At some point, you may have felt antsy or unfocused and wondered if you might have ADHD. As a culture, we generally associate hyperactive, inattentive, or disruptive behavior with ADHD. But this mental health disorder is actually very complex.
Attention deficit hyperactivity disorder, aka ADHD, does cause higher-than-usual levels of hyperactivity and impulsivity, but those are just a few of the symptoms.
ADHD can present itself in a wide range of behaviors, depending on a person’s age and even gender. Unfortunately, this can make getting an accurate diagnosis difficult.
Symptoms can appear as early as ages 3 to 6. About 9 percent of children ages 2 to 17 have ADHD, and up to 60 percent have symptoms into adulthood.
A 2011 survey found that more than 1 in 10 school-age children were diagnosed with ADHD — and that number appeared to increase each year.
Despite the prevalence of ADHD, doctors and researchers don’t know for sure what causes it. But according to the CDC, research doesn’t support the popular views that too much sugar, too much TV, or poverty can cause ADHD.
It’s no surprise that identifying ADHD in babies and toddlers is extremely difficult. Many of the signs of ADHD — short attention span, impulsivity, tantrums, and high levels of activity — are also behaviors associated with the “terrible twos.”
Before 2011, the American Academy of Pediatrics’ diagnostic guidelines applied only to children ages 6 to 12. These guidelines have since expanded to include kids from 4 to 18.
Possible symptoms
Many parents would agree that “active” and “energetic” describe a lot of young kids. Even the most spirited toddler can usually focus on a picture book or puzzle, but children with ADHD may not be able to complete these seemingly simple tasks.
Behaviors that may indicate ADHD include:
- restlessness
- running around, climbing, and jumping on things
- being constantly on the go
- talking nonstop
- inability to concentrate or listen for long
- difficulty settling down, taking naps, or sitting for meals
Diagnosis
Diagnosing a young child with ADHD takes time — 6 months, in fact. Not only does their behavior have to be tracked, they must also display symptoms in more than one setting.
Why? A developmental problem could be incorrectly diagnosed as ADHD, preventing the child from getting proper treatment.
The National Survey of Children’s Health found that nearly 195,000 children ages 2 to 5 were diagnosed with ADHD between 2010 and 2011. As of 2016, 388,000 children in that age range had received a diagnosis.
Behavioral difficulties aren’t the only reason a doctor may suspect ADHD at a young age.
Other indications include:
- genetic factors
- drug or alcohol use during pregnancy
- marijuana use during pregnancy
- environmental toxin exposure during pregnancy
- preterm birth or low birth weight
- central nervous system problems at critical moments in development
- a delay in motor development, speech, and language
- family history of ADHD
Just as there are no guidelines for diagnosing ADHD in toddlers, there are no protocols for treatment.
Preschool-age children and infants who show signs of ADHD should see a specialist, such as a developmental pediatrician, speech pathologist, psychologist, or psychiatrist.
After an evaluation, the specialist may be able to help your doctor determine the best course of treatment.
Beginning treatment
The CDC recommends behavioral therapy as a first step of treatment for toddlers. Parents will simultaneously receive training so they can better manage their child’s behavior. The child, meanwhile, will learn:
- new ways of behaving that don’t cause problems
- new ways of expressing themself
Behavioral therapy appears to be as effective as stimulants in young children, but if symptoms don’t improve, medication may be necessary.
In that case, your doctor will closely monitor the dosage to ensure your child gets the maximum benefit of the medication with the fewest possible side effects.
When your child is old enough for kindergarten, consider asking their school for additional educational support.
It’s common for children to daydream, fidget, and interrupt. But if these behaviors are so persistent that they’re affecting your child’s social life or academic performance, there may be an underlying issue.
On average, kids with ADHD are diagnosed at age 7, but they may show signs even earlier. One in 10 children between the ages of 5 and 17 are diagnosed with ADHD — it’s one of the most common neurodevelopmental disorders in the U.S.
14 common symptoms of ADHD in kids
ADHD is commonly associated with trouble in the classroom, but there are usually other indications.
Signs of ADHD include:
- Self-focused behavior: an inability to recognize the needs and desires of others
- Interrupting: butting into conversations or games they’re not part of
- Trouble waiting for their turn: difficulty waiting during classroom activities or while playing with others
- Emotional turmoil: angry outbursts at inappropriate times, temper tantrums, and trouble keeping emotions in check
- Fidgetiness: an inability to sit still, with frequent attempts to run around, fidget, or squirm in place when forced to sit
- Problems playing quietly: difficulty playing quietly or doing leisure activities calmly
- Unfinished tasks: showing interest in lots of things but having trouble finishing them once started
- Lack of focus: difficulty paying attention, even when someone is speaking directly to them
- Avoidance of tasks needing extended mental effort: inability to focus on things requiring sustained mental effort (like homework)
- Mistakes: difficulty following instructions that require planning or executing a plan, which can lead to careless mistakes
- Daydreaming: quieter and less involved than other kids — may include staring into space, daydreaming, and ignoring their surroundings
- Trouble getting organized: difficulty keeping track of or prioritizing tasks and activities
- Forgetfulness: tendency to forget chores or homework or to lose things
- Symptoms in multiple settings: displaying signs in more than one setting, like showing lack of focus both in school and at home
It’s easy to associate ADHD with loud, rambunctious behavior. But the disorder can actually present itself very differently in girls than in boys.
Boys are more likely to be diagnosed with ADHD, but that isn’t because girls are less susceptible to it. Symptoms in girls can be more subtle, making the disorder harder to pinpoint.
Research from 2010 shows that boys display more externalized symptoms (like running around and acting impulsively), while girls’ behaviors are more internalized (like daydreaming).
Since these signs are often overlooked, girls don’t get the evaluation or treatment they need. This can lead to physical and mental issues in the future.
ADHD signs in girls
Girls with ADHD tend to show more inattentive symptoms. For example, they’re more likely to forget an assignment at school than to disrupt the class or act out.
Because these signs aren’t as obvious as hyperactivity, teachers and parents may not realize the child is struggling. Instead, they may think she’s lazy, spacey, or immature or that she has a learning disability.
Unfortunately, as many as 75 percent of girls with ADHD go undiagnosed. And if they do finally get a diagnosis, it’s typically 5 years later than boys.
Girls with ADHD may show some of these behaviors:
- talking excessively, even after parents or teachers ask them to stop
- crying frequently, even from a small disappointment
- constantly interrupting conversations or activities that include friends
- difficulty paying attention
- daydreaming frequently
- having a messy bedroom, desk, or backpack
- difficulty finishing assignments
Risk factors of ADHD for girls
For young girls with undiagnosed ADHD, there’s more at risk than grades and social relationships. As they find it harder to function in everyday situations, they may begin to blame themselves and internalize their frustrations even more.
Research has shown that this can lead to low self-esteem, which is linked to even bigger issues such as:
- anxiety
- depression
- stress
- eating disorders
Young women with ADHD are also three to four times more likely to attempt suicide than girls undiagnosed with ADHD and two to three times more likely to self-harm.
Girls with undiagnosed ADHD are also more likely to have issues at school, in social settings, and in personal relationships than girls without ADHD.
ADHD signs in boys
Although boys are more commonly diagnosed with ADHD, the disorder is still sometimes overlooked. Since boys are perceived as more energetic, their hyperactivity may be written off as typical adolescent behavior.
While research has shown that boys with ADHD more often behave in impulsive and disruptive ways, they may also have inattentive symptoms, similar to those of girls. In those cases, it may be difficult for them to receive a correct diagnosis.
Common signs of ADHD in boys include:
Common signs of ADHD in boys include:
- impulsivity (or “acting out”)
- running, hitting things, and other hyperactive behaviors
- inattentiveness and an inability to focus
- inability to sit still
- physical aggression
- excessive talking
- frequent interruptions of conversations or activities
Risk factors of ADHD for boys
If their ADHD goes undiagnosed, boys may begin to feel the impact of the disorder in other areas of their lives. In addition to struggling at school, at work, and in relationships, they’re also at risk for developing:
- anxiety
- depression
- learning disabilities
Bottom line
ADHD symptoms tend to decrease with age, but the disorder doesn’t necessarily go away. Getting a prompt diagnosis can help lessen future effects and give your child a chance at getting better grades and maintaining a healthy mindset.
If your child shows signs of ADHD at school, ask for a detailed list of concerns from their teacher and school counselor. This way you can provide their doctor with as much information as possible.
Their doctor will perform an exam, provide a diagnosis, and develop a treatment plan (if necessary). The doctor may refer you to a child psychologist specializing in ADHD.
For most children, a combination of medication and therapy is the best course of action. Since not all symptoms of ADHD can be controlled by medication alone, therapy can provide additional support and help fill in any gaps.
More than half of children with ADHD will experience symptoms into adulthood. An estimated 2.5 percent of adults have ADHD, but many don’t even realize it. When this disorder goes untreated, it can cause a number of issues that affect your everyday life.
14 common signs of ADHD in adults
- Lack of focus: having trouble paying attention, being easily distracted, overlooking details, having difficulty following conversations, and being unable to complete tasks or projects
- Hyperfocus: the converse of being easily distracted — becoming so consumed in something that you lose awareness of what’s going on around you (which can lead to miscommunication and misunderstandings)
- Disorganization: regularly having a hectic or chaotic life experience, which leads to struggles with organizational skills, prioritizing, and keeping track of tasks
- Time-management issues: procrastination, an inability to be on time or to use time efficiently, and trouble focusing on anything beyond the present
- Forgetfulness: forgetting dates, belongings, or commitments regularly, to the point where it may be confused with carelessness or a lack of intelligence
- Impulsivity: acting inappropriately in social situations, rushing through tasks, interrupting conversations, and acting without considering the consequences (impulsive shopping is a common symptom of adult ADHD)
- Emotional problems: feeling like you’re on an emotional roller coaster, with boredom suddenly being replaced by a need for excitement, or small frustrations leading to depression or mood swings
- Poor self-image: being hypercritical of yourself, which can stem from an inability to concentrate (which may result in personal failures or underachievements)
- Lack of motivation: feeling open to doing everything while simultaneously feeling unmotivated to follow through
- Restlessness and anxiety: a need to keep moving and doing things, which can lead to frustration and anxiety if you can’t do something immediately
- Fatigue: possibly due to hyperactivity, restlessness, or an ADHD medication side effect — fatigue can worsen attention issues
- Health problems: symptoms like emotional problems, disorganization, and lack of motivation can cause you to neglect your health (think compulsive eating, neglecting exercise, or not taking important medication), and poor health can make ADHD symptoms even worse
- Relationship issues: inattentiveness, talking over people, and feeling bored easily can come across as insensitive or uncaring, which may negatively affect professional, platonic, and romantic relationships
- Substance misuse: though research behind the link isn’t conclusive, adults with ADHD are more likely to have issues with substance abuse (possibly because they attempt to self-medicate)
Whether you notice signs of ADHD in your child or in yourself, it’s important to see a doctor as soon as possible.
If your child regularly shows symptoms of ADHD or if their behavior is having a negative effect on their school performance or social life, you should contact their school and doctor immediately.
A guidance counselor may be able to do a preliminary assessment, which can help with the doctor’s professional evaluation.
You should also talk to your doctor if you have any ADHD symptoms. Changing jobs often, unhealthy patterns in relationships (like numerous divorces), and having few personal or professional achievements may be indicators of ADHD.
Recognizing the different expressions of ADHD is key to properly diagnosing and treating it. Age and gender can have a major influence on how the disorder presents itself.
Undiagnosed ADHD can have negative effects on many areas of your life, but seeking treatment can vastly improve the symptoms.
In addition to medication, cognitive behavioral therapy, eating right, learning how to handle stress, and getting the right amount of sleep can help you manage your ADHD.
Treating ADHD isn’t just about keeping your life in order. Children with ADHD are five times more likely to have depression, and up to 31 percent of adults with ADHD are also depressed.
Though the cause of ADHD is unknown, researchers are looking for answers. Genetics, nutrition, and even neurotoxins may all play a role in the disorder’s development.
