ADHD, attention deficit hyperactivity disorder, is a neurodevelopmental condition in which a child's brain manages attention, activity and impulses differently. A child may struggle to concentrate, sit still, wait or think before acting, to a degree unusual for their age, in more than one setting.
Key points
- ADHD affects attention, activity levels and impulse control. Symptoms start in childhood, appear in more than one setting, and cause at least moderate difficulty.
- Only a specialist can diagnose ADHD, usually a paediatrician or child psychiatrist. A GP or school cannot, and refers instead.
- ADHD is under-recognised in girls, who are less likely to be referred and may be given an incorrect diagnosis.
- NICE puts parent training and changes to the child's environment before medication, and bars medication under age 5 without a second specialist opinion.
- A diagnosis does not automatically produce an education, health and care plan.
Symptoms
- Inattention: easily distracted, hard to listen or follow instructions, forgetting everyday tasks or not finishing them.
- Hyperactivity and impulsivity: high energy, fidgeting, getting up when meant to sit still, talking noisily or interrupting.
- Girls more often show the quieter inattentive presentation, which is easy to overlook and read as daydreaming.
Causes and risk factors
- ADHD often runs in families and is thought to involve genetic differences, though no one gene causes it.
- Higher rates among children born preterm, looked-after children, and those with a neurodevelopmental condition such as autism.
- Not caused by parenting style, sugar or screen time, despite popular belief.
Treatment
- Under 5: an ADHD-focused group parent-training programme first; no child under 5 should be offered medication without a second specialist opinion.
- Age 5 and over: information and ADHD-focused support for parents, then changes to the child's environment, before medication is considered.
- Where medication is used: methylphenidate first, then lisdexamfetamine, then atomoxetine or guanfacine where stimulants are unsuitable.
When to speak to a professional
- Your child's attention, activity or impulsiveness shows up at home and at school and is holding back learning, friendships or family life.
- Your child is being excluded, is falling behind despite effort, or you are struggling to keep them safe from impulsive risks.
If you need help now: Samaritans, call 116 123, free, 24/7. Shout, text SHOUT to 85258. NHS 111, then choose the mental health option. Call 999 if anyone is in immediate danger.