ADHD symptoms and diagnosis
Attention deficit hyperactivity disorder (ADHD) is a chronic (long lasting) condition that can have a serious impact on the lives of affected children, parents and families. ADHD is more common in boys than girls, and it can persist into adulthood.
From time to time, most children won’t pay attention or will seem ‘hyperactive’, but this doesn’t necessarily mean they have ADHD. For ADHD to be diagnosed, a child should have significant and ongoing problems in more than one setting — for example, at home and at school.
What causes ADHD?
ADHD is caused by problems with brain development — scientists believe that neurotransmitters (chemical messengers) in the brains of people with ADHD do not work properly. There also seem to be structural changes in the brain. Although the exact cause of ADHD remains a mystery, the following factors seem to be involved:
- genetic factors (several genes may be involved) — many children with ADHD have at least one close relative with the disorder;
- head injury;
- premature birth;
- infections of the brain and spinal cord;
- exposure of the developing fetus to tobacco, alcohol or other drugs; and
- environmental agents — high levels of lead may be associated with a raised risk of ADHD, and research continues into whether other chemicals may contribute to the disorder.
So far, research into whether diet significantly affects ADHD symptoms has been inconclusive.
Symptoms of ADHD
Children with ADHD can have problems with inattention (being unable to concentrate), hyperactivity (always being ‘on the go’) and impulsivity (lack of self-control). When assessing ADHD, hyperactivity and impulsivity tend to be grouped together.
| ADHD symptoms | |
|---|---|
| Inattention symptoms | Hyperactivity / impulsivity symptoms |
|
|
Some children mostly have inattention symptoms, others primarily have hyperactivity and impulsivity symptoms; however, most children have a mixture of both types. ADHD symptoms often emerge gradually over a period of many months.
Diagnosing ADHD
Sometimes a child’s teachers will be the ones to notice that something is wrong; in other cases the situation concerns parents or caretakers before a child starts having problems at school. However, the diagnosis of ADHD should only be made by a professional — your GP will generally refer you and your child to a paediatrician (specialist in children’s health) or a child psychiatrist for a thorough assessment. Other professionals such as child psychologists may also be involved.
For a diagnosis of ADHD, a child must have had symptoms for at least 6 months, and these must have started before the age of 7. The symptoms must be causing noticeable problems in at least 2 settings (such as home and school) — this ensures the child is not having issues just with a particular teacher. When assessing a child, doctors also take into account what’s appropriate for the child’s developmental level — for example, it’s normal for a preschooler to have a short attention span.
There is no single test for ADHD. Doctors have to rule out other disorders that might be causing the symptoms, such as hearing loss, learning disabilities or an overactive thyroid. To do this, the specialist will usually examine your child and ask you all about their medical and developmental history and current behaviour. The specialist will probably also ask for information from your child’s teachers.
As part of the diagnostic process, you will generally be asked to fill in questionnaires and specific rating scales concerning your child’s behaviour, and your child may need to undergo neuropsychological tests — a series of written and spoken questions. These can be time-consuming but they help give a fuller picture of your child’s mental state and development.
A mixed picture
At the end of this process, your child may be diagnosed with ADHD. This resolves confusion about their behavioural problems, and it can pave the way to moving forward with treatment.
However, the picture may be more complex than a diagnosis of ADHD alone. Children with ADHD commonly also have other conditions, such as anxiety, learning difficulties or disruptive behaviour disorders. These may be detected during the ADHD assessments. If so, remember that help is available for these disorders, as it is for ADHD, and seeking assistance will give your child the best chance of reaching their full potential.
Last Reviewed: 14 July 2007
