Attention-deficit/hyperactivity disorder (ADHD) in children

Attention-deficit/hyperactivity disorder (ADHD) is a chronic condition that ... ADHD symptoms start before age 12, and in some children, ... June 25, 2019 ... COVID-19:Advice,updatesandvaccineoptions Weareopenforsafein-personcare. Learnmore: MayoClinicfactsaboutcoronavirusdisease2019(COVID-19) OurCOVID-19patientandvisitorguidelines,plustrustedhealthinformation Lateston COVID-19vaccination bysite: Arizonapatientvaccinationupdates Arizona, Floridapatientvaccinationupdates Florida, Rochesterpatientvaccinationupdates Rochesterand MayoClinicHealthSystempatientvaccinationupdates MCHS Skiptositenavigation SkiptoContent ThiscontentdoesnothaveanEnglishversion.ThiscontentdoesnothaveanArabicversion. SectionsforAttention-deficit/hyperactivitydisorder(ADHD)inchildrenSymptoms&causesDiagnosis&treatmentDoctors&departmentsCareatMayoClinic Print OverviewAttention-deficit/hyperactivitydisorder(ADHD)isachronicconditionthataffectsmillionsofchildrenandoftencontinuesintoadulthood.ADHDincludesacombinationofpersistentproblems,suchasdifficultysustainingattention,hyperactivityandimpulsivebehavior. ChildrenwithADHDmayalsostrugglewithlowself-esteem,troubledrelationshipsandpoorperformanceinschool.Symptomssometimeslessenwithage.However,somepeoplenevercompletelyoutgrowtheirADHDsymptoms.Buttheycanlearnstrategiestobesuccessful. Whiletreatmentwon'tcureADHD,itcanhelpagreatdealwithsymptoms.Treatmenttypicallyinvolvesmedicationsandbehavioralinterventions.Earlydiagnosisandtreatmentcanmakeabigdifferenceinoutcome.Products&ServicesBook:MayoClinicGuidetoRaisingaHealthyChild SymptomsTheprimaryfeaturesofADHDincludeinattentionandhyperactive-impulsivebehavior.ADHDsymptomsstartbeforeage12,andinsomechildren,they'renoticeableasearlyas3yearsofage.ADHDsymptomscanbemild,moderateorsevere,andtheymaycontinueintoadulthood. ADHDoccursmoreofteninmalesthaninfemales,andbehaviorscanbedifferentinboysandgirls.Forexample,boysmaybemorehyperactiveandgirlsmaytendtobequietlyinattentive. TherearethreesubtypesofADHD: Predominantlyinattentive.Themajorityofsymptomsfallunderinattention. Predominantlyhyperactive/impulsive.Themajorityofsymptomsarehyperactiveandimpulsive. Combined.Thisisamixofinattentivesymptomsandhyperactive/impulsivesymptoms. InattentionAchildwhoshowsapatternofinattentionmayoften: Failtopaycloseattentiontodetailsormakecarelessmistakesinschoolwork Havetroublestayingfocusedintasksorplay Appearnottolisten,evenwhenspokentodirectly Havedifficultyfollowingthroughoninstructionsandfailtofinishschoolworkorchores Havetroubleorganizingtasksandactivities Avoidordisliketasksthatrequirefocusedmentaleffort,suchashomework Loseitemsneededfortasksoractivities,forexample,toys,schoolassignments,pencils Beeasilydistracted Forgettodosomedailyactivities,suchasforgettingtodochores HyperactivityandimpulsivityAchildwhoshowsapatternofhyperactiveandimpulsivesymptomsmayoften: Fidgetwithortaphisorherhandsorfeet,orsquirmintheseat Havedifficultystayingseatedintheclassroomorinothersituations Beonthego,inconstantmotion Runaroundorclimbinsituationswhenit'snotappropriate Havetroubleplayingordoinganactivityquietly Talktoomuch Blurtoutanswers,interruptingthequestioner Havedifficultywaitingforhisorherturn Interruptorintrudeonothers'conversations,gamesoractivities Typicaldevelopmentalbehaviorvs.ADHDMosthealthychildrenareinattentive,hyperactiveorimpulsiveatonetimeoranother.It'stypicalforpreschoolerstohaveshortattentionspansandbeunabletostickwithoneactivityforlong.Eveninolderchildrenandteenagers,attentionspanoftendependsonthelevelofinterest. Thesameistrueofhyperactivity.Youngchildrenarenaturallyenergetic—theyoftenarestillfullofenergylongafterthey'veworntheirparentsout.Inaddition,somechildrenjustnaturallyhaveahigheractivitylevelthanothersdo.ChildrenshouldneverbeclassifiedashavingADHDjustbecausethey'redifferentfromtheirfriendsorsiblings. ChildrenwhohaveproblemsinschoolbutgetalongwellathomeorwithfriendsarelikelystrugglingwithsomethingotherthanADHD.Thesameistrueofchildrenwhoarehyperactiveorinattentiveathome,butwhoseschoolworkandfriendshipsremainunaffected. WhentoseeadoctorIfyou'reconcernedthatyourchildshowssignsofADHD,seeyourpediatricianorfamilydoctor.Yourdoctormayreferyoutoaspecialist,suchasadevelopmental-behavioralpediatrician,psychologist,psychiatristorpediatricneurologist,butit'simportanttohaveamedicalevaluationfirsttocheckforotherpossiblecausesofyourchild'sdifficulties. RequestanAppointmentatMayoClinic CausesWhiletheexactcauseofADHDisnotclear,researcheffortscontinue.FactorsthatmaybeinvolvedinthedevelopmentofADHDincludegenetics,theenvironmentorproblemswiththecentralnervoussystematkeymomentsindevelopment.MoreInformationAttention-deficit/hyperactivitydisorder(ADHD)inchildrencareatMayoClinicADHDdiet:Dofoodadditivescausehyperactivity? RiskfactorsRiskfactorsforADHDmayinclude: Bloodrelatives,suchasaparentorsibling,withADHDoranothermentalhealthdisorder Exposuretoenvironmentaltoxins—suchaslead,foundmainlyinpaintandpipesinolderbuildings Maternaldruguse,alcoholuseorsmokingduringpregnancy Prematurebirth Althoughsugarisapopularsuspectincausinghyperactivity,there'snoreliableproofofthis.Manyissuesinchildhoodcanleadtodifficultysustainingattention,butthat'snotthesameasADHD. ComplicationsADHDcanmakelifedifficultforchildren.ChildrenwithADHD: Oftenstruggleintheclassroom,whichcanleadtoacademicfailureandjudgmentbyotherchildrenandadults Tendtohavemoreaccidentsandinjuriesofallkindsthandochildrenwhodon'thaveADHD Tendtohavepoorself-esteem Aremorelikelytohavetroubleinteractingwithandbeingacceptedbypeersandadults Areatincreasedriskofalcoholanddrugabuseandotherdelinquentbehavior CoexistingconditionsADHDdoesn'tcauseotherpsychologicalordevelopmentalproblems.However,childrenwithADHDaremorelikelythanotherstoalsohaveconditionssuchas: Oppositionaldefiantdisorder(ODD),generallydefinedasapatternofnegative,defiantandhostilebehaviortowardauthorityfigures Conductdisorder,markedbyantisocialbehaviorsuchasstealing,fighting,destroyingproperty,andharmingpeopleoranimals Disruptivemooddysregulationdisorder,characterizedbyirritabilityandproblemstoleratingfrustration Learningdisabilities,includingproblemswithreading,writing,understandingandcommunicating Substanceusedisorders,includingdrugs,alcoholandsmoking Anxietydisorders,whichmaycauseoverwhelmingworryandnervousness,andincludeobsessivecompulsivedisorder(OCD) Mooddisorders,includingdepressionandbipolardisorder,whichincludesdepressionaswellasmanicbehavior Autismspectrumdisorder,aconditionrelatedtobraindevelopmentthatimpactshowapersonperceivesandsocializeswithothers TicdisorderorTourettesyndrome,disordersthatinvolverepetitivemovementsorunwantedsounds(tics)thatcan'tbeeasilycontrolled PreventionTohelpreduceyourchild'sriskofADHD: Duringpregnancy,avoidanythingthatcouldharmfetaldevelopment.Forexample,don'tdrinkalcohol,userecreationaldrugsorsmokecigarettes. Protectyourchildfromexposuretopollutantsandtoxins,includingcigarettesmokeandleadpaint. Limitscreentime.Althoughstillunproved,itmaybeprudentforchildrentoavoidexcessiveexposuretoTVandvideogamesinthefirstfiveyearsoflife. ByMayoClinicStaff Attention-deficit/hyperactivitydisorder(ADHD)inchildrencareatMayoClinic RequestanAppointmentatMayoClinic Diagnosis&treatment June25,2019 Print Shareon:FacebookTwitter Showreferences Attention-deficit/hyperactivitydisorder.In:DiagnosticandStatisticalManualofMentalDisordersDSM-5.5thed.Arlington,Va.:AmericanPsychiatricAssociation;2013.https://dsm.psychiatryonline.org.AccessedJan.26,2019. BrownA.AllscriptsEPSi.MayoClinic,Rochester,Minn.Oct.9,2018. AskMayoExpert.Attention-deficit/hyperactivitydisorder.Rochester,Minn.:MayoFoundationforMedicalEducationandResearch;2017. VoightRG,etal.,eds.Attention-deficit/hyperactivitydisorder.In:AmericanAcademyofPediatricsDevelopmentalandBehavioralPediatrics.2nded.Itasca,IL:AmericanAcademyofPediatrics;2018. Attention-deficit/hyperactivitydisorder.NationalInstituteofMentalHealth.https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtml.AccessedJan26,2019. MychildhasbeendiagnosedwithADHD―Nowwhat?CentersforDiseaseControlandPrevention.https://www.cdc.gov/ncbddd/adhd/treatment.html.AccessedJan.26,2019. WhatisADHD?AmericanPsychiatricAssociation.https://www.psychiatry.org/patients-families/adhd/what-is-adhd.AccessedJan.26,2019. ADHD.NationalAllianceonMentalIllness.https://www.nami.org/Learn-More/Mental-Health-Conditions/ADHD/Overview.AccessedJan.26,2019. RaCK,etal.Associationofdigitalmediausewithsubsequentsymptomsofattention-deficit/hyperactivitydisorderamongadolescents.JAMA.2018;320:255. Forparentsandcaregivers.NationalResourceCenteronADHD.https://chadd.org/for-parents/overview/.AccessedJan.28,2019. ComplementaryandintegrativeapproachesforADHD:Whatthesciencesays.NationalCenterforComplementaryandIntegrativeHealth.https://nccih.nih.gov/health/providers/digest/adhd-science.AccessedJan.28,2019. BikicA,etal.Meta-analysisoforganizationalskillsinterventionforchildrenandadolescentswithattention-deficit/hyperactivitydisorder.ClinicalPsychologyReview.2017;52:108. PartainPI,etal.Newstimulantformulationsforpediatricattention-deficit/hyperactivitydisorder:Acase-basedapproachfortheprimarycareprovider.CurrentOpinioninPediatrics.2019;31:166. Attention-deficit/hyperactivitydisorder:Dataandstatistics.CentersforDiseaseControlandPrevention.https://www.cdc.gov/ncbddd/adhd/data.html.AccessedJan.30,2019. WeydertJA,etal.Integrativemedicineinpediatrics.AdvancesinPediatrics.2018;65:19. Catala-LopezF,etal.Thepharmacologicalandnon-pharmacologicaltreatmentofattentiondeficithyperactivitydisorderinchildrenandadolescents:Asystematicreviewwithnetworkmeta-analysesofrandomisedtrials.PloSOne.2017;12:e0180355. MazharH,etal.Complementaryandalternativemedicineuseinpediatricattention-deficithyperactivitydisorder(ADHD):Reviewingthesafetyandefficacyofherbalmedicines.CurrentDevelopmentalDisordersReports.2016;3:15. AhnJ,etal.Naturalproduct-derivedtreatmentsforattention-deficit/hyperactivitydisorder:Safety,efficacy,andtherapeuticpotentialofcombinationtherapy.NeuralPlasticity.2016;2016:1320423. AmericanAcademyofPediatrics.Mediaandyoungminds.Pediatrics.2016;138:e20162591. VoightRG,etal.,eds.Complementaryhealthapproachesindevelopmentalandbehavioralpediatrics.In:AmericanAcademyofPediatricsDevelopmentalandBehavioralPediatrics.2nded.Itasca,IL:AmericanAcademyofPediatrics;2018. MoranLV,etal.PsychosiswithmethylphenidateoramphetamineinpatientswithADHD.NewEnglandJournalofMedicine.2019;380:1128. BergerS.Attentiondeficithyperactivitydisordermedicationsinchildrenwithheartdisease.CurrentOpinioninPediatrics.2016;28:607. StoreboOJ,etal.Methylphenidateforattentiondeficithyperactivitydisorder(ADHD)inchildrenandadolescents―Assessmentofadverseeventsinnon-randomisedstudies.CochraneDatabaseofSystematicReviews.https://www.cochranelibrary.com/.AccessedApril1,2019. BhagiaJ(expertopinion).MayoClinic,Rochester,Minn.May13,2019. MonarcheTNSSystem(classificationorderletter).DEN180041.U.S.FoodandDrugAdministration.https://www.fda.gov/about-fda/cdrh-transparency/evaluation-automatic-class-iii-designation-de-novo-summaries.AccessedJune5,2019. Related ADHDdiet:Dofoodadditivescausehyperactivity? AssociatedProcedures Familytherapy Psychotherapy NewsfromMayoClinic MayoClinicQandA:DiagnosingADHD Sept.09,2020,06:55p.m.CDT Products&Services Book:MayoClinicGuidetoRaisingaHealthyChild MayoClinicinRochester,Minn.,hasbeenrecognizedasoneofthetopPsychiatryhospitalsinthenationfor2021-2022byU.S.News&WorldReport. 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