In the United States, 11.3% of children 5-17 years of age have been diagnosed with Attention Deficit Hyperactivity Disorder (ADHD). With this high of a percentage of children and adolescents being diagnosed with ADHD, it is important for parents, caregivers, teachers, therapists, coaches and anyone else who interacts with children and adolescents to be knowledgeable of the diagnosis and how to effectively manage it. This blog post will explore what ADHD is, common myths, how it manifests in children and adolescents, and strategies for managing it effectively.
What is ADHD?
ADHD is a neurodevelopmental disorder that affects one’s attention, impulse control, and hyperactivity. Most people diagnosed with ADHD are diagnosed in childhood or adolescence. There are 3 subtypes of ADHD, inattentive type, hyperactivity type, and combined type. When one is diagnosed with ADHD they will be given the specifier of one of these subtypes, based on the symptoms they endorse. The following chart outlines the symptoms of ADHD based on inattention and hyperactivity.
ADHD Inattentive Symptoms | ADHD Hyperactive symptoms |
| Often fails to give close attention to details | Fidgets with hands or feet |
| Often has difficulty sustaining attention | Has difficulty remaining seated when needed |
| Often does not seem to listen when spoken to directly | Runs or climbs excessively |
| Often does not follow through on instructions and/or fails to finish schoolwork | Has difficulty doing things quietly |
| Often has difficulty organizing tasks and activities | Is “on the go” or acts as if “driven by a motor’ |
| Often avoids, dislikes or is reluctant to engage in tasks that require sustained mental effort | Talks excessively |
| Often loses things necessary for tasks or activities | Blurts out answers to questions before they have been completed |
| Is often easily distracted by extraneous stimuli | Has difficulty awaiting turn in group activities |
| Is often forgetful in daily activities | Interrupts or intrudes on other people’s activities |
In order to be diagnosed with ADHD Inattentive type, the child or adolescent and their parent must endorse 6 out of the 9 inattentive symptoms. To be diagnosed with ADHD Hyperactivity type, the child or adolescent and their parent must endorse 6 out of the 9 hyperactivity symptoms. And to be diagnosed with ADHD Combined type the child or adolescent and their parent must endorse 6 out of 9 symptoms in BOTH inattentive and hyperactivity. The most common type of ADHD is the combined type. Males have a higher rate of diagnoses due to their hyperactivity/impulsive presentation, while females have higher rates of inattention.
How ADHD Manifests in Children vs. Adolescents
Signs and symptoms of ADHD change as a person grows and matures. Because of this, there are different presentations we see based on age. Here are a few common behaviors and symptom expressions for both children and adolescents.
Children with ADHD tend to show more external behaviors. Common behaviors children will display include fidgeting, excessive talking, difficulty following directions, interrupting conversations, difficulty waiting their turn, forgetfulness, playing loudly, and trouble finishing tasks. These behaviors/symptoms experienced by children with ADHD may impact the child’s school performance, social relationships, and family dynamics. The following demonstrates the impacts in each of these areas of life.
- School Performance: Parents may see a decline in the student’s grades as they age due to the difficulties around completing tasks and paying attention for extended periods of time. It is important to note that the child is not unable to learn what is presented to them, but they may need the information presented to them in different ways. School performance can increase as the child is treated for ADHD.
- Social Relationships: Children may have difficulty making and maintaining friendships due to their impulsiveness, loudness, or excessive talking. Many times, a child with ADHD can be seen as a “trouble maker” in social settings, which turns other children away from wanting to play with them. Social skills may not come naturally to the child, but they can be taught with repetition and encouragement.
- Family Dynamics: Parents may find themselves feeling overwhelmed, exhausted, stressed, or anxious when it comes to raising a child with ADHD. These children tend to garner the most attention from the parents, which can result in siblings feeling left out or not as important. All of these feelings combined can turn into resentment in multiple family members which can make home life tense. Finding balance between family members and having routines can help improve the family dynamics.
As children grow into adolescents there can be many changes in symptom expression for ADHD. For instance, hyperactivity may decrease but inattention and impulsivity persist and/or become more intense. Adolescents with ADHD tend to become more disorganized, have emotional outbursts, engage in risky behaviors, and have difficulty following social cues. When ADHD goes undiagnosed, this may lead to more struggles in adolescence. It is very likely that an adolescent with undiagnosed or untreated ADHD will experience academic failure, social difficulties, and even experiment with substance abuse. These adolescents will also experience ongoing impacts in their school performance, social relationships, and family dynamics similar to what they experienced in childhood.
Common Myths About ADHD
As with any diagnosis, there are several myths or misconceptions about ADHD. Here we will address some of the most common myths about ADHD and provide insight into the truth about ADHD in children and adolescents.
- Myth 1: “ADHD is just an excuse for bad behavior.”
- Reality: ADHD is a neurodevelopmental disorder with a biological basis. This means that ADHD is connected to different parts of the brain and is therefore not something that a child or adolescent diagnosed with it can control. The behaviors associated with ADHD are not intentional or controllable without help.
- Myth 2: “Kids will grow out of ADHD.”
- Reality: ADHD stays with a person over the lifespan. As a child grows, their symptoms may change over time but they will not go away completely. For some, the symptoms and behaviors of ADHD can become more controllable which can make it appear like they “grew out of it”.
- Myth 3: “ADHD only affects boys.”
- Reality: ADHD affects people of all genders. It has historically been diagnosed more frequently in males vs females, due to the presentation of symptoms. We have learned over the years that symptoms can present differently in each gender which has led to more females being diagnosed in recent years.
- Myth 4: “ADHD is caused by poor parenting.”
- Reality: Symptoms and behaviors of ADHD are not caused by parenting style. ADHD is a neurodevelopmental disorder, which means it is not caused by the environment the person is in. In regards to nature vs nurture, nature wins this one. That being said, effective parenting strategies can help manage the symptoms of ADHD through childhood and adolescence.
Effective Management Strategies for ADHD
Children and adolescents with ADHD will need effective strategies to help them to manage the symptoms and behaviors they experience. For children, the parents will need to be responsible for helping their child learn and implement strategies, while adolescents can be held responsible for their strategies as they show competency with them. Effective strategies to manage ADHD include behavioral interventions, medication, diet and lifestyle adjustments, and social support.
Behavioral interventions can include parent training, behavioral therapy, and classroom strategies. It is important that parents are educated on how to set clear boundaries, use positive reinforcement, and establish routines for children and adolescents. These strategies can all be learned through research or connecting with a therapist who is trained to work with people diagnosed with ADHD. Cognitive-Behavioral Therapy (CBT) is an evidence based treatment for ADHD and can provide skills for children and adolescents to manage their symptoms. Most children and adolescents with ADHD will need strategies for being in the classroom as that is where they spend a good portion of their day. This can include formal accommodations such as preferential seating, extra time on assignments and tests, and frequent breaks. Having behavioral interventions in place sets your child and adolescent up for success as they grow and become more independent.
Medication is another effective strategy to help a child or adolescent manage their ADHD symptoms and behaviors. There are several types of medications that help mitigate ADHD symptoms and fall within two different categories: stimulants and non-stimulants. Common stimulants include Ritalin and Adderall while common non-stimulants include Strattera. It is important to work with a doctor to determine which kind of medication would work best for your child or adolescent. While your child’s PCP is fully capable of prescribing medication for ADHD, it may be more helpful to seek out a psychiatrist as they will be more aware of the variety of medications available to treat ADHD.
Diet and lifestyle adjustments are another way to help your child or adolescent to manage their symptoms and behaviors of ADHD. There has been some evidence that shows healthy eating habits that support brain health, such as omega-3 fatty acids and balanced meals throughout the day, will help with ADHD. It can also be very helpful to increase exercise and physical activity to help with focus and reduce restlessness. Children and adolescents with ADHD tend to have excessive energy that can be expressed through exercise or sports. Many have also found structured sports or martial arts to be helpful in redirecting their energy.
Social support skills will help your child or adolescent to learn how to make and maintain friendships. Many children and adolescents with ADHD can have difficulty making and maintaining friendships due to their impulsivity. They may say or do things to their friends without thinking, which can result in their friends not wanting to be around them. Children with ADHD also often find themselves in trouble at school, which can be a turn off to other children. Developing social skills is a proactive way to help a child or adolescent develop the social support they will need throughout their life.
ADHD is one of the most common mental health diagnoses for children and adolescents. If your child or adolescent has been diagnosed with ADHD, one of the best ways you can support them is by educating yourself on what ADHD is, how it presents in different ages, and how to effectively support management skills for them. The more active you are in helping your loved one with ADHD the more success they will have in the long run. If you or your loved one has questions about ADHD or is seeking therapy to help with ADHD, please contact our offices today.
