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Attention-deficit/hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder in children. It is a brain disorder in which parts of the frontal lobe (a part of the brain that helps with paying attention, planning and making decisions) are less mature than in children without the disorder.
ADHD is characterized by inattention, hyperactivity and/or impulsivity. At least some of these symptoms must be present prior to a child turning 12 years old, and the symptoms must affect his or her functioning in multiple environments, typically at school and home. Untreated ADHD can affect academic performance, peer interactions, family relationships and self-esteem. About 60-80% of children who have ADHD will continue to experience symptoms as an adult.
A variety of factors may increase a person’s risk of having ADHD. The most common risk factor is a family history of ADHD; however, there isn’t one specific gene identified as causing the condition.
Other factors that may contribute but are not proven to cause ADHD include a mother’s substance use (of drugs or alcohol) during pregnancy, low birth weight/prematurity, environmental toxins and a history of severe emotional neglect.
Attention-deficit/hyperactivity disorder occurs in approximately 11% of children in the United States, and it is twice as likely to be diagnosed in boys versus girls. However, girls are more likely than boys to have primarily inattentive symptoms with little or no hyperactivity.
ADHD with only inattentive symptoms is commonly referred to as attention deficit disorder, or ADD.
There are three primary subtypes of attention-deficit/hyperactivity disorder (ADHD): inattentive, hyperactive/impulsive and combined (both inattentive and hyperactive/impulsive symptoms). ADHD with only inattentive symptoms has commonly been referred to as “ADD.”
Parents will often report that their child can focus very well on a desired activity, such as videogames. This is not uncommon in ADHD, as individuals may be able to “hyper-focus” on activities of interest to them.
Children with ADHD are also more likely to experience learning disabilities, anxiety, depression, behavior difficulties (e.g., oppositional defiant disorder, disruptive mood dysregulation disorder) and substance use.
There are no medical tests (lab work or imaging) used to diagnose attention-deficit/hyperactivity disorder (ADHD). Our pediatric experts diagnose the condition based on a clinical interview and by gathering information from the child, parents, teachers, and sometimes other important people in his or her life. Behavior rating scales may also be used to help gather information and track symptoms overtime.
During the clinical interview, mental health providers at Children’s Hospital Colorado will assess for ADHD symptoms and effects on functioning at school and at home, as well as for any additional concerns such as anxiety, depression, behavioral issues and substance use.
Treatment for attention-deficit/hyperactivity disorder (ADHD) can include therapy and medication. Therapy is usually used first for young children.
ADHD medications are among the most effective medications in all of pediatrics and psychiatry. A combination of therapy and medication has been shown to be the “gold standard” treatment for many children with ADHD.
Children with ADHD often benefit from behavior therapy. Behavior therapy typically focuses on working with caregivers and teachers to develop strategies aimed at strengthening the child’s positive behaviors and eliminating problematic behaviors. These strategies may include use of praise and ignoring, development of reward systems, implementing an effective timeout procedure, and other strategies known to help motivate children to engage in more appropriate behaviors.
Behavioral health providers can also work directly with a child to help them learn new skills for managing their feelings and behaviors more effectively. Children with ADHD can learn more appropriate social behaviors through participation in social skills training as well.
There are several classes of medications that can be used to address ADHD symptoms including stimulants, atomoxetine and alpha 2 agonists. A pediatrician or child and adolescent psychiatrist can assess if medication is recommended for your child.
At Children’s Hospital Colorado, our Pediatric Mental Health Institute (PMHI) Outpatient Services are staffed by mental health professionals who are experts at evaluating and addressing your child’s symptoms. Our psychologists and therapists offer evidence-based individual, family and group-based therapies.
Our group therapies include the Safely Expressing Emotions Daily (SEEDS) group for children 5-7 years old and our Collaborative Coping Group for children ages 8-12. Our providers can provide medication management for ADHD symptoms, as well as for possible co-occurring disorders such as anxiety or depression. We also collaborate with primary care physicians in your child’s ongoing care.