activities. They may seem as if they are on a “constant motor,” talk excessively, blurt out answers, have trouble waiting their turn, and frequently interrupt others.

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ADHD can present in combined, predominantly inattentive, or predominantly hyperactive-impulsive forms.

Partial remission indicates that while full criteria were previously met, fewer symptoms are present but still cause impairment.

ADHD can be categorized as mild, moderate, or severe, based on the level of functional impairment.

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Temperament: Children who tend to be inhibited in their behavior, who must make a lot of effort to maintain control, who are more likely to experience negative emotions, or who seek new situations or sensations are often most likely to be diagnosed with ADHD.

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Environmental factors such as low birth weight and smoking during pregnancy are also associated with ADHD. ADHD is often hereditary, with research identifying specific genes that frequently work together in the development of ADHD.

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ADHD affects approximately 11% of children in the U.S., although prevalence rates vary widely. Generally speaking, boys are more likely to be diagnosed than girls, by a ratio of 3:1. On average, children tend to be diagnosed around 7 years old.

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During toddlerhood and preschool years, hyperactivity may be noticed, although it doesn’t become clearly unusual until after 4 years old.

By the time children enter elementary school, inattention symptoms become more apparent. Hyperactivity diminishes somewhat during adolescence, although many youths continue to feel agitated. Symptoms can continue into adulthood.

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Stimulant medications are commonly used to treat ADHD, including amphetamines (such as Adderall) or methylphenidate (such as Ritalin or Concerta). These medications tend to have a calming and focusing effect on individuals with ADHD and are usually taken daily.

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Providing structure at home is often recommended to address inattentive or hyperactive behavior. This includes ensuring that consistent, organized, and reliable routines are established throughout the day, with youth alerted when changes are about to happen. When youth need to focus, it is helpful to remove distractions. Limiting choices may also be useful for avoiding power struggles, and children with ADHD often require brief reminders of their responsibilities.

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Behavioral parent training (parent management training) is an effective psychosocial treatment for children with ADHD. This training involves active involvement from parents to implement a system of rewards and consequences to shape behavior. Parents are also instructed to monitor their child’s actions, manage behavioral outbursts, and work to prevent such outbursts from occurring.

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Behavioral classroom management involves interventions in which teachers provide rewards and consequences, using point systems or timeouts based on children’s behavior.

Behavioral peer interventions may help address some of the functional deficits among children with ADHD. These can involve social skills groups or peer-mediated interventions where teachers train other children in the classroom on how to respond in various situations involving the target child.