What Are the Symptoms of ADHD? 3 Types

Most children have difficulty focusing and behaving at some point, but children with attention deficit hyperactivity disorder (ADHD) do not grow out of these behaviors and symptoms can cause difficulty at school, at home, and with friends.

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder of childhood characterized by symptoms of inattention, hyperactivity, and impulsivity. Symptoms may continue into adulthood. 

About 8 to 10 percent of children aged 4 to 17 years have ADHD and the disorder occurs two to four times more often among boys than girls.

There are three different types of ADHD:

• Predominantly inattentive presentation (previously known as attention deficit disorder or ADD)
  • Difficulty organizing or finishing tasks
  • Difficulty paying attention to details or following instructions or conversations
  • Easily distracted 
  • Forgets details of daily routines
• Predominantly hyperactive-impulsive presentation
  • Fidgets and talks a lot
  • Has difficulty sitting still for long 
  • Smaller children may run, jump, or climb incessantly
  • Restlessness and impulsivity
  • Difficulty waiting for one’s turn or listening to directions
  • May have more accidents and injuries 
• Combined presentation
  • Symptoms of the above two types are equally present 

Most children have difficulty focusing and behaving at some point, but children with attention deficit hyperactivity disorder (ADHD) do not grow out of these behaviors and symptoms can cause difficulty at school, at home, and with friends.

Symptoms of attention deficit hyperactivity disorder (ADHD) include: 

• Hyperactivity
  • Symptoms are usually present by the time a child is four years old and tend to increase over the next three to four years
  • Symptoms may peak in severity when a child is seven to eight years of age, then begin to decline
  • By adolescence, hyperactive symptoms may be less noticeable, although ADHD may still be present
  • Excessive fidgeting or squirming
  • Excessive talking
  • Difficulty remaining seated 
  • Difficulty playing quietly
  • Frequent restlessness 
  • Always seems to be "on the go"
• Impulsivity
  • Similar to hyperactive symptoms, impulsive symptoms are usually present by the time a child is four years old and increase during the next three to four years to peak when a child is seven to eight years of age
  • Impulsive symptoms tend to continue to be a problem throughout a person’s life
  • Almost always occurs with hyperactivity in younger children
    • Difficulty waiting for turns
    • Blurting out answers too quickly
    • Disruptive classroom behavior
    • Intruding on or interrupting others' activities
    • Difficulty getting along with others/rejection by classmates
    • Unintentional injury
    • Taking unnecessary risks
    • Difficulty resisting temptation
• Inattention
  • These problems may become more apparent in school when a child is eight to nine years old
  • Inattention is most likely to persist through adolescence and potentially into adulthood
  • Forgetfulness
  • Being easily distracted
  • Losing or misplacing things
  • Disorganization
  • Underachievement in school
  • Making careless mistakes
  • Poor follow-through with assignments or tasks
  • Inability to concentrate
  • Lack of attention to detail
  • Daydreaming

The cause of attention deficit hyperactivity disorder (ADHD) is unknown, but genetics are believed to play a role. 

Other possible causes and risk factors for attention deficit hyperactivity disorder (ADHD) include:

• Brain injury
• Certain environmental exposures (e.g., lead) during pregnancy or at a young age
• Alcohol and tobacco use during pregnancy
• Premature delivery
• Low birth weight

There is no evidence ADHD is caused by: 

• Dietary factors (food additives, sugar, food sensitivity, mineral deficiency)
• Watching too much television
• Parenting
• Vaccines
• Social and environmental factors such as poverty or family chaos

These factors may worsen symptoms in some people, but they do not cause the disorder.

There is no single test used to diagnose attention deficit hyperactivity disorder (ADHD). Doctors must first rule out other possible conditions that may have similar symptoms. Tests may include a medical exam and hearing and vision tests.

The diagnostic criteria defined by the American Psychiatric Association for ADHD include:

• Symptoms must be present in more than one setting (e.g., school and home)
• Symptoms must persist for at least six months
• Symptoms must be present before the age of 12 years
• Symptoms must impair function in academic, social, or occupational activities
• Symptoms must be excessive for the age of the child
• Other mental disorders that could account for the symptoms must be excluded

Attention deficit hyperactivity disorder (ADHD) is usually treated with a combination of behavior therapy and medication. 

Behavioral treatments usually are recommended for preschool-aged children before medications are prescribed. School-aged children with ADHD usually do well with stimulant medicine plus behavioral treatments and counseling if needed. Medications do not cure ADHD, and behavioral treatments are usually needed to help a child learn to follow rules, stay motivated, and work well with others. 

Medications used to treat attention deficit hyperactivity disorder (ADHD) include: 

• Stimulants
  • Methylphenidate (Concerta, Focalin, Metadate, Methylin, Ritalin, Daytrana) 
  • Amphetamines (Adderall, Dexedrine, Dextrostat, Vyvanse)
    • Despite being stimulants, these medications do not cause children with ADHD to become more stimulated, but rather they work to improve attention, concentration, and self-control
• Atomoxetine (Strattera) is a non-stimulant medicine used as an alternative 

Behavioral treatments for attention deficit hyperactivity disorder (ADHD) include:

• Maintaining a schedule
• Keeping distractions to a minimum
• Providing specific places for the child to keep school work, toys, and clothes
• Setting reachable and clear goals
• Rewarding positive behavior 
• Using charts and checklists to help the child stay focused on the task at hand
• Taking physical activity breaks during tasks that require attention
• Limiting choices
• Finding activities such as sports or hobbies where the child can be successful 
• Using calm discipline such as time outs, distractions, or removing the child from the situation

In school, teachers may be able to help students with ADHD:

• Writing homework assignments down
• Having the child sit near the front of the classroom
• Having the teacher allow the child extra time to complete school work
• Giving the child a private signal when they veer “off-task”
• Providing a daily report card for parents to help monitor the child's symptoms and evaluate how well the current ADHD treatment plan is working