ADHD Symptoms In Kids: What To Look For

Children are often full of energy and excitement. However, there can be cases where parents and caregivers may wonder whether that excitement in children is a sign of an underlying mental difference. 

If your child's symptoms are causing functional difficulties at home and school, it may be beneficial to talk to a professional. Attention-deficit/hyperactivity disorder (ADHD) is a condition that has an affect in the brain development of a child and can affect a child’s school functioning, capacity for social interaction, and emotional well-being. There are several signs of ADHD in teens and children that parents can look for to ensure their child receives quality and early support. 

What is attention-deficit/hyperactivity disorder (ADHD)?

Attention-deficit hyperactivity disorder (ADHD) is a developmental mental health condition and form of neurodivergence that can cause a recurring pattern of inattentiveness, hyperactivity, and impulsivity. ADHD is a lifelong condition that can cause functional difficulty in professional, social, educational, and personal performance. 

ADHD symptoms in children often begin to appear after age three, and many cases are diagnosed when children are under 12 years old. Although ADHD diagnoses can happen at any age, adults who are diagnosed with ADHD must have experienced symptoms since adulthood to be diagnosed. Still, due to a lack of awareness of how ADHD can manifest, symptoms may go unnoticed for years.

ADHD diagnoses are divided into three presentations based on the present symptoms, including the following. 

The inattentive type of ADHD, once called attention deficit disorder (ADD), can affect a child's ability to connect to their surroundings. A child with this presentation may have trouble paying attention, keeping focus, listening to and following directions, and staying organized. Those who receive a primarily inattentive diagnosis show little to no symptoms of hyperactivity or impulsivity. 

Children with predominantly hyperactive/impulsive type ADHD tend to have high energy levels and trouble considering the consequences of their actions. According to the American Psychiatric Association (APA), a child with ADHD-HI may have a hard time “waiting his or her turn” and may struggle to “stay seated” or “do leisure activities quietly”. They may also make impulsive decisions and act without thinking, potentially causing disruptions in their environments. Those with this diagnosis may not show symptoms of inattention, though hyperactivity can decrease focus. Older children may have trouble playing by rules set out by authority figures.  

Combined type 

The most common type of ADHD is combined ADHD, a mixture of ADHD-HI and ADHD-PI symptoms. Children with this presentation show symptoms of each. 

What causes ADHD in children

ADHD is thought to develop during early childhood. Children with ADHD are believed to have decreased activity levels in areas of the central nervous system that control focus and activity.

​​The exact cause of ADHD symptoms in children is complex. ADHD may be caused by a combination of genetics, adversity in the home, substance or alcohol use during pregnancy, and dopamine deficiencies. In addition, many experts think that certain environmental factors, such as excessive screen time, can contribute to or worsen ADHD symptoms in children. 

Common risk factors for ADHD in children include:

• Smoking during pregnancy
• Drinking alcohol during pregnancy
• Using illicit substances (e.g., recreational drugs) during pregnancy
• Premature birth
• Exposure to certain environmental toxins, including lead
• Head trauma and brain injury at a young age

Note that ADHD is considered a form of neurodivergence, a brain difference that cannot be "cured" or "removed." For this reason, some adults with ADHD identify with the diagnosis as their core identity instead of a disability. Some believe that ADHD would not be as disabling if accommodations were present in their life. Professionals who take a neurodivergent-centered approach to treatment may focus on alleviating symptoms of the condition and helping individuals manage daily life instead of attempting to "cure" or "change" the child or adult. 

Signs and symptoms

ADHD presents itself at a young age, so distinguishing symptoms from general childlike behavior may be challenging. ADHD diagnosed in children may cause them to be naturally inattentive and energetic, especially when trying to finish schoolwork or stay focused on tasks that require sustained mental effort.

To recognize the signs of ADHD in children, it may be helpful to refer to the three presentations of ADHD: ADHD-PI, ADHD-HI, and combined type. Children who exhibit multiple symptoms from one category may be experiencing ADHD, especially if these observations impact their daily lives.

Inattentive symptoms of ADHD include the following: 

• Difficulty paying attention, such as listening in class 
• Disliking activities that require prolonged attention, like reading 
• Frequently forgetting appointments, homework, upcoming tests, etc.
• Not following through with tasks like homework or chores
• Struggling with organization and constantly losing books, pencils, phones, etc.
• Being easily distracted, which can cause trouble completing schoolwork
• Daydreaming, staring off into space, and not listening when being spoken to

Hyperactive and impulsive ADHD

Below are some of the symptoms of ADHD-HI: 

• Constant talking, even after being instructed to stay quiet 
• Restlessness, constantly being "on the go" 
• Running around and playing, even in calm settings
• Constant fidgeting or tapping
• Being prone to intense emotional changes, such as exciting quickly or having strong reactions to minor stimuli
• Experiencing impatience and difficulty waiting
• Tending to speak out of turn, interrupt, or intrude on others’ activities

For combined ADHD, a variety of different symptoms from the other types of ADHD may develop. However, children with combined-type ADHD don't necessarily have a more severe diagnosis. The symptoms they experience may just be spread more evenly among the two subtypes. 

Symptoms of other mental disorders

Sometimes, people with ADHD experience other mental health challenges alongside ADHD. Symptoms of other behavioral conditions (such as oppositional defiant disorder) or developmental disorders (such as autism spectrum disorder) may be present in a child with ADHD. For example, in addition to the above symptoms, a child who is living with comorbid ADHD and conduct disorder may exhibit antisocial behaviors (e.g., being hostile or harming people). 

In addition, concerns like low self-esteem can contribute to further mental health challenges, such as depression. Because ADHD symptoms in kids can reflect other mental health conditions or be the byproduct of childhood development, speak with a healthcare professional if you notice these symptoms in your child. 

ADHD tests and diagnosis

If left unmanaged, ADHD can cause significant personal and professional problems as a child develops into adulthood, which can highlight the importance of having ADHD treated early. If you have concerns about your child's mental health, it may be beneficial to speak with a child psychiatrist or other mental health professional.

Like other mental health conditions, there may not be one medical test a child can take to get a "certain" diagnosis. To accurately diagnose ADHD, healthcare professionals may gather information from you, other family members, their teachers, counselors, and the child.

An ADHD diagnosis may depend on the severity of the symptoms a child experiences and how significantly they impact daily life. Your doctor or mental health professional may ask questions that help them uncover the extent of your child's experiences. For example, they may ask the following:

• Do the symptoms cause disruptions and challenges at school? 
• Are these behaviors relatively constant, or do they only arise in specific situations? 
• How long has your child been experiencing these symptoms? 
• Does anything help your child control when they have severe symptoms? 
• Do you have a family history of ADHD, autism, dyslexia, or another form of neurodivergence? 
• Does your child experience sleep problems?
• Are they experiencing more accidents or injuries lately?
• Did your child have typical developmental milestones in their early years? 

A diagnosis of ADHD may be made if the child has shown at least six symptoms of the disorder in more than one setting consistently over the past six months. 

How treatment can positively affect behavior

To support a child with ADHD, it can be essential to understand neurodivergence and ADHD symptoms. Because many of the symptoms ADHD causes happen in the brain, some caregivers may misunderstand how they influence a child's behavior. For example, someone may mistakenly label a child as "lazy," "unmotivated," or "crazy" instead of seeing their symptoms as a sign of an underlying concern. If you’d like to learn more about ADHD, its symptoms, and treatment options, consider visiting the website of the National Resource Center on ADHD. 

There may be several approaches used to treat ADHD, depending on the child’s age, the specific behavior problems they experience, and whether they have other physical or mental health problems. The child’s doctor may prescribe a stimulant or non-stimulant form of medication, which can help with several of the most common symptoms, such as difficulty listening, inability to engage in quiet activities, and trouble staying focused on school work. Always consult a healthcare provider before starting or stopping any medication. 

Another option that can bring about significant change for children with ADHD and their families is the support of a mental health professional. Working with a therapist offers a way to gain insight into supporting a child with ADHD. If you are busy with parenting or other obligations, you can also try online therapy through a platform like BetterHelp. Teens aged 13 to 19 can sign up for online therapy with parental permission through an online platform like TeenCounseling.  

Professionals can offer support and effective treatment options online. A recent study demonstrated that online therapy may be an effective way to improve symptoms of ADHD for adults and children. The same study also noted that online therapy was a practical resource for supporting families of those with ADHD.