ADHD

What Is ADHD?

The most common childhood mental disorder in the U.S., attention deficit hyperactivity disorder, is characterized by restlessness, difficulty focusing, emotional sensitivity, and impulsivity. With fidgety, squirmy, noisy, and rambunctious kids who have a hard time waiting their turn, the symptoms can be obvious. But ADHD can present in many ways, and some kids with ADHD may be quiet, spacey, and withdrawn. All kids may act this way sometimes, but in kids with ADHD, it’s a sign of something more.

People with ADHD often have trouble with executive function, the cognitive skill that allows them to plan, focus attention, and complete complex tasks. This can lead to difficulty self-regulating emotions, remembering instructions, and completing schoolwork and chores.

About 11 percent of American children have ADHD, according to the Centers for Disease Control and Prevention. That number wasn’t always so high, which has led some people to wonder whether ADHD is real. And while it may be overdiagnosed, the vast majority of doctors agree that ADHD is a very real disorder.

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This story was produced in partnership with Akili Interactive, maker of EndeavorRx®.

“Many of the frustrating behaviors associated with ADHD are just as frustrating to the individuals with ADHD themselves, seeming to occur before they can get a handle on what is going on.”

— Dr. Joel Nigg

How ADHD is Diagnosed

There is no single test to diagnose ADHD. A pediatrician or mental health specialist must run a comprehensive evaluation to check whether the child meets certain criteria. The symptoms must occur in multiple settings (like at home and school), not be explained by another condition, and interfere with daily functioning.

The child’s symptoms will determine what exactly is included in the evaluation. However, it will generally include a full physical exam, a psychological exam, and a health history — including family history, because ADHD symptoms are highly heritable. Parents and teachers may be asked to fill out questionnaires about the child’s behavior, and the clinician may want to observe the child.

Although your primary care provider may be able to make the diagnosis, make sure that they have significant training and experience diagnosing ADHD. It can be tricky even for experienced doctors, and many children with ADHD are misdiagnosed because the symptoms can overlap with conditions such as anxiety and sleep disorders.

When a child is diagnosed with ADHD, they will have one of three presentations. Kids with the hyperactive-impulsive type usually can’t sit still, and they talk when they’re not supposed to. Children with the inattentive type may seem spacey and withdrawn, and they get distracted easily. They’re more likely to fly under the radar, especially when they’re girls. There is also a combined type of ADHD which includes aspects of both the hyperactive-impulsive and inattentive types.

ADHD Treatment Options

  • Medication

Stimulants such as Ritalin and Adderall improve ADHD symptoms in 70-80 percent of kids. There are also non-stimulant options, but they can take longer to have an effect. They usually aren’t prescribed unless the stimulants didn’t work or there is a medical concern about using them. Some of the most common side effects of both are a decrease in appetite and sleep problems. The American Academy of Pediatrics recommends that children 6 and up be treated with a combination of medication and behavior therapy.

  • Behavior Therapy

This type of therapy helps reduce unwanted behaviors such as being disruptive in class and improves skills such as organization. A therapist may see the child directly, but they will often also train the parents in behavior management. They may recommend behavioral interventions in the classroom. The American Academy of Pediatrics recommends behavior therapy for all children with ADHD.

  • Electrical Stimulation

In 2019, the FDA authorized an electrical stimulation device for kids age 7 to 12 to relieve ADHD symptoms. It works by sending a low electrical pulse through a nerve on the face that connects to the brain. It’s an option for families who want to manage the disorder without medication, but the device costs nearly $1,000 and may not be covered by insurance.

  • Diet Changes

Eating certain foods may help balance out mood swings, and limiting other foods, like sugar, may help with hyperactivity. This is a complementary therapy and should be used alongside other treatments.

  • Exercise

Running around and working out can burn off hyperactive energy and improve ADHD symptoms and cognitive functioning. This is a complementary therapy and should be used alongside other treatments.

  • Nature Therapy

Spending time in nature can improve concentration and relieve symptoms of ADHD, at least in the short term. Aim for at least 20 minutes per day. This is a complementary therapy and should be used alongside other treatments.

  • Mindfulness and Meditation

Mindfulness activities such as yoga can help kids with ADHD pay attention and self-regulate their emotions. This is a complementary therapy and should be used alongside other treatments.

  • Video Games

Recently, a digital therapeutic called EndeavorRx® was authorized by the FDA as indicated to improve attention function as measured by computer-based testing in children ages 8-12 years old with primarily inattentive or combined-type ADHD, who have a demonstrated attention issue. This is a complementary therapy and should be used alongside other treatments.

The Benefits of ADHD

With all the challenges that come with having ADHD, sometimes it can be hard to see the benefits. But many successful entrepreneurs have ADHD, and some like Richard Branson even credit the condition for their success. The potential positives include:

  • Non-linear Thinking

Kids with ADHD can jump quickly from thread to thread. This can make them skilled at seeing many pieces of a problem or challenge at once.

  • Hyperfocus

A child with ADHD can achieve hyperfocus when they land on a topic or activity that they’re passionate about. Careers for kids with ADHD are often built around these passions.

  • Resilience

Studies have shown that people living with ADHD are better able to respond to failures, at least in part because the challenge of their diagnosis forces them to experiment with different ways to go about specific tasks until they find one that works.

  • Athletic Prowess

Although hyperactivity can get kids in trouble, it can also lead them to excel on the field or court. Children with ADHD often have lots of energy to burn off with exercise, which can set them up to be a sports star like fellow athlete with ADHD Michael Jordan.

Can Kids Grow Out of ADHD?

About a third of people diagnosed with ADHD during childhood grow out of their symptoms by young adulthood, according to the Child Mind Institute. Some kids, such as those with severe symptoms in childhood, are less likely to grow out of it. Symptoms are more likely to persist in children who are also diagnosed with a psychiatric disorder, such as depression or anxiety.

Certain symptoms may become more or less prominent during childhood. Generally, hyperactivity fades throughout elementary school. Inattention may become a larger concern as schoolwork becomes more demanding and adults in the child’s life begin to take a more hands-off approach.

Four Common Difficulties for Parents of Kids with ADHD

Raising a child with ADHD can be exasperating. It’s normal to want to tear your hair out every now and then, and most of the difficulties are common — and approachable. For each roadblock you face, there are ways to parent your kid that jive with their brain and reduce frustration for the both of you.

If they don’t listen…

It may seem like your kid never listens to a thing you say. Most of the time, they’re not trying to ignore you. Your words just don’t stick in their brain. To get your child to follow instructions without provoking a battle, set routines for tasks that they need to do consistently, such as brushing their teeth before bed. If they break your house rules, enforce the punishment consistently. You’ll also need introspection: Are you being too negative and critical? This can cause kids with ADHD to tune you out.

If they can’t sit still…

Hyperactivity and inattention make it difficult for children with ADHD to stay still and quiet. Make sure they get plenty of exercise to burn off their excess energy. Sports like basketball that don’t have much downtime are a great choice, as are martial arts, which encourage self-discipline.

If they throw tantrums…

Kids with ADHD are more likely to throw tantrums and have emotional or angry outbursts. They’re less able to handle their big feelings and more likely to react to them impulsively. Setting clear instructions, providing structure in their lives, and praising good behavior can help avoid outbursts.

If they’re constantly messy…

Trouble with executive function can make it hard for kids with ADHD to stay neat and organized. They often have trouble cleaning up after themselves, even when parents clearly ask them to. To make staying clean easier for your child, break down tasks into small chunks, such as by using a checklist. Repeating directions can help them stick in your kid’s head. Give everything a place in the house and label where toys, shoes, and other belongings should go.

The Best Apps, Toys, and Tools for Kids with ADHD

This fidget toy is perfect for kids who need something to do with their hands — and it’s quiet enough to not distract others.

This interlocking disc set lets kids build whatever they can imagine, without the frustration of figuring out how certain pieces fit together or following instructions. It can also help develop spatial thinking.

Sponsored by Akili
EndeavorRx®

EndeavorRx® is a one-of-a-kind video game experience that has been indicated to improve attention function in children ages 8-12 years old with primarily inattentive or combined-type ADHD. EndeavorRx® requires a prescription from your child’s healthcare professional, so you should contact your child’s healthcare professional and review the important indications, safety and cautions in the Instructions for Use before deciding on using the EndeavorRx® treatment. EndeavorRx® is an adjunctive treatment, not a substitute for medication. See Instructions for Use at: https://my.akili.care/akiliassist/endeavor-ifu.

Each card in this deck gives a different physical test, such as ‘gallop like a horse’ or ‘stand like a flamingo.’ It’s a quick game for getting rid of excess energy. There are multiple ways to play, such as by challenging your child to complete as many cards as they can in two minutes.

This is a to-do list app with a role-playing spin to engage older kids with easily distracted minds. By crossing off completed chores, they can improve their stats, win rewards, and level up their character.

This app helps kids aged 2-5 improve social skills, attention, organization, and memory with their favorite Sesame Street characters.

Kids with ADHD easily lose track of time, but a visual timer can help them improve their time management skills.

These headphones get rid of noisy distractions to help kids with ADHD focus.

Kids can attach these bands to their desk to fidget with their feet, improving concentration while leaving their hands free for schoolwork.