What are the signs of ADHD in children?
ADHD (attention-deficit/hyperactivity disorder) symptoms fall into three groups. Most children with ADHD have symptoms of both the inattentive and the hyperactive-impulsive kinds, though some show only one. Not every child with ADHD has every sign.
| Type of sign | At home | At school |
|---|---|---|
| Inattention | Seems not to listen when spoken to, forgets everyday tasks like brushing teeth, leaves chores unfinished, loses things | Careless mistakes, trouble following instructions, unfinished assignments, lost books and papers, distracted by unrelated things |
| Hyperactivity | Constantly on the go, climbs or runs at the wrong times, cannot play quietly | Fidgets or squirms, gets up when expected to stay seated, talks a great deal |
| Impulsivity | Interrupts conversations and games, struggles to wait, acts without thinking | Calls out answers before the question is finished, cuts in line, intrudes on others |
What is typical for a child's age, and what is a pattern?
Almost all children have times when they cannot settle or finish what they start. The National Health Service in England points out that many children are easily distracted, impulsive and full of energy, particularly under age 5. That alone does not mean ADHD. It could be a sign of being tired, anxious or stressed.
A useful way to think about it is to compare your child with others the same age, not with an older sibling or with a quiet classmate. A pediatrician or mental health professional looks at how the behavior compares with what is expected for the child's age and development, based on reports from several adults.
These are the points that usually separate a phase from a pattern worth having checked:
- It has lasted more than 6 months, and it started before age 12.
- It shows up in at least two settings, such as home and school. A problem in only one place may have another explanation.
- It gets in the way of schoolwork, family life, friendships or activities like sports teams.
- It is out of step with other children of the same age.
Why might a quieter child be overlooked?
Parents often picture a child who cannot sit still. A child who mostly has attention symptoms may simply seem dreamy, messy or forgetful, and may not disrupt anyone. This inattentive pattern can be harder to recognize, and the National Health Service notes that it is more common in girls, which may be why ADHD is thought to be recognized less often in girls than boys.
Signs also change as children grow. Hyperactivity and impulsivity tend to be the most common symptoms in younger children. As academic and social demands increase, trouble with attention often becomes more prominent. A child who coped in the early grades can start struggling later, when work requires more organization.
What else can cause these behaviors?
Sleep disorders, anxiety, depression and certain learning disabilities can all look like ADHD or occur at the same time. So can stress at home or school. The evaluation process commonly includes a medical exam with hearing and vision tests, to rule out other problems with similar symptoms.
If you are also noticing worry, sadness, or changes in sleep or appetite, mention them. The National Institute of Mental Health (NIMH) suggests seeking help when a child's behavior or emotions last for weeks or longer, cause distress for your child or family, or interfere with school, home or friendships. Those are good reasons to talk with someone, whatever the cause turns out to be.
What should I ask my child's teacher?
NIMH suggests starting by talking with the people who see your child regularly, and teachers are a natural first stop. They see your child alongside others the same age and can offer valuable insights. A short conversation or email is enough to begin. Questions like these tend to bring back specific answers:
- How does my child compare with others this age in staying on task and finishing work?
- When do problems tend to happen: long seatwork, group time, transitions, recess?
- Is my child's schoolwork being affected, and how?
- What have you changed in the classroom, and did it help?
- Do you see any signs of worry, sadness or trouble with friends?
- Would you be willing to write down what you have noticed?
What are sensible next steps if I am concerned?
You do not have to be certain before you ask for help. These steps can move things forward without jumping to conclusions.
- Write down what you seeNote specific examples, when they happen, how long this has been going on and what seems to help. Keep report cards and notes from teachers together.
- Talk with your child's pediatricianDescribe what you have observed and what you heard from the school. A pediatrician can check for medical causes, may evaluate ADHD directly, or can refer you to a mental health professional.
- Ask the school about an evaluationThe Centers for Disease Control and Prevention notes that parents can contact the school system about a free evaluation for children 3 years or older. Ask the school how its process works.
- Try structure at home in the meantimeGive clear, simple instructions one at a time, keep a to-do list somewhere easy to see, split tasks into short stretches with breaks, encourage physical activity and regular sleep, and praise what goes well.
- Consider a full evaluationNo single test diagnoses ADHD. An evaluation gathers information from you, your child and the school. Our guide on how a child's psychiatric evaluation works explains what is asked.
What does care for children look like at DanShalom Behavioral Clinic?
We see patients ages 5 to 65, so a younger child should start with a pediatrician. A parent or guardian must be present at appointments for patients under 18. Visits are in person in Sugar Land, or by secure video if you and your child are physically in Texas, Idaho, Arizona or Maryland at the time. A first visit is about 60 minutes, and our ADHD page explains how treatment options are discussed.
When you are ready, you can use the request form, and this guide to preparing a child can help with the conversation beforehand. We check coverage before the first visit, and our insurance page has details on plans, self-pay and the sliding scale.
We are not an emergency service. If your child talks about wanting to hurt themselves or someone else, or their behavior is unsafe, seek help right away: call or text 988, or call 911 in a life-threatening situation.
Questions patients ask
My child can focus on video games for hours. Can it still be ADHD?
It can. NIMH describes children who cannot sit quietly except when doing something they enjoy, such as watching videos or playing video games. Staying absorbed in an activity your child loves does not rule ADHD out, and it does not point to it either. What matters more is how things go with tasks that take sustained effort, like homework.
Is my child's ADHD my fault?
Researchers are not sure what causes ADHD, but many studies suggest genes play a large role, and it often runs in families. It probably results from a combination of factors. Blaming yourself will not help your child, while the things you can do, like clear routines, consistent praise and asking for help, can make daily life easier.
Will my child grow out of it?
Some of it may change. Hyperactivity often eases with age, and teens may seem more restless than hyperactive, while attention problems frequently continue. Symptoms often last into the teen years and adulthood. That is why it can help to have persistent concerns looked at, instead of waiting to see whether they fade by themselves.
Does an ADHD diagnosis mean my child has to take medication?
No. ADHD care can include parent education, behavioral therapy, school supports and medication, and families weigh these together. If medication comes up, the decision follows an evaluation. Not every medication can be prescribed at every kind of visit, some may require an office visit, and we explain what applies. See medication management. A child's medication should only be changed with the prescriber's advice.
My child's teacher thinks it is ADHD. Does that settle it?
A teacher's concern is worth taking seriously, and teachers offer valuable insight into how a child does beside others the same age. It is one part of the picture, though. A diagnosis comes from a mental health professional or a primary care provider such as a pediatrician, who also gathers information from you and looks for other possible causes.
References
- Children and Mental Health: Is This Just a Stage? (National Institute of Mental Health)
- Attention-Deficit/Hyperactivity Disorder: What You Need to Know (National Institute of Mental Health)
- Diagnosing ADHD in Children: Guidelines and Information for Parents (HealthyChildren.org, American Academy of Pediatrics)
- ADHD in Children and Young People (National Health Service, England)
- Diagnosing ADHD (Centers for Disease Control and Prevention)
Reviewed by Victor Onodjacha, MSN, PMHNP-BC, . This page is general information, not medical advice or a diagnosis.