Ask the Expert About ADHD

Q: Is my child’s erratic behavior a sign of ADHD?

A: Attention deficit hyperactivity disorder (ADHD) affects about 3 to 7 percent of school-aged children in the U.S., according to the Centers for Disease Control and Prevention. This condition may affect relationships with parents, who can get frustrated when kids do not listen or sit still.

ADHD also can influence success at school, since kids who have it often disrupt class or do not finish their work. Even friendships are disturbed, as peers can view kids with ADHD as “bossy” or “annoying.”

More than passing problems

There are two sets of symptoms in ADHD:

  1. Inattention, which may involve being easily distracted, not paying attention at school, or being forgetful and poorly organized
  2. Hyperactivity and impulsivity, often exhibited by signs like fidgeting, not being able to enjoy quiet play, interrupting others, talking excessively or acting impulsively without regard for consequences

“Often, children with ADHD display both types of behaviors,” says Denise Bothe, MD, developmental behavioral pediatrician. “Other kids with the condition are either mostly inattentive or mostly hyperactive and impulsive.”

The key to diagnosis is to compare a child’s behavior to expected behavior for other kids the same age. All children jump on furniture or space out on occasion. These symptoms are much more frequent and severe in children with ADHD, and must be present in more than one setting, such as at home and in school. Other signs that a child has ADHD: The symptoms tend to show up before age 7 and last for at least six months. It is important to rule out other causes of inattention or behavioral problems, such as anxiety, depression, poor sleep and learning disabilities.

What causes these behaviors in the first place? The exact cause of ADHD is unknown, but these symptoms seem to stem from a brain development and/or chemical difference, and can run in families. Many children with ADHD also have signs of brain immaturity or developmental delays. Many children have both ADHD symptoms and a specific learning disability as they enter school age, so if they are struggling in school, they should have a learning evaluation.

Treatment can turn things around

Behavior management and teaching, along with medications, are an important part of treating core ADHD symptoms. “Children with ADHD need to learn ways to focus better, and develop organizational and social skills to be successful in everyday life, both at home and in school,” Dr. Bothe says. “They should see their doctors regularly for followup visits to ensure they are making progress and to manage and monitor medication types and doses.”

Parents are an important part of treatment as well, and can help by setting and enforcing consistent routines and rules. “Giving frequent praise and positive feedback is a great way to promote good behavior and keep a child’s self-esteem up,” Dr. Bothe says.

bothe-denise Denise Bothe, MD
Developmental Behavioral Pediatrician
UH Rainbow Babies & Children’s Hospital

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