What are signs of attention-deficit hyperactivity disorder (ADHD)?

Children with attention-deficit hyperactivity disorder, or ADHD, may have signs of hyperactive behaviour, a lack of attention and difficulty concentrating.
Signs of hyperactive behaviour
  • Fidgeting and restlessness, almost constantly
  • Not sitting in the same seat for any length of time
  • Running or climbing inappropriately
  • Talking too much
  • Always playing too loudly
  • Always "on the go"
  • Blurting out answers to questions in school
  • Cutting in line or unable to wait for a turn in activities
  • Interrupting others
Signs of a lack of attention
  • Difficulty following instructions
  • Not seeming to listen to parents or teachers
  • Not being able to focus attention on activities
  • Frequently losing things needed for school or at home
  • Not being able to pay attention to details
  • Appearing disorganized
  • Being unable to plan ahead effectively
  • Being forgetful
  • Appearing very distractible

Most children with ADHD show signs of both hyperactivity and attention problems. Some children, though, may have only signs of inattention. They may have trouble concentrating and paying attention, but they may not show signs of hyperactivity. This kind of problem used to be called attention-deficit disorder (ADD). ADD is now thought of as a form of ADHD.

My child definitely seems too active. How can I tell if the problem is ADHD?
It might help to ask yourself some questions about your child's behaviour. In fact, if you've talked with your doctor about your child's behaviour, your doctor may have already asked you some of these questions.
  How long has my child been too active? Hyperactive children with ADHD have had problems with hyperactive, impulsive behaviour since before age six. Mothers of children with ADHD sometimes even remember that their baby was hyperactive in the womb. Also, children with ADHD are often described by their parents as being fussy and difficult to quiet in infancy. Sustained restlessness, even when eating or at bedtime, is characteristic of children with ADHD.

Is my child's restlessness and impulsivity a problem in several different settings? ADHD is less likely to be present if your child only shows behavioural problems at home, but not in other places, such as at school or at the grocery store. ADHD problems often become worse in settings where there is more activity and noise.

When my child is misbehaving, is he off in a world of his own or is he looking over his shoulder to see if I'm watching him? Children with ADHD cannot control at least some of their hyperactive, impulsive behaviour. Suspect ADHD if your child appears "off in a world of his own" and does not respond to you when, for example, he is climbing on a table, jumping on the sofa or misbehaving in some other way. Children who misbehave on purpose often will look over their shoulders to see how adults react to their misbehaviour. You can tell by the look on your child's face.

Am I primarily angry with my child or am I primarily frustrated? It's normal for parents to get irritated and even to get angry with their children from time to time. Most parents can sense when their children misbehave on purpose. The hyperactivity of children with ADHD is irritating, but parents can sense that their child simply can't--as opposed to won't--sit still or quiet down. This is frustrating.

Can my child stick to activities, or is the house littered with a trail of unfinished games and projects? Children with ADHD often lose interest in an activity in five minutes--or even less. They go from one activity to another, and another and another. You may ask your child many times to clean up, but he or she will not even be able to focus long enough to do that!

My child can watch cartoons on television for a long time. Does this rule out ADHD? Children with ADHD are often able to keep their attention on the fast-paced world of cartoons and video games. If your child's attention stays glued to the screen for programs such as cartoons, suspect ADHD. Often, such children will keep their eyes on the screen, but will be constantly fidgeting their legs and arms.

Has disciplining my child worked? Parents of children with ADHD usually have "tried everything"--from ignoring their child's misbehaviour, to "time-outs," to spanking--but nothing seems to work.

I suspect that my child may have ADHD. What should I do?

It might be hard for your doctor to tell if your child has ADHD particularly if your child is not hyperactive. For this reason, your doctor may want you and your child to see someone who has a great deal of experience working with ADD/ADHD since there are many conditions that can look like ADD/ADHD. Many children with ADHD aren't hyperactive and those who are, may not be hyperactive in the doctor's office.  Information about your child's behaviour needs to be collected from different people who know your child including your child's teachers or anyone else who is familiar with your child's behaviour.

Your doctor will do vision and hearing tests if these tests haven't been done recently. Your doctor also may have forms or checklists that you and your child's teacher can fill out. This will help you and your doctor compare your child's behaviour with other children's behaviour.

Your doctor may recommend a trial of medicine to see if the medicine helps to control your child's hyperactive behaviour. A medicine trial alone cannot be the basis for diagnosing ADHD, but it can be an important part of evaluating your child if ADHD is suspected.  

This information provides a general overview on ADHD and may not apply in each individual case. Consult your physician to determine whether this information can be applied to your personal situation and to obtain additional information.