Understanding ADHD

ADHD is one of the most common conditions in childhood. It impacts how kids function in school and in everyday life. Suspecting or hearing that your child has ADHD (also known as ADD) can raise many questions, even basic questions like “what is ADHD?” You may wonder about symptoms and how to help your child.

Understanding the challenges of ADHD allows you to find the best help possible for your child. This overview can answer many of your questions about ADHD, no matter where you are on your journey. It provides basic information to get you started. But you’ll also find more in-depth information, tips and expert insight.

Snapshot: What ADHD

ADHD is a disorder involving a group of key skills known as executive function. Executive function impacts the ability to focus, organize, use working memory, and other executive skills.

ADHD is caused by differences in the development of brain anatomy and wiring. It often runs in families. Everyone has symptoms of ADHD at one time or another. But to be diagnosed with ADHD, kids must have far more difficulty with these problems than their peers. Kids with ADHD also have challenges in more than one area—for example, at school, at home and in friendships.

Prevalence

Estimates of how many children in the U.S. have ADHD range from 5 percent to 11 percent. For a long time, people thought ADHD was something only kids—boys, in particular—had. But research has shown that ADHD symptoms can persist into adulthood in some people, and that women and girls have it as often as men and boys.

ADHD is essentially an issue with executive function. Because of that, kids with ADHD often have trouble:

Core Difficulties:
  • Managing time
  • Getting and staying organized
  • Managing emotions
  • Paying attention and remembering things
  • Shifting focus from one thing to another
  • Getting started on tasks
  • Thinking before saying or doing things

The "Hyperfocus" Paradox

There’s one very confusing sign of ADHD. Kids who lack focus most of the time often can “hyperfocus” or focus very well on tasks or activities they find really interesting, like sports, video games, or crafts.

Focusing on schoolwork can be very hard, however, even when kids know it’s important. This can make it look like ADHD is a “willpower problem,” when in reality it isn’t. There’s a big difference between “won’t” (willpower) and “can’t.” A child’s brain with ADHD has a harder time shifting focus.

ADHD Signs and Symptoms

The main symptoms of ADHD are inattention, impulsivity and hyperactivity. They can look different in different kids, however. And some symptoms may change or even disappear as kids get older.

The stereotype of kids with ADHD is that they’re always in motion, they’re impulsive and hyperactive, and they often have behavior problems at home and at school.

But some kids with ADHD never have those symptoms. They may have only problems with inattention. These kids might be identified as having ADHD Inattentive Type. (It may also be referred to as ADD, or ADHD Without Hyperactivity.)

Some kids show symptoms of ADHD in preschool. But for many, there are no clear signs of ADHD until third or fourth grade. Some kids won’t show signs of ADHD until they face the challenges of middle school or high school. This might be because demands on executive function—organizing, planning, managing time—get more intense as kids progress in school.

Here are some signs you or your child’s teacher might see at different grade levels:
Preschool – Grade 2
  • Ignores directions or doesn’t follow them
  • Grabs things without permission
  • Gets easily and extremely frustrated
  • Needs to be frequently reminded to stop and listen
  • Has trouble getting started on tasks
  • Gets up, fidgets or talks when expected to be quiet
Grades 3 – 7
  • Seems daydreamy and distracted, and easily loses focus
  • Frequently loses or forgets things
  • Is often restless
  • Tends to forget to bring home assignments or turn them in
  • Doesn’t consider consequences before doing things
  • Doesn’t finish tasks in a reasonable amount of time
Teens
  • Has trouble getting organized and prioritizing things
  • Often acts impulsively
  • Frequently fidgets and talks too much
  • Has trouble meeting deadlines and finishing tasks
  • Often needs to re-read things or have directions repeated
  • Often rushes through assignments, making errors

While many kids with ADHD rush through assignments, others actually work more slowly than other kids. Slow processing speed is common in kids with ADHD. It can make it harder to complete tasks or explain things as quickly as their peers.

Other Issues That Can Co-Occur With ADHD

ADHD isn’t a learning disability, even though it can affect learning. But ADHD often co-occurs with common learning issues like dyslexia, dyscalculia and dysgraphia. Many kids with ADHD also struggle with mental health issues like anxiety and depression at some point.

Here are some issues that often co-occur with, or are mistaken for, ADHD:
Executive functioning issues and ADHD are closely related.

In fact, the symptoms and difficulties of ADHD are problems of executive function. Trouble with attention, self-control, memory and organization are often due to weak executive skills.

Dyslexia occurs in roughly 20 to 40 percent of kids with ADHD.

This common learning issue impacts the ability to read. Dyslexia can also interfere with other learning skills like math, spelling and writing.

Dyscalculia and dysgraphia are also common in kids with ADHD (and vice versa).

Dyscalculia is a learning disorder that impacts math, while dysgraphia impacts writing.

Slow processing speed isn’t part of ADHD, but it can add to the challenges.

Processing speed is like the engine that drives how well kids can use executive functioning skills. So kids with slow processing speed may have a harder time starting tasks, staying focused and monitoring how they’re doing.

Sensory processing issues can occur in some kids with ADHD.

These kids have trouble handling input that comes through the senses. They can get overwhelmed by things like smell, noise, taste and textures.

Auditory processing disorder can look like ADHD.

That’s because trouble following directions or talking with people can be signs of both. But while their symptoms may appear to be similar, these two issues are very different.

Nonverbal learning disabilities are learning issues that impact social skills.

Kids with ADHD often struggle with social skills, too, and these two issues can co-occur.

Anxiety and depression both commonly occur with ADHD.

Kids with ADHD have a greater risk of mental health issues than kids who don’t have ADHD.

Possible Causes of ADHD

There’s been a lot of research in the last few years that has pointed to possible causes of ADHD. Brain-imaging studies have looked at brain anatomy and wiring in people who have ADHD and those who don’t.

Studies have shown that brain development is very similar. But kids with ADHD have a delay in development of about three years in some specific parts of the brain. These are the areas involved in executive functions. That’s why kids with ADHD may act one to three years younger than other kids their age.

Research also shows some differences in the networks that help parts of the brain communicate with each other. And there are differences in how brain chemicals act when they’re involved in that communication.

Genetics also appear to play a role. Research has shown that ADHD tends to run in families. A child with ADHD has a one in four chance of having at least one parent who also has it. And there’s a strong likelihood that another close family member also has ADHD. It’s important to know that these differences have nothing to do with intelligence or IQ. Kids with ADHD are just as smart as kids without ADHD.