ADD/ADHD in Children (page 6)

All children get fidgety or impatient from time to time. Now and then, their attention wanders or they need to run around and blow off steam. And as we know, sometimes kids say the darndest things. But when inattention, hyperactivity, and impulsive behavior are the norm for a child, it may be a sign of ADHD. ADHD can lead to problems at home and at school, with family, teachers, and peers, so it's important to identify the symptoms and get help.

What is ADD or ADHD?

You know these kids: the ones who can't sit still, the ones who never seem to listen, who don't follow instructions no matter how clearly you present them, who blurt out inappropriate comments at inappropriate times. There's at least one in every classroom, and that one may be yours, because attention deficit disorder (ADD) affects people across the spectrum of race, class, gender, and age.

Attention Deficit (Hyperactivity) Disorder (ADD/ADHD) is a neurological condition that makes it difficult for people to inhibit their spontaneous responses—responses that can involve movement, speech, and attentiveness. The National Institute of Mental Health estimates that between 3 and 5 percent of children in the United States have ADHD. This means that in a classroom of 25 to 30 children, at least one is likely to have ADHD.

Types of ADD/ADHD

There are three subtypes of ADD/ADHD:

• Predominantly inattentive
• Predominantly hyperactive-impulsive
• Combined: inattentive and hyperactive-impulsive

That means children with ADD/ADHD don't all have the same problems. Some are hyperactive, while others sit quietly (with their attention miles away). Some put too much focus on a task and have trouble shifting it to something else. Others are only mildly inattentive but overly impulsive. Still others have significant problems in all three areas.

Signs and symptoms of ADD/ADHD in children

Now and again, every child is absent-minded, restless, or impulsive. These symptoms point to ADD/ADHD when they're the rule and not the exception.

Symptoms of inattention

It isn't that children with ADD/ADHD can't pay attention: When they're doing things they enjoy or hearing about topics in which they're interested, they have no trouble focusing and staying on task. (The hard part may be pulling them away to the next activity.) But if a child with ADD isn't viscerally engaged by an activity, the attention of that child will quickly seek out a different activity or something else to think about.

Some symptoms of the inattentive type of ADD are:

• being easily distracted from a task, lesson, or conversation
• difficulty keeping the mind on any one thing
• getting bored with a task before it's completed
• skipping over details
• making careless mistakes
• difficulty listening when directly addressed
• difficulty following instructions or finishing tasks
• disorganization and forgetfulness

Children with ADD often bounce from task to task without completing any of them, or skipping necessary steps in procedures. They often have difficulty learning new material. Organizing their schoolwork and their time is harder for them than it is for most children.

Symptoms of hyperactivity/impulsivity

Youngsters with hyperactive or impulsive symptoms of ADHD seem to be always in motion. Sitting still can be very difficult for them. They may try to do several things at once, bouncing around from one activity to the next.

Children experiencing the hyperactive/impulsive form of ADHD may:

• fidget and squirm or have trouble staying seated at all
• move around constantly, often running or climbing inappropriately
• have difficulty with quiet, sedentary activities
• talk excessively
• blurt out answers before questions are completed
• speak tactlessly or inappropriately
• exhibit difficulty waiting
• interrupt or intrude on others

Because we expect very young children to be easily distractable and hyperactive, it's the impulsive behaviors — the dangerous climb, the blurted insult — that often stand out in preschoolers with ADD/ADHD. By age four or five, though, most children have learned how to pay attention to others, to sit quietly when instructed to, and not to say everything that pops into their heads. So by the time children reach school age, those with ADD/ADHD stand out in all three behaviors: inattentiveness, hyperactivity, and impulsivity.

How ADD/ADHD affects children's lives

ADD affects not only schoolwork but relationships with family members and peers. If you're a kid with ADD, you may be mentally running a video game while the teacher is explaining how to structure a five-paragraph essay, while you're standing out in center field, or while Mom is lecturing you yet again about cleaning up your room. As a result, the essay and the bedroom are a mess, and the other team just scored three runs because you let the ball drop behind you. Everyone's exasperated and frustrated.

Learning

ADD/ADHD, obviously, gets in the way of learning. You can't absorb information or get your work done if you're running around the classroom or zoning out on what you're supposed to be reading or listening to. Persons with ADD/ADHD also tend to have problems with working memory, the ability to remember information long enough to use it in the short term. That can be a big obstacle if you're trying to remember which numbers go where in a math problem or taking a pop quiz.

Executive Function

ADD/ADHD impairs the brain areas responsible for executive function. Executive functioning includes the abilities to plan, prioritize, organize, persist, multi-task, move toward a goal, delay gratification, and monitor your own behavior. Instructions like "Be patient" and "Just wait a little while" are twice as hard for children with ADD/ADHD to follow as they are for other youngsters.

Problems with executive function often express themselves as:

• poor sense of time and timing
• carelessness
• inconsistency
• difficulty waiting for an outcome
• low boiling point for frustration
• poor judgment

Many kids with ADD/ADHD have trouble recognizing interpersonal boundaries and reading social cues such as body language and facial expressions, which can lead to rebuffs and even ostracism by other children.

Inhibition

In terms of behavior, the lowered inhibitions of children with ADD/ADHD can cause problems with self-control in attitude, gesture and speech, often making adults experience them as lazy, disrespectful, or annoyingly needy and other children view them as weird, foolish, or uncool. Children with ADD/ADHD tend to be moody and to overreact emotionally. Because they censor themselves less than other kids do, they'll interrupt conversations, ask irrelevant questions in class, make tactless observations and ask overly personal questions, express their feelings too openly for people's comfort, and cling to adults physically and emotionally when other children are able to detach.

It's important to remember that the self-regulation problems seen in youngsters with ADD/ADHD are not a matter of deliberate choice. These problems are caused by neurological conditions beyond their control. People with ADD/ADHD know how to behave. They generally know what is expected of them in given situations. But they run into trouble at the point of performance — that moment in time when they must inhibit behavior to meet situational demands.

Positive characteristics of children with ADD/ADHD

Lest you think ADD is nothing but trouble, consider some of the positive traits associated with people, including children, who have ADD or ADHD:

• Creativity – Children who have ADD/ADHD can be marvelously creative and imaginative. The child who daydreams or has ten different thoughts at once can become a master at problem-solving or creative expression. Someone with ADD can be a fountain of ideas, an invaluable asset in brainstorming sessions. In a creative or problem-solving situation, divergent thinking can be very useful in coming up with multiple possible solutions and allows for rare insights in such fields as art, music, business, and science. Children with ADD may be easily distracted, but sometimes they notice what others don't see.
• Flexibility – Because children with ADD consider a lot of options at once, they don't become set on one alternative early on and are more open to different ideas.
• Enthusiasm, spontaneity, liveliness – Children with ADD are rarely boring! They're interested in a lot of different things and have lively personalities. In short, if they're not exasperating you (and sometimes when they are), they're a lot of fun to be with.
• Energy, drive, and tenacity – When youngsters with ADD/ADHD are motivated, they work or play hard and strive to succeed. It actually may be difficult to distract them from a task that interests them, especially if the activity is interactive or hands-on.
  Keep in mind, too, that ADD/ADHD has nothing to do with intelligence or talent. Many children with ADD/ADHD are intellectually or artistically gifted.

Helping a child with ADD / ADHD

Parents can help a child with ADD/ADHD at home and teachers can use many strategies in dealing with ADD/ADHD in the classroom. Sometimes a physician or therapist who specializes in ADD can help you decide how to proceed in treating your child with ADD/ADHD and can provide appropriate interventions.

Parents with a child with ADD / ADHD

Parents with a child with ADD / ADHD may feel frustrated and hopeless trying to get their child to behave. There are things parents can do to reduce their child's hyperactivity, without sacrificing the natural energy, playfulness and sense of wonder unique in every child.
Read Parenting a child with ADD / ADHD

Children with ADHD

Children with ADHD are eligible for special services or accommodations at school under the Individuals with Disabilities in Education Act (IDEA) and an anti-discrimination law known as Section 504.
Read ADD/ADHD in the Classroom

Getting help for children

Once your child is diagnosed, you can connect with professionals who provide therapy, support, and practical assistance, working with children to help them understand their feelings and cope with the realities of having ADD / ADHD.
Read Professional Help for Children with ADD / ADHD

Persistent and negative side effects of stimulants

Persistent and negative side effects of stimulants have been documented, including sleep disturbances, reduced appetite, and suppressed growth, which might have important health implications for the millions of children who are currently taking medication for ADHD.
Read Medications for Treating ADHD

Related links for ADD/ADHD in children

Helpguide's ADD / ADHD Series

ADD / ADHD in children - Recognizing the signs, symptoms and effects 

Parenting a child with ADHD - Strategies for family and home life

ADD / ADHD in the Classroom - Tips for teachers and parents

Getting help for children with ADD / ADHD - Guide to diagnosis and treatment

Medications for Treating ADD / ADHD - Benefits, safety, and side effects

Adult ADD / ADHD - Recognizing the signs, symptoms and effects

Self Help for Adult ADD - Coping skills and professional help

Professional Help for Adult ADD - Getting a diagnosis and finding treatment

Causes of ADHD / ADD - possible causes and risk factors

Signs and symptoms of childhood ADD/ADHD

Attention-Deficit/Hyperactivity Disorder – This booklet in PDF format covers most aspects of ADD / ADHD. (National Dissemination Center for Children with Disabilities)

Attention Deficit Hyperactivity Disorder – A long, detailed write-up of ADHD symptoms, possible causes, diagnosis, and treatment, which can be printed out in PDF. (National Institute of Mental Health)

ADHD Gets Some Attention – Kid-oriented and very readable combination of information and advice. (Neuroscience for Kids, University of Washington)

Attention deficit hyperactivity disorder – This page is the introduction to a 12-page series on ADHD. (University of Maryland Medical Center)