


Related concepts:

Attention Deficit Disorder, ADD, Hyperactivity

Introduction to ADHD:


What is ADHD?

ADHD is a problem with inattentiveness, over-activity, impulsivity, or some combination of these. Scientific studies, using advanced neuroimaging techniques of brain structure and function, show that the brains of children with ADHD are different from those of other children. These children handle neurotransmitters (including dopamine, serotonin, and/or adrenalin) differently from their peers.

While we still don’t know exactly what causes ADHD, it appears that it is often genetic. Whatever the specific cause may be, it seems to be set in motion very early in life as the brain is developing. Other problems, such as depression, sleep deprivation, specific learning disabilities, tic disorders, and oppositional/aggressive behavior problems, may be confused with or appear along with ADHD. Every child suspected of having ADHD deserves a careful evaluation to sort out exactly what is contributing to his concerning behaviors.

Who gets ADHD?

There is a lot of controversy surrounding the actual number of children with ADHD. The Diagnostic and Statistical Manual (DSM-IV) suggests that it occurs in 3 to 5 percent of all children. Other estimates are far higher or lower. It is diagnosed much more often in boys than in girls.


What are the symptoms of ADHD?



  2. Often has difficulty sustaining attention in tasks or play activities
  3. Often does not seem to listen when spoken to directly
  5. Often has difficulty organizing tasks and activities
  8. Is often easily distracted by extraneous stimuli
  9. Is often forgetful in daily activities


  1. Often fidgets with hands or feet or squirms in seat
  4. Often has difficulty playing or engaging in leisure activities quietly
  6. Often talks excessively.


  1. Often blurts out answers before questions have been completed
  2. Often has difficulty awaiting turn

Is ADHD contagious?


How long does ADHD last?

ADHD is a long-term, chronic condition. About half of the children with ADHD will continue to have troublesome symptoms of inattention or impulsivity as adults. However, for many children, the symptoms of ADHD may improve with time.

How is ADHD diagnosed?

Too often, difficult children are incorrectly labeled with ADHD. Some of these children may actually have other mental illnesses or learning difficulties that are not being appropriately managed.

Others may be unfairly judged based on their age.  Recent studies show that children who are young relative to the other children in their class are much more likely to be labeled as having ADHD than children who are older than their classmates. (Journal of Health Economics 29 (2010) 657–673)



To be diagnosed with ADHD, children should have at least 6 of the attention symptoms or 6 of the activity/impulsivity symptoms listed in the DSM-IV. They must display these to a degree beyond what would be expected for children their age.

The symptoms must be present for at least 6 months, observable in 2 or more settings, and not caused by another problem. The symptoms must be severe enough to cause significant difficulties. Some defining symptoms must be present before age 7.

Older children who still have symptoms but no longer meet the full definition have ADHD in partial remission.


How is ADHD treated?

The American Academy of Pediatrics (AAP) has developed evidence-based guidelines for the treatment of ADHD:

  • ADHD is a chronic condition and must be treated as such.
  • It is important to set specific, appropriate target goals to guide therapy.
  • Medication and/or behavior therapy should be started.
  • When treatment has not met the target goals, it is important to evaluate the original diagnosis, the possible presence of other conditions, how well the treatment plan has been implemented, and the use of all appropriate treatments.
  • Systematic follow-up for the child with ADHD is important to regularly reassess target goals, results, and any adverse effects of medications. Information should be gathered from parents, teachers, and the child.

ADHD is a frustrating problem. A number of alternative remedies have become quite popular, including herbs and supplements, chiropractic manipulation, and dietary changes. While there is evidence suggesting the value of a healthy, varied diet, with plenty of fiber and other basic nutrients (the diet that would be best for most children), there is little or no solid evidence for many remedies that are marketed to parents. The most promising specific nutritional actions include getting adequate iron and omega 3 fats in the diet, and possibly avoiding certain artificial dyes and chemical preservatives. Adequate sleep has been proven to help ADHD symptoms.


How can ADHD be prevented?

New links are being discovered between ADHD and environmental triggers. Avoiding prenatal tobacco, lead, or organophosphate pesticide exposure, for instance, has been linked with lower rates of ADHD. Minimizing unnecessary exposure to known neurotoxins and maximizing healthy food and sleep may prevent ADHD, but this has yet to be proven.

Early identification and treatment can prevent many of the problems associated with ADHD.

Related A-to-Z Information:

Depression, Enuresis (Bed-wetting), Sleep Apnea, Tourette’s Syndrome, Tonsillitis

Last reviewed: August 07, 2013
Dr. Alan Greene

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