Attention-deficit hyperactivity disorder

Attention-deficit/hyperactivity disorder (ADHD) is a chronic condition that affects millions of children and often persists into adulthood. Problems associated with ADHD include inattention and hyperactive, impulsive behavior. Children with ADHD may struggle with low self-esteem, troubled relationships and poor performance in school.

While treatment won't cure ADHD, it can help a great deal with symptoms. Treatment typically involves psychological counseling, medications or both.

A diagnosis of ADHD can be scary, and symptoms can be a challenge for parents and children alike. However, treatment can make a big difference, and the majority of children with ADHD grow up to be vibrant, active and successful adults.

ADHD has been called attention-deficit disorder (ADD) and hyperactivity. But ADHD is the preferred term because it describes both primary aspects of the condition: inattention and hyperactive-impulsive behavior.

While many children who have ADHD tend more toward one category than the other, most children have some combination of inattention and hyperactive-impulsive behavior. Signs and symptoms of ADHD become more apparent during activities that require focused mental effort.

In most children diagnosed with ADHD, signs and symptoms appear before the age of 7. In some children, signs of ADHD are noticeable as early as infancy.

Signs and symptoms of inattention may include:

* Often fails to pay close attention to details or makes careless mistakes in schoolwork or other activities
* Often has trouble sustaining attention during tasks or play
* Seems not to listen even when spoken to directly
* Has difficulty following through on instructions and often fails to finish schoolwork, chores or other tasks
* Often has problems organizing tasks or activities
* Avoids or dislikes tasks that require sustained mental effort, such as schoolwork or homework
* Frequently loses needed items, such as books, pencils, toys or tools
* Can be easily distracted
* Often forgetful

Signs and symptoms of hyperactive and impulsive behavior may include:

* Fidgets or squirms frequently
* Often leaves his or her seat in the classroom or in other situations when remaining seated is expected
* Often runs or climbs excessively when it's not appropriate or, if an adolescent, might constantly feel restless
* Frequently has difficulty playing quietly
* Always seems on the go
* Talks excessively
* Blurts out the answers before questions have been completely asked
* Frequently has difficulty waiting for his or her turn
* Often interrupts or intrudes on others' conversations or games

ADHD behaviors can be different in boys and girls.

* Boys are more likely to be hyperactive, whereas girls tend to be inattentive.
* Girls who have trouble paying attention often daydream, but inattentive boys are more likely to play or fiddle aimlessly.
* Boys tend to be less compliant with teachers and other adults, so their behavior is often more conspicuous.

You may suspect your child's behavior is caused by ADHD if you notice consistently inattentive or hyperactive, impulsive behavior that:

* Lasts more than six months
* Occurs in more than just one setting (typically at home and at school)
* Regularly disrupts school, play and other daily activities
* Causes problems in relationships with adults and other children

Normal behavior vs. ADHD
Most healthy children are inattentive, hyperactive or impulsive at one time or another. For instance, parents may worry that a 3-year-old who can't listen to a story from beginning to end may have ADHD. But preschoolers normally have a short attention span and aren't able to stick with one activity for long. Even in older children and adolescents, attention span often depends on the level of interest. Most teenagers can listen to music or talk to their friends for hours but may be a lot less focused about homework.

The same is true of hyperactivity. Young children are naturally energetic — they often wear their parents out long before they're tired. And they may become even more active when they're tired, hungry, anxious or in a new environment. In addition, some children just naturally have a higher activity level than do others. Children should never be classified as having ADHD just because they're different from their friends or siblings.

Children who have problems in school but get along well at home or with friends are not considered to have ADHD. The same is true of children who are hyperactive or inattentive only at home but whose schoolwork and friendships aren't affected by their behavior.

When to see a doctor
If your child has disruptive behaviors you think may be signs of ADHD, such as trouble concentrating, sitting still or controlling his or her behavior, see your pediatrician or family doctor. Your doctor may refer you to a specialist, but it's important to have a medical evaluation first to check for likely causes of your child's signs and symptoms.

If your child is already being treated for ADHD, he or she should see the doctor regularly — at least once during the month following diagnosis, and then at least every six months after that. Be sure to discuss how often your child should be seen for appointments with his or her doctor. Call the doctor if your child has any medication side effects, such as loss of appetite, trouble sleeping or increased irritability. Over time some children taking stimulant medications may also lose weight or grow more slowly, although these changes are usually temporary.