ADHD in children, or attention deficit hyperactivity disorder in children (kids), is a common neurodevelopmental condition that affects behavior, causing difficulty in paying attention, staying focused, and controlling impulses. Kids with ADHD often display symptoms such as inattention, hyperactivity, and impulsivity, which can interfere with their learning, social interactions, and daily functioning. The exact causes of ADHD in kids are not fully understood, but genetic, environmental, and neurological factors are believed to play a role. Early diagnosis and appropriate treatment, including behavioral therapy and medication, can help manage symptoms and improve the quality of life for children with ADHD. The purpose of this discussion is to offer a comprehensive overview of attention deficit hyperactivity disorder in young children causes and symptoms, helping caregivers and professionals recognize symptoms early, understand the underlying causes, and explore effective treatment options.
Table of Contents
What is ADHD?
What is ADHD? Attention deficit hyperactivity disorder (ADHD) is a complex neurodevelopmental disorder that can affect individuals across the lifespan. It is associated with widespread heterogeneity in terms of causes, clinical presentations, and treatment outcomes. ADHD is primarily characterized by developmentally inappropriate, persistent, and impaired levels of inattention, hyperactivity, and impulsivity resulting from a widespread and subtle alteration of gene expressions in multiple brain regions affecting brain function. Attention Deficit Hyperactivity Disorder globally affects 5% – 7.2% of youth and 2.5% – 6.7% of adults.
What Is ADHD in Children?
ADHD attention-deficit hyperactivity disorder in children is a common neurodevelopmental condition that affects behavior, causing difficulty in paying attention, staying focused, and controlling impulses. Recent estimates indicate that prevalence is even higher in children in the United States (U.S.), around 8.7% or 5.3 million. Although it has long been conceptualized as a disorder of childhood, up to 90% of children with ADHD continue to experience symptoms into adulthood. Obtaining a diagnosis in adulthood is also possible, as in one study, 75% of adults with ADHD were not previously diagnosed in childhood. While in childhood the male to female ratio is 4:1, the ratio is closer to 1:1 in adults.
ADHD has been most commonly diagnosed in school-age children, but it can occur in any age group. Emerging evidence also suggests that ADHD is among the biggest contributors to the global burden of disease in children and adolescents and evidence suggests that the cost of raising children with ADHD is considerably high when compared with raising children without such disorder. the prevalence of ADHD in children and adolescent ranged from 5.9 to 14 %.
Childhood ADHD Types
A series of articles have suggested six clinical latent classes of ADHD, including:
- moderate inattentive
- moderate combined,
- moderate hyperactive
- severe combed
- severe inattentive
- and hyperactive
However, these latent classes have also not yet been successfully externally validated or translated into clinical practice. Intermediate phenotypes like executive function have also been suggested as having utility for parsing the heterogeneity of ADHD such that there may be a group of children with ADHD who also experience executive dysfunction, best captured by an executive dysfunction subtype(s). Yet, this idea has received relatively little empirical attention, and preliminary data suggest that this idea has limited clinical utility, at least so far.
Symptoms of ADHD in Children
Attention deficit hyperactivity disorder symptoms in children vary from child to child. ADHD symptoms in kids often include difficulty focusing, impulsivity, and excessive fidgeting or restlessness. Symptoms of attention deficit hyperactivity disorder (ADHD) in kids tend to show a combination of these key signs:
- Inattention (Symptoms of inattention in children are: having a short attention span and being easily distracted. making careless mistakes – for example, in schoolwork. appearing forgetful or losing things)
- Impulsivity
- Hyperactivity (Symptoms of hyperactivity in children are: Kids who are hyperactive are fidgety, restless, and easily bored. They may have trouble sitting still, or staying quiet when needed. They may rush through things and make careless mistakes. They may climb, jump, or roughhouse when they shouldn’t)
Signs of hyperactivity and impulsivity include:
- Fidgeting
- Squirming
- A hard time sitting still for quiet tasks
- Running or climbing at inappropriate times
- Talking too much or interrupting
- Trouble waiting their turn
- Signs of inattention include:
- Trouble with finishing tasks
- Losing things often
- Forgetfulness
- Disorganization
- Being easily distracted
- Making careless mistakes
- Seeming not to listen
ADHD in children checklist
As a parent or carer, you may be wondering how to distinguish typical childhood behavior from potential signs of ADHD in children behaviour. This ADHD symptoms in children checklist aims to empower parents by highlighting some common behavioral patterns to look out for. ADHD in children signs:
- Your child’s apparent inability to sit still constantly disrupts classrooms;
- You’ve noticed them flitting between tasks and activities seemingly at random, struggling to see any through to completion;
- Frequent mood swings are impacting life at home;
- Or consistent forgetfulness is damaging academic performance.
Facts about ADHD in children
Kids with ADHD might:
- have trouble listening and paying attention.
- need lots of reminders to do things.
- get distracted easily.
- seem absent-minded.
- be disorganized and lose things.
- not sit still, wait their turn, or be patient.
- rush through homework or other tasks or make careless mistakes.
Causes of ADHD in Children
Attention Deficit Hyperactivity Disorder is thought to be caused by a combination of factors: genetic, neurobiologic, and environmental. Twin studies show that ADHD is highly hereditable (60–70%), and scientists have identified a number of genes believed to underlie vulnerability to the disorder. This includes genes that regulate the expression of Brain Derived Neurotrophic Factor, which plays a role in learning and memory, as well as those involved in modulation of the brain’s dopaminergic system. Environmental risk factors like perinatal complications and toxic exposures are also believed to play a role.
Pathophysiology
The pathophysiological mechanisms of ADHD are not yet adequately understood. On the basis of the available study findings, ADHD is presumed to be multifactorial in most cases. Genetic factors and early environmental risk factors that interact in complex ways to affect the structural and functional development of the brain play a major role and account for a high degree of etiological heterogeneity. Each individual factor accounts for only a small part of the variance, i.e., each one is relevant only to a small percentage of affected persons or else has only a weak effect.
Genetics
ADHD tends to run in families. First-degree relatives have a five- to tenfold increased risk of developing ADHD. Twin studies have revealed a high degree of heritability. 70–80% of the phenotypic variance is attributable to genetic factors, sometimes in interaction with environmental factors (epigenetic changes in gene expression due to specific environmental factors). The remaining variance is explained by pre-, peri-, and postnatal environmental factors that twin siblings do not share. Shared environmental effects are of secondary importance.
Meta- analyses of candidate gene studies have shown that genes encoding the receptors and transporters of the catecholaminergic and serotonergic neurotransmitter systems play a role in the etiology of the disorder. Moreover, nicotinergic and glutamatergic systems and genes regulating neural development and synaptogenesis also play a role in the etiology of ADHD. Genome-wide association studies have revealed many other potential risk variants, and their findings suggest that some 40% of the genetically determined variance is due to common variants.
There are a number of genetic syndromes which are known to be associated with the symptoms of ADHD, including fragile X syndrome, microdeletion 22q11 syndrome, tuberous sclerosis, and Williams–Beuren syndrome.
Environmental risk factors
Epidemiological studies have shown associations between ADHD and various environmental factors. These primarily include pre- and perinatal risk factors (maternal stress, smoking or alcohol consumption during pregnancy, low birth weight, prematurity), environmental toxins (organophosphates, polychlorinated biphenyls, lead), unfavorable psychosocial conditions (severe early-childhood deprivation, maternal hostility), and dietetic factors. The causal role of
Multiple studies have shown that negative mother–child interactions can be a result (but not a cause) of ADHD symptoms in early childhood, but that maternal hostility negatively influences symptoms in the further course of the disorder (e28, e29). The associations of ADHD with prenatal exposure to maternal stress and maternal smoking seem to be partially due to confounding factors, although the association of ADHD with low birth weight, prematurity and lead exposure is probably not explained by confounding variables;
Neuropsychology
Studies have shown various neuropsychological impairments in the area of executive functions (inhibitory control, working memory, planning ability) and non-executive functions (regulation of activation and arousal, temporal processing, memory, reaction-time variability). However, only about half of all persons with ADHD have marked neuropsychological impairment. Currently, it is unclear whether the associated abnormalities are of causal relevance or should rather be seen as epi-phenomena of the etiological mechanisms
Global brain volume is reduced by 3–5%, with the gray matter preferentially affected. More marked volume loss, correlated with the severity of the symptoms of ADHD, is seen in the prefrontal areas, the basal ganglia, and the cerebellum.
The persistence of ADHD symptoms into adulthood is correlated with the persistence of these neuroanatomical abnormalities. Functional imaging reveals hypoactive activation patterns in the prefrontal cortical areas, the anterior cingulate gyrus, and associated parietal, striatal, and cerebellar structures.
ADHD in Children Diagnosis
No specific test can diagnose ADHD, and the DSM-5 requires the presence of a sufficient number of core symptoms and functional impairment. A positive family history for ADHD is supportive of an ADHD diagnosis. Physicians who inherit a patient with a previous ADHD diagnosis should review the diagnostic process, and current symptoms and treatment needs. Rating scales should be included in the medical record to monitor progress and adjust treatment accordingly.
Attention deficit hyperactivity disorder in children scale
There are multiple scales used to assess attention deficit hyperactivity disorder (ADHD) in children, including:
ADHD Rating Scale (ADHD-RS)
A parent or teacher can use this inventory to rate a child’s behavior over the past six months. The ADHD-RS-5 is the current version of the scale, which is in correlation with the DSM-5. The scale uses a four-point Likert scale to rate the frequency of each symptom, with a total score range of 0 to 54.
Vanderbilt ADHD Diagnostic Rating Scale
This scale is often used by healthcare professionals to diagnose ADHD in children ages 5 to 12. There are two versions of the scale, one for parents and one for teachers. A healthcare professional will consider diagnosing ADHD if a child scores a 2 or 3 on at least six behaviors that indicate hyperactivity or inattention.
ADHD Current Symptoms Scale (ADHD CSS)
This scale is also known as the Barkley Current Symptoms Scale. It can be used by either the parent or the child to report on current ADHD symptoms. The scale uses four answer choices for each item: never or rarely, sometimes, often, and very often.
Children with ADHD are most commonly diagnosed by pediatricians or other primary care physicians (53%); approximately 14% of children with ADHD received their diagnosis from a psychologist. Neuropsychological tests are useful in psychological testing for ADHD because Pediatric Neuropsychology can provide information about the underlying neurocognitive processes that may contribute to ADHD symptoms. Dr. Mahone recommends that parents look for the following signs of ADHD in children aged 3 or 4 that are associated with an ADHD diagnosis when children reach school age: Dislikes or avoiding activities that require paying attention for more than one or two minutes.
Childhood ADHD Treatment
ADHD is generally treated in the outpatient setting. If outpatient treatment fails due to poor compliance, inadequate family resources, difficult drug adjustments, or impending expulsion from school, it may be necessary to conduct partial or full inpatient treatment. Certain differential diagnostic questions or a complex burden of comorbidities constitute further possible reasons for inpatient treatment. ADHD in children and how to help them manage it can involve behavioral therapy, structured routines, and clear communication strategies.
There are a number of effective treatments available to reduce ADHD symptoms and related impairments. Current best practices for child ADHD treatment comprise:
- psychoeducation,
- pharmacotherapy
- behavioral treatments
Recommendations for the use of medication and behavior therapy are age specific. Behavior therapy in the form of parent training is recommended as the first-line treatment for children younger than 6 years, whereas a combination of medication and behavior therapy is recommended for children aged 6–11 years; medication is recommended for adolescents aged 12–17 years with encouragement for it to be delivered in combination with behavioral interventions if available.
The decision for drug treatment should be made only after careful consideration in all cases, as should the further decisions about when to treat, for what duration, and at what dosage. Behavioral therapy is always preferable to drug therapy for preschool children and for school-age children with only mild symptoms. Primary treatment with drugs is indicated from school age onward in the case of pronounced and situationally independent ADHD symptoms that are causing marked functional impairment. Moreover, there is evidence to support primary drug treatment for some children with moderate ADHD symptoms.
In addition to parent training, behavioral classroom management, behavioral peer interventions, and organizational training have demonstrated well-established effectiveness.
Now, the question is, how do we know if your child needs a neuropsychological evaluation for ADHD? Watch the video below in full to answer this question.
How Parents Can Help?
Parents can find valuable resources and strategies offering help for ADHD in kids, promoting better focus, behavior, and learning outcomes. Behavioral parent management training and cognitive–behavioral therapy (CBT) for ADHD are common non-pharmacological interventions for children with ADHD. When parenting a child with ADHD, it is important to understand how your actions may impact your child’s ADHD symptoms. Emphasize consistency at home, and advocate for your child at school. Complications of ADHD in children can include difficulties in school performance, strained relationships with peers and family, and increased risk of behavioral issues. Helping a child with ADHD requires patience, understanding, and tailored strategies to support their focus and emotional well-being.
Parenting tips for children with ADHD
here are best parenting tips for children with attention deficit hyperactivity disorder.
- Discipline and ADHD in Children: Research shows that inconsistent discipline is a common thread in the homes of children who have ADHD. Disciplining consistently will set clear standards for your child, and help them feel regulated despite their ADHD symptoms.
- Allow anxiety to run your life: Living with ADHD can be overwhelming, and your child may struggle. Don’t allow their anxiety to take you over too. Instead, show them how to remain calm and confident even when life gets complicated.
- Forget that your child is a child: As you become involved with helping your child to manage their ADHD, don’t forget that your child is a child. Learning the tools you provide takes time, so be patient and let them know that you are proud as long as they are trying.
- Let their behavior get out of control: Early intervention will hugely benefit a child with ADHD as they age. Don’t wait too long to seek out professionals who specialize in ADHD. Asking for help does not make you a failure. It makes you a responsible parent setting your child up for success.
Living with childhood ADHD and managing ADHD in children can be both challenging and rewarding, as it requires patience, creativity, and understanding to help children thrive despite their unique obstacles.
It’s good to hear episode The Tie Between ADHD & Anxiety of Journey With Me Through ADHD: A podcast for kids by Dr. Katelyn Mabry.
Conclusion
In conclusion, ADHD in children is a neurodevelopmental disorder characterized by symptoms such as inattention, hyperactivity, and impulsivity that can affect a child’s academic, social, and emotional functioning. The exact causes are multifactorial, involving genetic, environmental, and neurological factors. Early diagnosis and intervention are crucial for managing ADHD in kids, and treatment options typically include a combination of behavioral therapies, medication, and support systems at home and school. With appropriate care, children with ADHD can develop strategies to manage their symptoms and thrive in various aspects of their lives.
Frequently Asked Questions about ADHD
Frequently Asked Questions about attention deficit hyperactivity disorder in children (kids)
Can ADHD cause headaches in children?
Children with ADHD may be twice as likely to experience headaches as are children without ADHD. Children with ADHD are also at greater risk for migraines.
Does ADHD cause violent behavior in children?
Challenges with aggressive behaviors are common in children with ADHD, and these outbursts and physical displays may be disruptive and harmful to these children or those around them.
Does smoking cigarettes while pregnant cause ADHD in children?
parental smoking or exposure to nicotine during pregnancy were the risk factors for offspring developing ADHD.
What does ADHD look like in a 5-year-old?
Because they are hyperactive, kids with ADHD may: climb, jump, or roughhouse when it’s time to play quietly. fidget and seem unable to sit still. rush instead of take their time.
What age is hardest for kids with ADHD?
Usually, the most difficult times for persons with ADHD are their years from middle school through the first few years after high school.
Is ADHD genetic?
ADHD tends to run in families and, in most cases, it’s thought the genes you inherit from your parents are a significant factor in developing the condition.
How to reduce impulsivity in ADHD child?
Techniques like breath awareness and mindfulness meditation can help improve impulse control.
How to stop ADHD child swearing?
To help your child behave, tell them exactly what you would like them to do. Explain what behavior is okay and show them good behavior so they can copy it
How to help an ADHD child focus?
Give praise and rewards when rules are followed. Give practical directions or commands. Establish healthy habits. Develop routines around homework and chores. Help your child build relationships, develop strong social skills and maintain friendships.
How to explain ADHD to a child?
Some recommendations from Ms. Tamanini: Don’t say, “You are ADHD.” Your child is not a medical diagnosis. Try saying, “ADHD is just something you have, but it doesn’t define who you are today or who you will grow up to be.”
Reference
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https://pubmed.ncbi.nlm.nih.gov/30301823
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