Attention-deficit hyperactivity disorder facts for kids
Attention-deficit hyperactivity disorder (ADHD), or attention deficit disorder (ADD), is a neurodevelopmental disorder.
People with this disorder can do everything people without ADHD can, their brains just have a harder time keeping focussed because their thoughts jump from one thing to the next. They can be very active and find it hard to sit still, and sometimes, can be impulsive (which means doing things or making choices before thinking about whether they are good or bad or have any risks involved.)
Some countries have more people with ADHD than others, and not everyone uses the same tests. Psychologists have found more people with ADHD in North America than in Africa and the Middle East. In the United States, about one in every fourteen children has ADHD (7%), including one in every ten boys (10%) and one in every twenty-five girls (4%). This could be because more boys get ADHD, or because fewer girls take ADHD tests.
Some (less than half) people with ADHD in childhood find things get better when they are adults. Their symptoms are less noticeable. In some cases the symptoms go away entirely when they reach adulthood.
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Signs and symptoms
Inattention, hyperactivity (restlessness in adults), disruptive behaviour, and impulsivity are common in ADHD. Academic difficulties are frequent, as are problems with relationships. The signs and symptoms can be difficult to define, as it is hard to draw a line at where normal levels of inattention, hyperactivity, and impulsivity end and significant levels requiring interventions begin.
According to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and its text revision (DSM-5-TR), symptoms must be present for six months or more to a degree that is much greater than others of the same age. This requires at least six symptoms of either inattention or hyperactivity/impulsivity for those under 17 and at least five symptoms for those 17 years or older. The symptoms must be present in at least two settings (e.g., social, school, work, or home), and must directly interfere with or reduce quality of functioning. Additionally, several symptoms must have been present before age twelve.
Causes
ADHD arises from brain maldevelopment. It is associated with functional impairments in some of the brain's neurotransmitter systems, particularly those involving dopamine and norepinephrine.
Genetic factors play an important role. ADHD has a heritability rate of 70-80%. The remaining 20-30% of variance is mediated by de-novo mutations and non-shared environmental factors that provide for or produce brain injuries; there is no significant contribution of the rearing family and social environment. Very rarely, ADHD can also be the result of abnormalities in the chromosomes.
Diagnosis
ADHD is diagnosed by an assessment of a person's behavioural and mental development, including ruling out the effects of medications, and other medical or psychiatric problems as explanations for the symptoms. ADHD diagnosis often takes into account feedback from parents and teachers with most diagnoses begun after a teacher raises concerns. While many tools exist to aide in the diagnosis of ADHD, their validity varies in different populations, and a reliable and valid diagnosis requires confirmation by a clinician while supplemented by standardized rating scales and input from multiple informants across various settings.
The most commonly used rating scales for diagnosing ADHD are the Achenbach System of Empirically Based Assessment (ASEBA) and include the Child Behavior Checklist (CBCL) used for parents to rate their child's behaviour, the Youth Self Report Form (YSR) used for children to rate their own behaviour, and the Teacher Report Form (TRF) used for teachers to rate their pupil's behaviour.
In North America and Australia, DSM-5 criteria are used for diagnosis, while European countries usually use the ICD-10.
Very few studies have been conducted on diagnosis of ADHD on children younger than 7 years of age, and those that have were found in a 2024 systematic review to be of low or insufficient strength of evidence.
Management
The management of ADHD typically involves counseling or medications, either alone or in combination. While there are various options of treatment to improve ADHD symptoms, medication therapies substantially improves long-term outcomes, and while completely eliminating some elevated risks such as obesity, they do come with some risks of adverse events.
Behavioural therapies
There is good evidence for the use of behavioural therapies in ADHD. They are the recommended first-line treatment in those who have mild symptoms or who are preschool-aged. Psychological therapies used include: psychoeducational input, behavior therapy, cognitive behavioral therapy, interpersonal psychotherapy, family therapy, school-based interventions, social skills training, behavioural peer intervention, organization training, and parent management training.
Medication
The medications for ADHD appear to alleviate symptoms via their effects on the pre-frontal executive, striatal and related regions and networks in the brain; usually by increasing neurotransmission of norepinephrine and dopamine.
Exercise
Exercise does not reduce the symptoms of ADHD. The conclusion by the International Consensus Statement is based on two meta-analyses: one of 10 studies with 300 children and the other of 15 studies and 668 participants, which showed that exercise yields no statistically significant reductions on ADHD symptoms. A 2024 systematic review and meta analysis commissioned by the Patient-Centered Outcomes Research Institute (PCORI) identified seven studies on the effectiveness of physical exercise for treating ADHD symptoms. The type and amount of exercise varied widely across studies from martial arts interventions to treadmill training, to table tennis or aerobic exercise. Effects reported were not replicated, causing the authors to conclude that there is insufficient evidence that exercise intervention is an effective form of treatment for ADHD symptoms.
Diet
Dietary modifications are not recommended as of 2019[update] by the American Academy of Pediatrics, the National Institute for Health and Care Excellence, or the Agency for Healthcare Research and Quality due to insufficient evidence. A 2013 meta-analysis found less than a third of children with ADHD see some improvement in symptoms with free fatty acid supplementation or decreased consumption of artificial food colouring. These benefits may be limited to children with food sensitivities or those who are simultaneously being treated with ADHD medications. There is a small amount of evidence that lower tissue zinc levels may be associated with ADHD. In the absence of a demonstrated zinc deficiency (which is rare outside of developing countries), zinc supplementation is not recommended as treatment for ADHD.
Interesting facts about ADHD
- Experts think that, throughout the world, about one in twenty children (5%) has ADHD.
- ADHD is most common in children: fewer adults have ADHD.
- The first clear description of ADHD is credited to George Still in 1902 during a series of lectures he gave to the Royal College of Physicians of London.
- ADHD was officially known as attention deficit disorder (ADD) from 1980 to 1987; prior to the 1980s, it was known as hyperkinetic reaction of childhood.
- Although people with ADHD struggle to persist on tasks with temporally delayed consequences, they may be able to do so on tasks they find intrinsically interesting or immediately rewarding.
Images for kids
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The left prefrontal cortex, shown here in blue, is often affected in ADHD.
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Percent of people 4–17 ever diagnosed in the US as of 2011
See also
In Spanish: Trastorno por déficit de atención con hiperactividad para niños
