by Caraline McDonnell, BA
To some extent, having difficulty focusing or behaving at home or in school can be completely normal, especially for younger children. However, kids with ADHD may struggle with a consistent pattern of attention difficulties, impulsive behaviors, and/or hyperactivity that creates frequent difficulties at home and at school.
There are three different subtypes of ADHD that can be diagnosed based on which symptoms are present most in the child.
Predominantly Inattentive Presentation
A kid who has a predominantly inattentive presentation often has challenges with paying attention to details, organizing tasks, staying focused, and following instructions or conversations well. Inattention can include making careless mistakes on school-related work, easily becoming distracted in work or play, appearing not to listen even when spoken to directly, struggling to complete chores, and losing items needed for specific activities (homework, pencils, soccer cleats).
Predominantly Hyperactive-Impulsive Presentation
With a predominantly hyperactive-impulsive presentation, a child will struggle more with fidgeting, excessive talking, interrupting, sitting still, and waiting their turn. This may look like tapping with their hands or feet and squirming, having difficulty staying seated in the classroom, running or climbing when it’s not appropriate, talking over others, blurting out answers without waiting their turn, and interrupting or intruding on activities.
Combined Presentation
Some kids may have a combined presentation where they will experience challenges in both categories.
It is normal for kids to display these inattentive or hyperactive behaviors at one point or another. We should expect that younger kids may have short attention spans, and that it may be challenging for them to always act in an even-manner way with caregivers or peers.
The concern for ADHD arises when a child is struggling with these symptoms to a degree that impacts their daily functioning, and the functioning of their environments and people around them, across settings. To diagnose ADHD, symptoms must be present both at home and in school. If they are only present in one of these two places, it is likely that their symptoms are a result of something other than ADHD.
Risk factors and causes of ADHD
The exact causes of ADHD are not clear, but research has been able to point to some risk factors that may make ADHD in childhood more probable.
Some of these risk factors include having blood relatives with ADHD or another mental health condition, exposure to environmental toxins (like lead, which is often found in old paint and in pipes of older buildings), maternal alcohol or drug use during pregnancy, and premature birth.
We often hear in the media that sugar is linked to ADHD, but there is no scientific evidence for this claim. Excessive sugar intake may lead to immediate hyperactivity, but this is not the same as having ADHD. In a similar vein, we hear that watching too much TV may cause ADHD according to the media, but there is not sufficient scientific evidence for this either. It is possible that some of these things may make symptoms worse, but they are not directly linked causes.
Why does it matter?
We know that having ADHD can make the common demands of childhood difficult for children. Many kids with ADHD will struggle in the classroom which can lead to failure and loss of self-esteem. They are also more likely to have accidents and sustain injuries from impulsive play and have a harder time forming social connections with peers and adults because of their impulsivity in interactions. Kids with ADHD have also been found to be at risk of alcohol and drug use, as well as other delinquent behavior, as they grow up.
How do I get a diagnosis?
If you suspect that your child may have ADHD, getting a diagnosis is the first step towards identifying their specific needs and formulating a treatment and support plan to help them succeed.
Before visiting a mental health professional, consult with your pediatrician to rule-out any medical problems that may result in ADHD-like symptoms (ex: hearing and vision difficulties, learning disabilities). Once medical challenges have been ruled out, pursue a mental health evaluation.
The evaluation should include a thorough assessment of all mental health challenges, since many problems, like anxiety, depression, traumatic stress, and sleep issues, can often have similar symptoms. To officially diagnose ADHD, the assessment will also require questionnaires from parents and teachers, and sometimes the child, to address the presence of symptoms across both home and school.
Children with ADHD are more likely than other kids to have coexisting conditions, which will also be evaluated through an assessment. Keep an eye out for upcoming blogs to learning about common coexisting conditions with ADHD, and proven treatments for ADHD and other disruptive behavior disorders.
Want to learn more?
- Watch our FREE ADHD webinar
- Read Coexisting Conditions: ADHD and Disruptive Behavior Disorders
- Read Science-Backed Treatments for ADHD and Other Disruptive Behavior Disorders
- Read Client Spotlight: A Cathartic Camp Experience
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