Kids are balls of energy. They squirm in their chairs; they run when you tell them to walk; they stop in the middle of cleaning their room to play with their toys. These are all normal parts of being a kid. But some of these behaviors can also be signs of attention deficit hyperactivity disorder (ADHD).
So, how can you tell the difference? Your child’s energy level, attention span, and focus can help you see if they’re “acting their age” or if they may have a condition that needs extra support.
Children with ADHD fall into three types. They may be:
- Hyperactive/lacking impulse control
- Inattentive
- A combination of the first two types
Hyperactivity
One study found that kids have the same staying power as trained endurance athletes! They’re also curious about the world and eager to explore. But if your little one’s always active in ways that don’t fit the time or setting, they may be hyperactive.
If your child is hyperactive, they may:
- Run and shout when playing, even indoors
- Find it hard to sit still
- Fidget
- Bump into things because they move so fast
- Tend to play too rough
- Talk a lot (including blurting out answers and talking over others)
- Get angry easily
Older kids and teens can often sit still for longer times. But hyperactive teens may still squirm or want to keep their hands busy.
Inattention
Children naturally have a shorter attention span than adults do. As they get older, their attention span grows. They get better at tuning out things that distract them.
If your child has a problem with attention, they could:
- Get distracted easily
- Become easily bored by a task
- Struggle to get or stay organized
- Make simple mistakes because they rush
- Often lose or forget where they put things
- Appear not to listen when you're talking to them
- Not finish homework assignments or household chores
Kids who have a hard time with focus can sometimes also get what’s called a “hyperfocus.” Once they find something that interests them, whether it’s a video game or a book, it’s all they want to do or talk about.
Poor Impulse Control
Kids often see a big jump in self-control between the ages of 5 and 6. (Girls are usually better at this skill than boys.)
If your child acts impulsively, they could:
- Act silly to get noticed
- Find it hard to follow rules
- Be aggressive
- Get upset when they make a mistake or are criticized
- Not realize how their words or actions affect others
Teens who are impulsive often take more risks than other kids their age.
It's important to note that ADHD can look different in boys and girls. Boys are more likely to be hyperactive, while girls are more likely to be inattentive, though both genders can have both types of symptoms. Girls are often diagnosed at a later age than boys because they don't appear hyperactive. Girls are diagnosed with ADHD half as often as boys. But men and women are diagnosed around the same rate. Girls with ADHD may also have low self-esteem, anxiety, and depression at higher rates than girls without ADHD.
When to Get Help
If your child can sit still, focus, or show self-control at least some of the time, that may be normal for their age. If they struggle in these areas all the time – for instance, at home, with friends, as well as in school – ADHD could be the cause.
ADHD affects 1 in 10 children under the age of 17. But other health issues can also cause similar symptoms. Those conditions include:
- Hearing problems
- Learning disabilities
- Anxiety or depression
- Sleep issues (like sleep apnea or not sleeping enough)
Check in with your child’s doctor if you have concerns. They can ask you both more questions to get a better idea of what’s going on. They may refer you to a specialist if it looks like your child needs testing.
If your child does have ADHD or another condition, counseling, medication, and extra support at school can all help.
ADHD Assessment
If your child is under 17 and shows six or more or more symptoms of inattention or of hyperactivity and impulsivity (or five or more if they're over 17), it may be time to get them assessed.
There isn't a specific test that will tell whether your child has ADHD or not. A doctor will usually do a physical exam to make sure there isn't a physical reason for your child's inattention – for instance, they'll check your child's hearing and vision. They'll also look at medical and school records and talk to family members and teachers. Sometimes, children display signs of ADHD in one setting (like school) but not in another. The child may show no signs in the doctor's office. The doctor will also look at ADHD symptom checklists and standardized behavior rating scales to make a diagnosis.
ADHD Treatment for Kids
Treatment is usually a combination of medication and behavior management. For children under 6, the American Academy of Pediatrics recommends that you try parent training in behavior management before medication. That's because young kids will have more side effects from the medications than older kids, and the long-term effects of medication on these younger children has not been studied as much.
A therapist gives this training to parents because kids under 6 are too young to change behavior without parental help. They'll teach you ways to use positive reinforcement and discipline to change your child's behavior and assign activities for you to do with your child.
For older children and teens, parent training is usually combined with behavior management for the child and medication. Medications are broken down into stimulants (like forms of methylphenidate and amphetamine) and non-stimulants (like atomoxetine and guanfacine).
Stimulants are usually given first because they act fast to reduce ADHD symptoms. They work by increasing the level of dopamine in the brain, which has a positive effect on motivation and attention. But these medications can have side effects such a loss of appetite or problems with sleep. Also, these are considered controlled substances, as there is potential for misuse and abuse, particularly among teens. So they require special refills – for instance, a doctor usually can't call in a refill over the phone. Not every child reacts the same way to each medication, so careful monitoring is key, especially at the beginning.
Non-stimulants are used when stimulants haven't helped. They take longer to work, but their effects can last 24 hours. They stimulate the norepinephrine system, which is part of your body's nervous system, and increase alertness and attention. In general, non-stimulants don't work as well as stimulants, though some kids find them more helpful. Side effects include nervousness, sleep problems, and an upset stomach. As these are not controlled substances, doctors have more freedom as far as offering samples or calling in refills.
Here are some other ways to help your child with ADHD:
Provide healthy outlets
Children with ADHD are hard-wired to take risks. Don't try to stop them. Instead, help them learn the difference between negative and positive ones. For example, learning a sparring routine in a martial arts class is a positive risk that you should encourage. That's much different than starting fights on the playground.
Encourage social activity
Kids with ADHD may find it hard to make friends because they often don't pick up on social cues. This can make them feel lonely and isolated. It can also affect their self-esteem. Children who have the disorder are more likely to bully others or become victims of bullying themselves.
Try to make opportunities for your child to interact with their peers. During these interactions, provide structure, set time limits, and choose activities with easy-to-understand rules to avoid outbursts.
Limit downtime
The more kids have to do, the less likely they are to engage in negative or risky behaviors. Too much time spent in front of the TV, online, or playing video games may make ADHD symptoms worse, according to a study in the journal Attention Deficit and Hyperactivity Disorders.
Give rewards and set consequences
To help kids feel successful – which may limit outbursts – provide simple instructions and set goals they're almost sure to meet. Then reward them. For example, your child is more apt to hit a goal to do homework rather than to get all As and Bs on a report card. If you set goals that are too big or whose consequences are too harsh, it could backfire and make them give up.
When your child acts in negative ways, remember that impulsive, risk-taking behavior is a result of the circuits in the brain; it's not willfulness.
Make a plan
This is one of the most important things you can do to help manage your child's behavior if they have ADHD. Work with your pediatrician or psychiatrist to find a treatment plan to keep symptoms in check. That plan may involve medication, therapy, and a healthy dose of positive reinforcement.
