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Attention-Deficit/Hyperactivity Disorder

What is ADHD?

Attention-deficit/hyperactivity disorder (ADHD) is a developmental disorder marked by persistent symptoms of inattention and/or hyperactivity and impulsivity that interfere with functioning or development.

Symptoms begin in childhood and can affect daily life, including social relationships and school or work performance. ADHD is well-known among children and teens, but many adults also have the disorder.

People with ADHD experience an ongoing pattern of:

  • Inattention: Having problems staying on task, paying attention, or being organized, which are not due to defiance or a lack of comprehension.
  • Hyperactivity: Being extremely restless or constantly moving, including in situations when it is not appropriate; excessively fidgeting or tapping; or talking too much.
  • Impulsivity: Acting without thinking, interrupting others, or having difficulty with self-control. Impulsivity can also involve a desire for immediate rewards or an inability to delay gratification or consider long-term consequences.

What are the signs and symptoms of ADHD?

Some people with ADHD mostly have symptoms of inattention. Others mostly have symptoms of hyperactivity and/or impulsivity. Some people have both types of symptoms.

It is common for people to experience inattention, excess activity, and impulsivity some of the time. But, for people with ADHD, these behaviors:

  • Are more severe
  • Occur more often
  • Interfere with or impair functioning in social situations, at school, or at work

Inattention

People with symptoms of inattention may often:

  • Overlook or miss details and make seemingly careless mistakes during school, work, or other activities
  • Have difficulty sustaining attention during play, work, or tasks, such as conversations, lectures, or homework
  • Not seem to listen when spoken to directly
  • Find it hard to follow through on instructions or finish work, chores, or assignments  
  • Start tasks but lose focus and get easily sidetracked
  • Have difficulty organizing tasks and activities, doing tasks in order, keeping track of materials and belongings, managing time, and meeting deadlines
  • Avoid tasks that require sustained attention, such as doing homework, preparing reports, completing forms, or reading long papers
  • Lose important things, such as school supplies, books, wallets, keys, paperwork, eyeglasses, and cell phones
  • Be easily distracted by unrelated thoughts or stimuli
  • Be forgetful in daily activities, such as completing chores, running errands, returning calls, and keeping appointments

Hyperactivity-impulsivity

People with symptoms of hyperactivity and impulsivity may often:

  • Fidget and squirm while seated
  • Leave their seats in situations when staying seated is expected, such as in the classroom or at the office
  • Run, dash around, or climb at inappropriate times or, in teens and adults, feel frequently restless
  • Be unable to play or engage in hobbies quietly
  • Be constantly in motion or act as if driven by a motor
  • Talk excessively or interrupt others
  • Answer questions before they are fully asked, finish other people’s sentences, or speak when it is not their turn in a conversation
  • Have difficulty waiting, for example, in conversations, games, or activities

Primary care providers sometimes diagnose and treat ADHD. They may also make a referral to a mental health professional, such as a psychiatrist or psychologist, who can do a thorough evaluation and make an ADHD diagnosis.

For a person to receive an ADHD diagnosis, the symptoms of inattention and/or hyperactivity and impulsivity must:

  • Be chronic or long-lasting
  • Impair functioning
  • Cause them to fall behind typical development for their age

Stress, sleep disorders, anxiety, depression, and other physical conditions or illnesses can cause similar symptoms to those of ADHD. Therefore, a thorough evaluation is necessary to determine the cause of symptoms.

Most people with ADHD receive a diagnosis during the elementary school years. For teens or adults to be diagnosed with ADHD, their symptoms must have been present before age 12.

Symptoms of ADHD can be mistaken for emotional or disciplinary problems or missed entirely in children who primarily have symptoms of inattention, leading to a delay in diagnosis. Adults with undiagnosed ADHD may have a history of poor academic performance, problems at work, or strained relationships.

ADHD symptoms can change as a person ages.

  • In young children, hyperactivity and impulsivity are the most common symptoms.
  • In elementary school, inattention may become more prominent, leading children to struggle academically.
  • In adolescence, hyperactivity often lessens, and symptoms are more likely to include restlessness or fidgeting. Many teens with ADHD struggle with relationships and have a greater tendency to engage in risky behaviors, such as substance use or unsafe sexual activity.
  • Adults with ADHD may be irritable, have a low tolerance for frustration and stress, or show frequent or intense mood changes. Inattention, restlessness, and impulsivity tend to persist into adulthood, although, in some people, those symptoms become less severe and less impairing.

How is ADHD diagnosed?

Based on their specific symptoms, a person can be diagnosed with one of three types of ADHD:

  • Inattentive: Mostly symptoms of inattention but not hyperactivity or impulsivity
  • Hyperactive-impulsive: Mostly symptoms of hyperactivity and/or impulsivity but not inattention
  • Combined: Symptoms of both inattention and hyperactivity and/or impulsivity

ADHD symptoms must begin in childhood (before age 12). Symptoms can appear as early as preschool and often continue into the teen years and adulthood. The criterion for a diagnosis differs slightly based on age.

  • Children up to 16 years must show at least six symptoms of inattention, hyperactivity and/or impulsivity, or both.
  • Adults and youth over 16 years must show at least five symptoms of inattention, hyperactivity and/or impulsivity, or both.

To be diagnosed with ADHD, a person’s symptoms must also:

  • Occur for at least 6 months
  • Be present in two or more settings (for example, at home, at work, in school, or with friends)
  • Interfere with or impair social, school, or work functioning

What are the risk factors for ADHD?

Researchers are not sure what causes ADHD, although many studies suggest that genes play a large role. Like many other disorders, ADHD probably results from a combination of factors.

In addition to genetics, researchers are looking at possible environmental factors that might raise the risk of developing ADHD, including brain injuries, nutrition, and social environments.

ADHD is more common in males than females. Females with ADHD are more likely to show inattention as the primary symptom. People with ADHD often have other conditions, such as learning disabilities, anxiety disorder, conduct disorder, depression, or substance use disorder.

How is ADHD treated?

While there is no cure for ADHD, currently available treatments may reduce symptoms and improve functioning. Common treatments are medication, psychotherapy, and other behavioral interventions. For children, treatment often includes parent education and school-based programs. Many people with ADHD receive a combination of treatments.

Medication

For many people with ADHD, medication reduces hyperactivity and impulsivity and improves their ability to focus, work, and learn. Sometimes, several different medications or dosages must be tried before finding the one that works for a particular person. Anyone taking a medication must be monitored closely by their prescribing doctor.

  • Stimulants: The most common type of medication for treating ADHD is stimulants. Stimulants work by increasing levels of brain chemicals with key roles in thinking and attention.
  • Nonstimulants: Nonstimulant medications can also be used to treat ADHD. These medications take longer to start working than stimulants, but they can help improve focus, attention, and impulsivity in people with ADHD.

Although not approved by the U.S. Food and Drug Administration (FDA) specifically for ADHD, nonstimulants may be used alone or in combination with a stimulant to treat symptoms. Doctors may prescribe a nonstimulant when a person has unwanted side effects from stimulants, when a stimulant is not effective, or in combination with a stimulant to increase its effectiveness. For instance, antidepressants can be helpful if a person has a co-occurring disorder, such as anxiety, depression, or another mood disorder.

Under medical supervision, both stimulant and nonstimulant medications are considered safe. However, all medications can have side effects, especially when misused or taken over the prescribed dose. A health care provider must know about other medications you are taking and monitor how you are reacting to the medication(s). 

Providers and patients should work together to find the best medication and dose. To find the latest information about medications, talk to a health care provider and visit the FDA website . You can also learn more about stimulants and other mental health medications

Psychotherapy and behavioral interventions

Several types of psychotherapy and other behavioral interventions have been shown to help people with ADHD and their families manage symptoms and improve everyday functioning.

Many children, teens, and adults benefit from therapy. However, all types of therapy for children and teens with ADHD require parents to play an active role. Therapy that includes only the child (without parent involvement) is not usually effective for managing ADHD symptoms and may be better for addressing symptoms of anxiety or depression that may occur along with the disorder.

  • Behavioral therapy aims to help people change their behavior. It might involve the therapist providing practical assistance, such as helping organize tasks or complete schoolwork, or offering guidance on working through difficult events. Behavioral therapy also teaches people how to monitor their behavior and give themselves praise for acting in a desired way, such as controlling anger or thinking before acting.
  • Cognitive behavioral therapy helps people learn to be aware and accepting of their thoughts and feelings to improve focus and concentration. The therapist can help people with ADHD adjust to life changes that come with treatment, such as taking the time to think before acting or resisting the urge to take unnecessary risks.
  • Social skills training teaches people interpersonal and social skills. It can involve a therapist teaching children how to wait their turn, share toys, ask for help, or respond to teasing. Adults may learn communication skills like active listening and how to be better at self-control and social problem-solving. Learning to read facial expressions and tone of voice in others and how to respond appropriately can also be part the training.

For families, frustration, blame, and anger may have built before a child is diagnosed. Parents and children may need professional help to overcome these negative feelings. Mental health professionals can educate parents about ADHD and how it affects a family. They can also help children and their parents develop new skills, attitudes, and ways of relating to each other.

  • Family and marital therapy can help family members and partners find productive ways to handle disruptive behaviors, encourage behavior changes, and improve interactions with the person with ADHD.
  • Parenting skills training (behavioral parent management training) teaches parents skills for encouraging and rewarding positive behaviors in their children. Parents are taught to use a system of rewards and consequences to change their child’s behavior, to give immediate and positive feedback for behaviors they want to encourage, and to ignore or redirect behaviors they want to discourage.
  • Stress management techniques can benefit parents of children with ADHD by increasing their ability to deal with frustration so that they can respond calmly to their child’s behavior.
  • Support groups can help parents and families connect with others who have similar problems and concerns. Groups often meet regularly to share challenges and successes, to exchange information about specialists and strategies, and to talk with experts.

Learn more about psychotherapy.

School-based programs and accommodations

Many children and teens with ADHD benefit from school-based behavioral interventions and academic accommodations. Specific classroom interventions and academic accommodations can effectively manage ADHD symptoms and improve functioning at school and with peers.

  • Classroom interventions can include behavior management plans or classroom-taught organizational and study skills.
  • Academic accommodations can include preferential seating in the classroom, reduced classwork, or extended time on tests and exams.

Schools may provide accommodations through what is called a 504 Plan or, for children who qualify for special education services, an Individualized Education Plan (IEP). To learn more about the Individuals with Disabilities Education Act (IDEA), visit the U.S. Department of Education’s IDEA website .

Training and feedback

Some newer ADHD treatments aim to enhance brain function to improve attention and self-regulation. Two of these are cognitive training and neurofeedback. Although these treatments can help reduce ADHD symptoms in some people, their effects are usually lower than those seen from medication or psychotherapy. Additional research is needed to refine the treatments and determine for whom they work and under what conditions.

  • Cognitive training typically involves using exercises to improve executive functions and working memory. The approach involves repeatedly performing a program or activity to improve specific skills, such as memory or attention, with exercises tailored to the person’s ongoing performance.
  • Neurofeedback uses real-time brain activity to train self-regulation of brain waves. An electronic device monitors and records a person’s brain activity while performing a task and provides immediate feedback on how their brain is functioning. Through this feedback, the person learns to self-regulate their brain activity to directly alter the associated behavior. The assumption is that, with repeated, real-time information, people can change their internal brain activity, with observable effects on behavior and cognition.

How can children and adults with ADHD stay organized?

For children

Parents, family members, and teachers can help kids with ADHD stay organized and follow directions. Other strategies that may help are the following:

  • Maintain a consistent routine. Follow the same schedule every day, from wake up to bedtime. Schedule times for homework, outdoor play, indoor activities, and so forth. Keep the schedule on the refrigerator or a bulletin board. Note changes as far in advance as possible.
  • Organize everyday items. Have a place for everything (such as clothing, keys, phones, backpacks, and toys), and keep everything in its place.
  • Use homework and notebook organizers. Use organizers and organization apps for school assignments and supplies. Stress to your child the importance of writing down assignments and bringing home necessary materials.
  • Be clear and consistent. Children with ADHD need predictable rules they can understand and follow. Give consistent feedback on behavior and help establish clear rules, chore lists, and structured routines.
  • Give praise or rewards when your child follows rules. Children with ADHD often receive and expect criticism. Instead, look for good behavior and praise it.

For adults

A professional therapist or life coach can help adults with ADHD learn to organize their life with tools. They can also provide practical tips for managing daily life, such as:

  • Stick to routines.
  • Make lists for different tasks and activities.
  • Use a calendar for scheduling events.
  • Write reminder notes.
  • Get regular exercise, especially when feeling hyperactive or restless.
  • Assign a special place for important items, like keys, bills, and paperwork.
  • Break down large tasks into more manageable, smaller steps so that completing each part of the task provides a sense of accomplishment.

How can I find a clinical trial for ADHD?

Clinical trials are research studies that look at new ways to prevent, detect, or treat diseases and conditions, including ADHD. The goal of a clinical trial is to determine if a new test or treatment works and is safe. Although people may benefit from being part of a clinical trial, they should be aware that the primary purpose is to gain new scientific knowledge so that others can be better helped in the future.

Researchers at NIMH and around the country conduct many studies with people with and without ADHD. We have new and better treatment options today because of what clinical trials uncovered. Talk to a health care provider about clinical trials, their benefits and risks, and whether one is right for you.

To learn more or find a study, visit:

Where can I learn more about ADHD?

Free brochures and shareable resources

Multimedia

Federal resources

Research and statistics

  • Journal Articles : References and abstracts from the National Library of Medicine’s PubMed
  • Statistics—ADHD: Statistics on the prevalence and treatment of ADHD among children, teens, and adults

Last Reviewed: September 2024

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