|ADHD: Signs and symptoms||1923.00000000000||ADHD: Signs and symptoms||ADHD: Signs and symptoms||A||English||Psychiatry||School age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)||Brain||Brain||Conditions and diseases||Caregivers
Adult (19+)||NA||2017-06-16T04:00:00Z||Alice Charach, MD, MSc, FRCPC;Rosemary Tannock, PhD||10.0000000000000||54.0000000000000||1571.00000000000||Health (A-Z) - Conditions||Health A-Z||<p>Discover the main sign and symptoms of ADHD in school-aged children and teens.</p>||<h2>What are the main symptoms of ADHD in children?</h2><p>The main symptoms of
<a href="/Article?contentid=1922&language=English">ADHD </a>are difficulties controlling attention, behaviour and emotions, as expected for age.</p><h3>Difficulty controlling attention</h3><p>A child who has difficulty controlling attention may make careless mistakes or fail to pay attention to detail, not seem to listen when spoken to, have trouble organizing tasks and activities and be easily distracted. Sometimes they may focus very well (over-focus) on tasks of high interest such as video games but not on tasks that may be difficult, require more effort or be less interesting to them, such as school work.</p><h3>Difficulty controlling behaviour and emotions</h3><p>A child who finds it difficult to control their behaviour might show symptoms of hyperactivity. They may often fidget, have trouble playing quietly, be "on the go" or talk too much. If a child has symptoms of impulsivity, they may have trouble waiting for their turn and frequently interrupt others.</p>||<h2>What is the difference between ADHD and normal inattention or high energy in children?</h2>
<p>It is not unusual for most children to have one or two symptoms of ADHD now and then. For a diagnosis of ADHD, however, the symptoms must cause problems for the child at home, play and school. In particular, they must be:</p>
<p>This means a child must experience more frequent and/or more severe symptoms than other children of the same age and sex.</p>
<p>ADHD symptoms have continued for many months and are not a response to a temporary stressful situation such as divorce, trauma or starting a new school or grade.</p>
<p>When symptoms are pervasive, they occur in several different settings such as at school, at home, restaurants, church, shopping malls, after-school activities and so on.</p>
<h2>Does a child with ADHD show symptoms all the time?</h2>
<p>ADHD symptoms may not be present all the time. Usually, they become more obvious in more demanding situations. For instance, obvious symptoms appear to be minimal when a child with ADHD is watching TV or playing a videogame but more noticeable when they need to sit still and focus on a long or difficult task.</p>
<h2>Do ADHD symptoms change over time?</h2>
<p>Symptoms of ADHD may look different at different ages.</p>
<p>Hyperactive and impulsive symptoms are more easily noticed by parents and teachers in early childhood. They may first appear when a child is in kindergarten or primary grade school. Children may act without thinking or seem "driven by a motor". These symptoms often become less obvious as a child grows and may disappear by the teen years. However, while teens and adults may appear calmer, they may still feel restless, make rash decisions without thinking and talk in sudden bursts.</p>
<p>Difficulties controlling attention often last from childhood into adulthood. They are less obvious to other people than hyperactivity and impulsivity and tend to emerge later in childhood, when school work and expectations for following classroom routines increase. The symptoms of inattention include forgetfulness, disorganization and problems concentrating, especially when the material is not interesting.</p>||<h2>Key points</h2>
<li>The main symptoms of ADHD are difficulty controlling attention, behaviour and impulses. This can appear as inattention, over-focusing, hyperactivity and impulsivity.</li>
<li>Symptoms usually become more obvious from age seven to nine but can sometimes appear as late as age 13 to 15.</li>
<li>ADHD is diagnosed when a child’s symptoms are excessive, last for a number of months and occur in two or more settings. </li>
<li>An ADHD diagnosis is made by a qualified health-care professional, based on a thorough clinical history, a physical examination and descriptions of symptoms by the parent and teacher.</li>
</ul>||<h2>How ADHD appears in school-age children</h2><p>One of the key times for diagnosing children is when they are aged seven to nine years old. At this age, parents and teachers often start to notice problems with the child's school work and friendships.</p><h3>School performance</h3><p>Many children with ADHD may also have more difficulties than their peers with learning to read, spell or do math. But even without any specific learning difficulty (such as dyslexia), ADHD can interfere with a child’s ability to learn, follow classroom routines and complete school work. They may have trouble understanding how the classroom works and may find it hard to give focused, organized answers to a teacher's questions. Homework can also be a challenge, as ADHD may make it difficult for a child to write down homework, remember to take the necessary books home and start or complete homework by themselves.</p><p>The website
<a href="http://www.teachadhd.ca/Pages/default.aspx" target="_blank">TeachADHD</a> offers more information on how ADHD affects children in the classroom and offers a range of guidelines for teachers. </p><h3>Social emotional abilities</h3><p>Children with ADHD often have more social and emotional problems than other children. This is true for both boys and girls. For instance, ADHD is linked with being a victim of bullying and being rejected by peers.</p><p>In terms of emotions, children with ADHD can experience sudden mood swings, which may appear as over-reactions to small issues or becoming frustrated very quickly. They may also have a strong need for instant satisfaction.</p><p>These social and emotional issues can occur because of a child’s:</p><ul><li>difficulty reading social cues, for example failing to read facial expressions accurately or interpreting neutral behaviour or comments as negative</li><li>problems with conversation skills, problem-solving or other social skills</li><li>trouble controlling behaviour, for instance interrupting or not taking turns, which may irritate other children</li><li>difficulty controlling their emotions, for example reacting angrily or inappropriately when they are upset</li></ul><h2>How ADHD appears in teens</h2><p>While a diagnosis of ADHD is usually confirmed by age nine, some older children may not be diagnosed until they transition to high school. This is because the transition and adjustment to high school usually place new demands on a child's organizational skills and reveal difficulties with controlling attention that might have been hidden previously.</p><h3>School performance</h3><p>Many of the school difficulties experienced by younger children with ADHD continue into the teen years. Compared with their peers, teens with ADHD are three times more likely to drop out of school. However, many students with ADHD do graduate from high school and go on to higher education, which is encouraging. They may still face challenges with learning and academic performance, however, so proper supports remain essential.</p><h3>Social emotional abilities</h3><p>Teens with ADHD may have:</p><ul><li>more negative moods, such as anger,
<a href="/Article?contentid=18&language=English">anxiety</a> and stress</li><li>fewer positive moods, such as happiness, alertness and a sense of wellbeing</li></ul><p>In teenage boys, ADHD may contribute to risky behaviours such as gambling and addictions, including substance abuse and video addiction. In girls, ADHD is more likely to be associated with obesity,
<a href="/Article?contentid=291&language=English">suicide</a> and
<a href="/Article?contentid=289&language=English">self-harm</a>, and eating disorders such as
<a href="/Article?contentid=282&language=English">bulimia</a> and
<a href="/Article?contentid=277&language=English">binge eating</a>. For older teens, there is increased risk of driving offences and accidents.</p>||<h2>How is ADHD diagnosed?</h2>
<p>There is no specific test for ADHD. Usually, your doctor or another qualified health-care professional will examine your child and ask questions about:</p>
<li>your child’s developmental history</li>
<li>how your child behaves at home and in other situations</li>
<li>how long your child has had symptoms and whether they cause problems</li>
<li>whether your child is experiencing problems at school or with school work</li>
<p>The health-care professional will usually ask you to fill in some structured questionnaires so they can learn about your child’s general behaviour at home. If you have any concerns that the doctor has not asked about, such as problems with your child’s nutrition or sleep, make sure to discuss them. It might help to write down your questions before your child’s appointment.</p>
<p>Often families seek advice from a doctor after they and/or the child’s teacher have expressed concerns about the child’s symptoms.</p>
<p>Once your child is in school, the health-care professional can find out if they are inattentive, impulsive or hyperactive in that setting as well as at home. Your child’s teacher will likely be asked to fill in structured questionnaires or rating scales as well as report cards to provide the information the health-care professional needs. A child will be diagnosed with ADHD only if their symptoms are excessive and persistent and cause difficulties at home and at school.</p>
<h2>Will a diagnosis be made right away?</h2>
<p>It will probably take two or three visits to the doctor to diagnose ADHD, as they will need time to collect information from your child's teacher and consider all the information that has been gathered.</p>||<h2>What happens after a diagnosis of ADHD?</h2>
<p>Once your child is diagnosed with ADHD, treatment can begin. You, your child's doctor or psychologist and the school will need to work together on a plan to manage your child’s ADHD.</p>
<p>This plan will begin with a thorough discussion about ADHD and possible treatments and supports for parents and for your child or teen. Next, a treatment plan is developed based on a clear discussion with you and your child about your needs and preferences.</p>
<p><a href="/Article?contentid=1998&language=English">Medication</a> is often an important part of treatment, but it is rarely enough to help a child do their best. Before starting a child on medication, many parents prefer to engage with other forms of treatment, such as <a href="/Article?contentid=1997&language=English">adapting their parenting style</a> for challenging behaviour and <a href="/Article?contentid=1999&language=English">working with the child’s school</a> to develop an individual education plan (IEP).</p>||<h2>Further information</h2><p>For more information on ADHD, please see the following pages:</p><p>
<a href="/Article?contentid=1922&language=English">ADHD: Overview</a></p><p>
<a href="/Article?contentid=1997&language=English">ADHD: How to help your child at home</a></p><p>
<a href="/Article?contentid=1999&language=English">ADHD: Communicating with your child's school</a></p><p>
<a href="/Article?contentid=1998&language=English">ADHD: Treatment with medications</a></p><h2>Resources</h2><p>The following resources offer support and additional information on ADHD.</p><h3>Websites</h3><p>
<a href="http://www.ldao.ca/" target="_blank">Learning Disabilities Association of Ontario</a></p><p>
<a href="http://www.caddac.ca/cms/page.php?2" target="_blank">Centre for ADHD Awareness, Canada - CADAC</a></p><h3>Journal articles</h3><p>Cortese, S. & Tessari, L. (2016).
<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5247534/" target="_blank">Attention-Deficit/Hyperactivity Disorder (ADHD) and Obesity: Update 2016</a>.
<em>Current Psychiatry Reports </em>19 (4) doi: 10.1007/s11920-017-0754-1.</p><p>Heinonen, K. et al (2010).
<a href="https://bmcpediatr.biomedcentral.com/articles/10.1186/1471-2431-10-91" target="_blank">Behavioural symptoms of attention deficit/hyperactivity disorder in preterm and term children born small and appropriate for gestational age: A longitudinal study</a>.
<em>BMC Pediatrics</em>. Dec 15 2010 10:91. doi: 10.1186/1471-2431-10-91.</p><p>Sucksdorff, M. et al (2015).
<a href="https://pediatrics.aappublications.org/content/136/3/e599..info" target="_blank">Preterm Birth and Poor Fetal Growth as Risk Factors of Attention-Deficit/ Hyperactivity Disorder</a>.
<em>Pediatrics</em> Sept 2015 136 (3) e599-e608. doi:10.1542/peds.2015-1043.</p>||https://assets.aboutkidshealth.ca/AKHAssets/ADHD_signs_and_symptoms.jpg||ADHD: Signs and symptoms||False|