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Pediatric adhd symptoms


Attention-Deficit / Hyperactivity Disorder (ADHD) in Children

What is ADHD?

ADHD, also called attention-deficit disorder, is a behavior disorder, usually first diagnosed in childhood, that is characterized by inattention, impulsivity, and, in some cases, hyperactivity. These symptoms usually occur together; however, one may occur without the other(s).

The symptoms of hyperactivity, when present, are almost always apparent by the age of 7 and may be present in very young preschoolers. Inattention or attention-deficit may not be evident until a child faces the expectations of elementary school.

What are the different types of ADHD?

Three major types of ADHD include the following:

  • ADHD, combined type. This, the most common type of ADHD, is characterized by impulsive and hyperactive behaviors as well as inattention and distractibility.

  • ADHD, impulsive/hyperactive type. This, the least common type of ADHD, is characterized by impulsive and hyperactive behaviors without inattention and distractibility.

  • ADHD, inattentive and distractible type. This type of ADHD is characterized predominately by inattention and distractibility without hyperactivity.

What causes attention-deficit/hyperactivity disorder?

ADHD is one of the most researched areas in child and adolescent mental health. However, the precise cause of the disorder is still unknown. Available evidence suggests that ADHD is genetic. It is a brain-based biological disorder. Low levels of dopamine (a brain chemical), which is a neurotransmitter (a type of brain chemical), are found in children with ADHD. Brain imaging studies using PET scanners (positron emission tomography; a form of brain imaging that makes it possible to observe the human brain at work) show that brain metabolism in children with ADHD is lower in the areas of the brain that control attention, social judgment, and movement.

Who is affected by attention-deficit/hyperactivity disorder?

Estimates suggest that about 4% to 12% of children have ADHD. Boys are 2 to 3 times more likely to have ADHD of the hyperactive or combined type than girls.

Many parents of children with ADHD experienced symptoms of ADHD when they were younger. ADHD is commonly found in brothers and sisters within the same family. Most families seek help when their child's symptoms begin to interfere with learning and adjustment to the expectations of school and age-appropriate activities.

What are the symptoms of attention-deficit/hyperactivity disorder?

The following are the most common symptoms of ADHD. However, each child may experience symptoms differently. The 3 categories of symptoms of ADHD include the following:

  • Inattention:

    • Short attention span for age (difficulty sustaining attention)

    • Difficulty listening to others

    • Difficulty attending to details

    • Easily distracted

    • Forgetfulness

    • Poor organizational skills for age

    • Poor study skills for age

  • Impulsivity:

    • Often interrupts others

    • Has difficulty waiting for his or her turn in school and/or social games

    • Tends to blurt out answers instead of waiting to be called upon

    • Takes frequent risks, and often without thinking before acting

  • Hyperactivity:

    • Seems to be in constant motion; runs or climbs, at times with no apparent goal except motion

    • Has difficulty remaining in his/her seat even when it is expected

    • Fidgets with hands or squirms when in his or her seat; fidgeting excessively

    • Talks excessively

    • Has difficulty engaging in quiet activities

    • Loses or forgets things repeatedly and often

    • Inability to stay on task; shifts from one task to another without bringing any to completion

The symptoms of ADHD may resemble other medical conditions or behavior problems. Keep in mind that many of these symptoms may occur in children and teens who do not have ADHD. A key element in diagnosis is that the symptoms must significantly impair adaptive functioning in both home and school environments. Always consult your child's doctor for a diagnosis.

How is attention-deficit/hyperactivity disorder diagnosed?

ADHD is the most commonly diagnosed behavior disorder of childhood. A pediatrician, child psychiatrist, or a qualified mental health professional usually identifies ADHD in children. A detailed history of the child's behavior from parents and teachers, observations of the child's behavior, and psychoeducational testing contribute to making the diagnosis of ADHD. Because ADHD is a group of symptoms, diagnosis depends on evaluating results from several different sources, including physical, neurological, and psychological testing. Certain tests may be used to rule out other conditions, and some may be used to test intelligence and certain skill sets. Consult your child's doctor for more information.

Treatment for attention-deficit/hyperactivity disorder

Specific treatment for attention-deficit/hyperactivity disorder will be determined by your child's doctor based on:

  • Your child's age, overall health, and medical history

  • Extent of your child's symptoms

  • Your child's tolerance for specific medications or therapies

  • Expectations for the course of the condition

  • Your opinion or preference

Major components of treatment for children with ADHD include parental support and education in behavioral training, appropriate school placement, and medication. Treatment with a psychostimulant is highly effective in most children with ADHD.

Treatment may include:

  • Psychostimulant medications. These medications are used for their ability to balance chemicals in the brain that prohibit the child from maintaining attention and controlling impulses. They help "stimulate" or help the brain to focus and may be used to reduce the major characteristics of ADHD.
    Medications that are commonly used to treat ADHD include the following:

    • Methylphenidate (Ritalin, Metadate, Concerta, Methylin)

    • Dextroamphetamine (Dexedrine, Dextrostat)

    • A mixture of amphetamine salts (Adderall)

    • Atomoxetine (Strattera). A nonstimulant SNRI (selective serotonin norepinephrine reuptake inhibitor) medication with benefits for related mood symptoms. 

    • Lisdexamfetamine (Vyvanse)

    Psychostimulants have been used to treat childhood behavior disorders since the 1930s and have been widely studied. Traditional immediate release stimulants take effect in the body quickly, work for 1 to 4 hours, and then are eliminated from the body. Many long-acting stimulant medications are also available, lasting 8 to 9 hours, and requiring 1 daily dosing. Doses of stimulant medications need to be timed to match the child's school schedule to help the child pay attention for a longer period of time and improve classroom performance. The common side effects of stimulants may include, but are not limited to, the following:

    Most side effects of stimulant use are mild, decrease with regular use, and respond to dose changes. Always discuss potential side effects with your child's doctor.

    Antidepressant medications may also be administered for children and adolescents with ADHD to help improve attention while decreasing aggression, anxiety, and/or depression.

  • Psychosocial treatments. Parenting children with ADHD may be difficult and can present challenges that create stress within the family. Classes in behavior management skills for parents can help reduce stress for all family members. Training in behavior management skills for parents usually occurs in a group setting which encourages parent-to-parent support. Behavior management skills may include the following:

    Teachers may also be taught behavior management skills to use in the classroom setting. Training for teachers usually includes use of daily behavior reports that communicate in-school behaviors to parents. Behavior management techniques tend to improve targeted behaviors (such as completing school work or keeping the child's hands to himself or herself), but are not usually helpful in reducing overall inattention, hyperactivity, or impulsivity.

Prevention of attention-deficit/hyperactivity disorder

Preventive measures to reduce the incidence of ADHD in children are not known at this time. However, early detection and intervention can reduce the severity of symptoms, decrease the interference of behavioral symptoms on school functioning, enhance the child's normal growth and development, and improve the quality of life experienced by children or adolescents with ADHD.

The Signs of ADHD in Children and Adults

Attention deficit hyperactivity disorder (ADHD) is a complex neurodevelopmental disorder that can affect your ability to function in many different aspects of your life, such as at school, at work, and even at home.

Although ADHD can cause visible challenges in everyday life, the symptoms in children and adults vary and are sometimes difficult to recognize.

ADHD is generally diagnosed in children by the time they’re teenagers, with the average age for moderate ADHD diagnosis being 7 years old. Adults with ADHD may have exhibited elaborate symptoms early in life that were overlooked, leading to a late diagnosis later in life.

Below, we’ll discuss some of the common signs and symptoms of ADHD in children and adults, as well as tips for living with ADHD and where to find support.

ADHD primarily causes symptoms related to inattention, hyperactivity-impulsivity, or a combination of both.

With ADHD, someone may experience difficulties paying attention and staying organized, excess fidgeting or restlessness, and trouble with self-control or impulsive behaviors.

In children or toddlers with ADHD, this can lead to symptoms at home, in day care, or at school, such as:

  • trouble focusing on activities and becoming easily distracted
  • low attention span while playing or doing schoolwork
  • fidgeting, squirming, or otherwise having trouble sitting still
  • constantly needing movement or frequently running around
  • engaging in activities loudly or disruptively
  • excess talking and interrupting other people

Symptoms of ADHD in teenagers

As children with ADHD get older, the symptoms they experience may change. In some cases, certain symptoms seen in childhood may become less problematic in adolescence, while new symptoms can arise amidst the changing responsibilities that accompany growing older.

In adolescents and teenagers with ADHD, other symptoms that may appear can include:

  • difficulty focusing on schoolwork or other work
  • frequently making mistakes while doing work
  • trouble finishing tasks, especially schoolwork or chores
  • trouble with task organization and time management
  • frequently forgetting things or losing personal items
  • frequently avoiding mentally taxing tasks
  • experiencing increased frustration and emotional sensitivity
  • trouble navigating social and familial relationships
  • increased conflict with parents due to ADHD symptoms affecting the home life

It’s important to understand that while these symptoms of inattentiveness, hyperactivity, and impulsivity can sometimes cause adolescents and teenagers with this condition to appear “immature,” they are simply a part of ADHD and have nothing to do with a child’s maturity level.

Although most people with ADHD receive a diagnosis during childhood, sometimes the signs and symptoms of this condition are overlooked or misinterpreted.

But as long as the symptoms of ADHD have been present for that individual before 12 years of age, they can still receive a diagnosis in adulthood.

In adults, the symptoms of ADHD can appear different than those in adolescence or childhood due to the different responsibilities someone may have in adulthood. According to the literature, adults tend to experience:

  • difficulties at college or work
  • trouble passing classes or completing work
  • issues with self-esteem and overall mental well-being
  • substance misuse issues, especially with alcohol
  • relationship challenges with partners, family, or co-workers
  • frequent accidents or injuries

While ADHD affects people of all ages and genders, research suggests that ADHD is roughly four times as prevalent in males as it is in females.

The differences in ADHD between sex and genders are not just refined to the prevalence. In fact, ADHD can present differently in women than in men, which can further contribute to the reduced rate of diagnosis in women and girls.

A recent article published in BMC Psychiatry reviewed the research on different symptoms, co-occurring conditions, and the level of functioning in females who have ADHD.

According to the research, females often experience a mix of both inattentive and hyperactive-impulsive symptoms, many of which are less severe than their male counterparts, especially in the hyperactive-impulsive category.

Other notable differences in ADHD presentation in women and girls are:

  • more severe difficulties with mood changes and emotional regulation
  • a higher likelihood of severe social problems, especially with bullying
  • an increased risk of sexually transmitted infections (STIs) and pregnancy due to an increased number of sexual partners
  • more severe challenges in the areas of academics and self-esteem
  • increased behaviors used to compensate for difficulties at home, school, or work

In addition, ADHD symptoms seem to become more severe with age and during periods of transition, such as puberty and adulthood.

Hormonal changes, such as those that occur with menstruation, pregnancy, or menopause, can also cause an increase or worsening of ADHD symptoms.

ADHD in the transgender community

Most of the sources used in this article do not delineate between (and sometimes conflate) sex and gender and can be assumed to have primarily cisgender participants.

While research on ADHD within the transgender community is new, recent surveys state that transgender individuals are “significantly more likely” to report an ADHD diagnosis.

One study in Australia reports that ADHD is four times more common among transgender people than the cisgender population.

At the time of publication, no research could be found that discussed the breakdown of symptoms between trans men, trans women, and gender nonconforming people. Intersex people were also not represented.

When we look at the presentation of ADHD symptoms, age seems to be the biggest factor for differences in symptoms between individuals. However, ethnic and cultural differences can also play a significant role in the diagnosis and treatment of this condition.

According to research, differences in beliefs, values, and even medical approaches can impact the way that certain behaviors — many of which are the direct result of ADHD — are viewed.

In fact, various studies have shown that children who belong to marginalized ethnic groups are less likely to receive the correct diagnosis and treatment they need for their ADHD.

Other cultural factors that can influence the perception, diagnosis, and treatment of ADHD include:

  • lack of knowledge about the condition
  • fear of the stigma surrounding the condition
  • lack of trust in the medical system
  • reduced ability to recognize when symptoms are problematic
  • differences in the way certain behaviors are viewed between genders
  • language barriers for non-native English speakers
  • no access or limited access to insurance or healthcare services
  • lack of healthcare professionals who are culturally competent

All of these factors can play a role in the way that ADHD symptoms are viewed and can lead to barriers in the diagnosis and treatment of ADHD in historically marginalized communities.

Without treatment, ADHD can make it difficult to function at your best in your home life, at work or school, or even within your relationships.

If you believe that you, your child, or someone close to you is displaying signs of ADHD, reach out to a doctor or psychologist to ask about a potential diagnosis and start on the path to treatment.

If you’ve received an ADHD diagnosis, you might find the following treatment options can reduce symptoms and help you function better in your everyday life:

  • Therapy. Behavioral therapy is one of the most beneficial types of therapy for ADHD, especially for children and adolescents, because it helps identify the thoughts, feelings, and behaviors that are having the most impact.
    • In younger children with ADHD, behavioral therapies that focus on parent training, classroom management, and peer interventions are most effective.
    • In adolescents and adults, a type of behavioral therapy called cognitive behavioral therapy (CBT) can also be helpful.
  • Medication. Medications can be used alone or in conjunction with behavioral therapy to reduce the symptoms of ADHD in both children and adults.
    • According to research, psychostimulants — which are medications that increase the activity of the central nervous system — are the first-line medication for ADHD.
    • Other nonstimulant medication options for ADHD can include certain high blood pressure medications, antidepressants, antipsychotics, and mood stabilizers.
  • Lifestyle changes. Lifestyle changes for ADHD involve strategies that can help you work through the inattentiveness, hyperactivity, and impulsivity that the condition causes. Here are some helpful ways to create structure for yourself if you have ADHD:
    • Fine tune your study skills.
    • Create organizational techniques.
    • Implement time management strategies.

Getting support

It can feel overwhelming to receive a diagnosis of ADHD, but the most important thing to remember is that you’re not alone. If you’re looking for more support after your diagnosis, here are a few resources to get you started:

  • Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD). CHADD is an organization that focuses on providing information about ADHD, as well as resources related to support and advocacy for people with ADHD.
  • ADHD Foundation. The ADHD Foundation is a U.K.-based organization that provides education and resources for people living with ADHD, while also providing information for caretakers and professionals who care for individuals with ADHD.
  • Attention Deficit Disorder Association (ADDA). The ADDA is another organization that provides resources for people with ADHD, including a list of virtual support programs for different groups, such as People of Color, LGBTQIA+ individuals, and more.

ADHD is a neurodevelopmental condition that causes a person to experience inattention, hyperactivity-impulsivity, or a mixture of both.

In children, ADHD symptoms can sometimes be misunderstood by parents and caretakers, while untreated ADHD in adults can cause symptoms that significantly interfere with daily functioning.

With the right diagnosis and treatment, you can learn to manage the symptoms of ADHD and improve your overall quality of life.

Attention deficit hyperactivity disorder (ADHD) in children - description of the disease, causes, symptoms

Attention deficit hyperactivity disorder (ADHD) is a condition in which a child's activity and excitability exceed the norm.

Causes

  • Pregnancy complications: toxicosis, high blood pressure, intrauterine fetal asphyxia.
  • Violations of the normal lifestyle of a pregnant woman: difficult working conditions and bad habits, such as smoking.
  • Complications of the course of labor: prolonged or, conversely, rapid labor.

Symptoms almost always appear between 2 and 3 years of age. The average age of going to the doctor is 8-10 years: at this age, study and housework begin to require independence and concentration from the child.

Symptoms

  • Restlessness, fussiness, restlessness.
  • Impulsivity, emotional instability, tearfulness.
  • Ignoring the rules and norms of behavior.
  • Sleep problems.
  • Delayed speech development.
  • Tendency to perform simultaneously without completing several tasks at once.

Suspecting such violations in a child at any age, parents should definitely consult a neurologist for an examination, since sometimes the cause of hyperactive behavior in a child is another, more severe disease.

Of the additional methods, electro- and echoencephalography are used, in some cases - computed tomography, electroneuromyography, emission spectrometry, etc.

Prophylaxis

Correction of ADHD should include a set of techniques, i.e. be multimodal. The main directions are: physical activity, psychological and pedagogical correction, family psychotherapy, behavioral therapy, relaxation techniques, treatment of comorbidities.

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causes, symptoms, signs, diagnosis, treatment of attention deficit hyperactivity disorder in children and adults

Symptoms of ADHD in children

Causes of pathology

Diagnosis

Treatment methods for ADHD

Prevention


Today, more and more children are being diagnosed with ADHD (Attention Deficit Hyperactivity Disorder). As a rule, it is diagnosed in children aged 6-8 years, when the child goes to school. It is at this time that it becomes obvious that the child has pronounced problems with behavior and perception of information.

ADHD is a neurological-behavioral developmental disorder. Pathology makes itself felt in childhood, but in the absence of timely therapy, it can persist into adulthood. According to statistics, ADHD is most common in boys, but can also occur in girls. If the pathology is not diagnosed and treated in a timely manner, this is fraught with poor school performance, the child may develop serious social problems, which increases the risk of substance abuse in the future.

Symptoms of ADHD in children

Consider some of the signs that may signal ADHD in children:

  • The child is constantly distracted, inattentive, when communicating with him there is a feeling that he is not listening to you.
  • It is difficult for him to keep his attention on the teacher's words for a long time, because of which the understanding of information also suffers.
  • Increased activity is observed - the child literally cannot sit in one place. Even during school hours, he can get up and walk around the classroom.
  • The child is impatient, cannot wait for his turn, constantly interrupts, answers questions without waiting for them to finish.
  • Children with ADHD are characterized by emotional instability, which can be manifested by frequent mood swings: a child can suddenly become irritable, tearful, and restless for no reason.
  • Lack of concentration is characteristic - children with this diagnosis often lose their belongings (for example, school supplies, money, keys).
  • Problems with sleep and appetite, with daily routine.

Additionally, some neurological abnormalities may be observed. For example, a child with ADHD may have poor motor coordination, resulting in some clumsiness. Also, in some cases, twitching of the facial muscles and trembling of the limbs are observed.

The first signs of attention deficit hyperactivity disorder are observed at the age of 2-3 years, but at this age it is difficult to determine whether they are a manifestation of pathology or normal age-related features.

However, if by the age of 6-8 years the child has not become more attentive and collected, this is an alarming sign that makes it possible to assume ADHD with a high degree of probability. That is why, if you have the above symptoms, you should definitely consult a doctor and start treatment.

Causes of pathology

There is no single reason for the development of ADHD. Many experts agree that the most common cause may be genetic mutations that lead to a disruption in the production of dopamine and the work of dopamine receptors.

Also, the causes of the development of attention deficit hyperactivity disorder may be the following factors:

  • Severe pregnancy, complicated delivery, including prolonged or rapid.
  • Use by the expectant mother during pregnancy of potent drugs, alcoholic beverages, toxic substances.
  • Serious pathologies suffered by a child at an early age, including craniocerebral trauma.
  • Psychological trauma in a child.
  • Fetal asphyxia.

It is also worth noting that this pathology has a hereditary predisposition. It was found that the presence of ADHD in parents significantly increases the likelihood of developing this syndrome in a child.

Diagnostics

The diagnosis of ADHD is not established only on the basis of existing complaints. To accurately confirm the diagnosis, it is necessary to conduct some examinations. First of all, you need to visit a neurologist, psychiatrist and psychologist.

During the consultation, the doctor collects an anamnesis, conducts various tests, conversations, and diagnostic surveys.

In order to identify the cause of the development of ADHD, consultations with other specialists may also be required, as well as instrumental and laboratory examination methods, such as: EEG, MRI of the brain, general and biochemical blood tests.

Treatments for ADHD

It should be noted that attention deficit hyperactivity disorder most often has a favorable prognosis (provided that therapy is started in a timely manner). It is possible to significantly improve the behavior and learning of the child.

Depending on the severity of the pathological process and the causes of its occurrence, the doctor may prescribe such types of treatment as:

  • Medical treatment: the patient may be prescribed sedatives, antidepressants, neurostimulants.
  • Cognitive behavioral therapy.
  • A clear daily routine: a balanced diet, good sleep.
  • Family therapy: if there are conflicts in the family, ADHD often develops against this background.
  • Biofeedback therapy: this method of treatment is aimed at training the child's ability to self-regulate their conditions with the help of computer game tasks.
  • Physiotherapy techniques, eg massage, exercise, kinesiotherapy.

Additionally, other methods of treatment can be used.

Prophylaxis

Unfortunately, it is not always possible to prevent the development of ADHD. However, there are some factors that significantly reduce the risk of developing pathology. For example, the expectant mother should follow a healthy lifestyle, eat a balanced diet, give up bad habits. Before conception, it is desirable to undergo a complete examination, if necessary, to pre-treat existing pathologies.

Also, as a prevention of ADHD, the following recommendations should be observed:

  • The child should be active, walk outdoors more often.
  • The regimen of the day and meals must be clear.
  • Monitor the child's behavior, immediately stop unacceptable behavior on his part.
  • It is very important to build a trusting relationship between parents and children.
  • Family conflicts should be avoided.

At the first signs of ADHD, it is recommended to contact specialists who will help minimize the risk of developing more serious pathologies in the future.

You can learn more about the treatment of attention deficit hyperactivity disorder at a face-to-face appointment with a doctor. Be healthy!


Author of the article:

Markelov Gleb Vladimirovich

neurologist, online consultations

work experience 4 years

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