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by Riley J

Attention Deficit Hyperactivity Disorder and Attention Deficit Disorder

(ADHD and ADD; Hyperkinetic Syndrome; Hyperkinetic Impulse Disorder)

Definition

Attention deficit hyperactivity disorder (ADHD) is a change in the brain that can affect how you behave. It can make it hard to be still or pay attention. It can also make it hard to control some behavior. There are 3 types of ADHD:
  • Inattentive (classic "ADD")
  • Hyperactive-impulsive
  • Combined inattentive and hyperactive—the most common type

Causes

The exact cause of ADHD is not known. Changes may happen as the brain develops. Genes and thing or events in the world around you may both play a role.
Child's Brain
Child Brain
Copyright © Nucleus Medical Media, Inc.

Risk Factors

Things that increase the risk of ADHD include:
  • Having a parent, brother, or sister with ADHD
  • Smoking, alcohol, or drug use in mother during pregnancy
  • Toxins from the environment (like lead) during pregnancy or after
  • Premature birth and low birth weight
  • Brain injury

Symptoms

ADHD is often first noticed when you are a child. Some with mild symptoms may not be aware they have ADHD until they are older. Symptoms are always present. They occur in home, school and work. Symptoms that are only present in one area may not be ADHD.
Symptoms based on type of ADHD are:
  • Inattentive (classic "ADD")
    • Easily distracted by sights and sounds
    • Little or no attention to detail
    • Does not seem to listen when spoken to
    • Careless mistakes are common
    • Problems with follow through on instructions or tasks
    • Does not like activity that needs longer periods of mental effort
    • Loses or forgets things needed for tasks
    • Forgetful in day-to-day activities
  • Hyperactive-Impulsive
    • Restless, tends to fidget and squirm
    • Not able to stay seated, prefers to run and climb
    • Blurts out answers before hearing the entire question
    • Hard time playing quietly
    • Talks more than needed
    • Interrupts others
    • Has difficulty waiting in line or waiting for a turn
  • Combined ADHD—mix of the symptoms above.
All children have some of these problems at some point. Children with ADHD have more severe symptoms. They will also occur more often.
In adults, these symptoms can cause problems with relationships and work. They can make it difficult to do a job well or keep a job.
Other health or behaviors that are more common in those with ADHD include:

Diagnosis

There is no standard test for ADHD. A trained health professional will make a diagnosis. They will observe you or your child and talk to family, caregivers, and teachers.
A doctor will also rule out any other health issues that may be causing problems.

Treatment

ADHD is a lifelong condition. The effects of ADHD can be managed with treatment. The goal of treatment is to improve ability to grow or succeed, and have healthy relationships. Doctors should work together with parents, school staff, and other health professionals. Together, they can set realistic goals and keep an eye on the child's response. Proper treatment can prevent problems later in life.
Treatments include:

Sleep

Children who do not sleep enough may suffer from worse behavioral problems. A key part of treatment is to ensure that children with ADHD get plenty of sleep.

Medicine

Medicine may be used alone or with therapy in people over 6 years of age. It can help to control behavior and increase focus.
Stimulants are the most common type of medicine used to treat ADHD. They increase activity in parts of the brain that seem to be less active in those with ADHD. There are different types of medicine. The medical team will work with patients to find what works best. They will also work to balance benefit and risk of each medicine.
Other medicine choices are:
  • Selective norepinephrine reuptake inhibitors—to improve attention and decrease impulsiveness and hyperactivity
  • Antidepressants—to manage depression symptoms
  • Antipsychotics—to treat aggressive behavior
  • Certain blood pressure lowering medication—to treat impulsivity

Behavior Therapy

Therapy may be all that is needed for younger children. Therapy can also help children who take medicine do better.
Therapy will help by teaching new social and problem solving skills. Parents and teachers will also be shown ways to help their children adapt. This may include changes in the classroom, as well as changes to how they parent. For example, an air cushion on a child's seat at school allows the child to move their body without distracting other students. Moving their body may help them increase their attention span.
ADHD coaching can also be helpful for older children and adults. Coaches work with people to help them organize and be more successful.

Prevention

There are no current guidelines to prevent ADHD because the cause is unclear.

RESOURCES

Attention Deficit Disorder Association
https://www.add.org
Children and Adults with Attention-Deficit/Hyperactivity Disorder
http://www.chadd.org

CANADIAN RESOURCES

About Kids Health—The Hospital for Sick Children
http://www.aboutkidshealth.ca
Canadian Psychiatric Association
http://www.cpa-apc.org

References

Alternative treatments for ADHD in children. EBSCO DynaMed website. Available at: http://www.dynamed.com/topics/dmp~AN~T908158/Alternative-treatments-for-ADHD-in-children . Accessed July 22, 2020.
Attention-deficit hyperactivity disorder (ADHD). Family Doctor—American Academy of Family Physicians website. Available at: https://familydoctor.org/condition/attention-deficit-hyperactivity-disorder-adhd. Accessed July 22, 2020.
Attention deficit hyperactivity disorder (ADHD) in adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/attention-deficit-hyperactivity-disorder-adhd-in-adults . Accessed July 22, 2020.
Attention-deficit hyperactivity disorder (ADHD) in children. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/attention-deficit-hyperactivity-disorder-adhd-in-children-and-adolescents . Accessed July 22, 2020.
Diagnosing ADHD in children: Guidelines & information for parents. Healthy Children—American Academy of Pediatrics website. Available at: https://www.healthychildren.org/English/health-issues/conditions/adhd/Pages/Diagnosing-ADHD-in-Children-Guidelines-Information-for-Parents.aspx. Accessed July 22, 2020.
Attention-deficit hyperactivity disorder (ADHD). National Institute of Mental Health website. Available at: https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtml#part%5F145446. Accessed July 22, 2020.
Medications for attention deficit hyperactivity disorder (ADHD) in children. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/attention-deficit-hyperactivity-disorder-adhd-in-children-and-adolescents . Accessed July 22, 2020.
Understanding ADHD: Information for parents. Healthy Children—American Academy of Pediatrics website. Available at: https://www.healthychildren.org/English/health-issues/conditions/adhd/Pages/Understanding-ADHD.aspx. Accessed July 22, 2020.
11/29/2017 DynaMed Plus Systematic Literature Surveillance https://www.dynamed.com/topics/dmp~AN~T113926/Attention-deficit-hyperactivity-disorder-ADHD-in-children-and-adolescents : Man KKC, Chan EW, et al. Prenatal antidepressant use and risk of attention-deficit/hyperactivity disorder in offspring: population based cohort study. BMJ. 2017 May 31;357:j2350.
6/3/2019 DynaMed Systematic Literature Surveillance https://www.dynamed.com/topics/dmp~AN~T113926/Attention-deficit-hyperactivity-disorder-ADHD-in-children-and-adolescents : Maher GM, O'Keefe GW, et al. Association of hypertensive disorders of pregnancy with risk of neurodevelopmental disorders in offspring: A systematic review and meta-analysis. JAMA Psychiatry. 2018 Aug 1;75(8)809-819.

Revision Information

  • Reviewer: EBSCO Medical Review Board Adrian Preda, MD
  • Review Date: 07/2020
  • Update Date: 07/22/2020
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