In short
- The symptoms of ADHD in children fall into three groups: inattention, hyperactivity and impulsivity.
- Signs change with age. Hyperactivity is easiest to see in young children; inattention often becomes the bigger problem later.
- For a diagnosis, the signs must be frequent, present in more than one setting, and causing real difficulty in daily life.
- Lots of things can look like ADHD, including poor sleep, hearing problems, anxiety and learning difficulties.
- ADHD is not caused by parenting, laziness or a lack of discipline.
Most parents who search for the signs of ADHD in children already have a child in mind. Perhaps a teacher has mentioned it, or you have seen something online that sounded very familiar. This guide sets out the symptoms of ADHD in children the way a paediatrician thinks about them: what each sign looks like in everyday life, how the picture changes with age, and the many things that can look like ADHD but are not.
What are the signs of ADHD?
ADHD (attention deficit hyperactivity disorder) is a neurodevelopmental condition. That means it relates to how the brain develops, not to a child's character or the way they have been brought up. The signs fall into three groups:
- inattention: difficulty focusing, organising and remembering
- hyperactivity: high levels of movement and restlessness
- impulsivity: acting or speaking before thinking
Children with ADHD do not all look the same. Some mainly struggle with attention, some are mainly hyperactive and impulsive, and many have both. Doctors call these the inattentive, hyperactive-impulsive and combined presentations. You can read more in our page on what ADHD is.
Signs of inattention
Inattention is the part of ADHD that is easiest to miss, because a child who is struggling quietly rarely causes trouble. Signs include:
- making careless mistakes in schoolwork, even when they know the material
- finding it hard to stay focused on tasks or play, unless the activity is very exciting
- seeming not to listen when spoken to directly, as if their mind is elsewhere
- starting tasks and not finishing them: homework, chores, getting dressed
- struggling to organise themselves, their belongings and their time
- avoiding tasks that need sustained mental effort, such as writing or long homework
- regularly losing things: jumpers, water bottles, reading books, pencils
- being easily distracted by noises, movement or their own thoughts
- forgetting everyday routines, like brushing teeth or bringing their PE kit
Parents often say "they can focus on what they like". That is common in ADHD. The difficulty is with steering attention to things that are less interesting, not with paying attention at all.
Signs of hyperactivity
Hyperactivity is what most people picture when they think of ADHD. In children, it can look like:
- constant fidgeting, squirming, or tapping hands and feet
- getting up from their seat in class or at mealtimes when they are expected to sit
- running or climbing in situations where it is not appropriate
- finding it hard to play quietly
- being always "on the go", as if driven by a motor
- talking a great deal, often loudly
In older children and teenagers, hyperactivity often becomes less visible. It may show as inner restlessness, difficulty relaxing, or always needing to be doing something.
Signs of impulsivity
Impulsivity is about the gap between an urge and an action. Children with ADHD often find that gap very small. Signs include:
- blurting out answers before the question is finished
- finding it very hard to wait their turn in games, queues or conversations
- interrupting or butting into other people's conversations or play
- acting without thinking about danger, such as running into the road
- saying things they regret, then feeling genuinely sorry afterwards
Impulsivity can cause friendship problems and lead to children being labelled as naughty or rude. In most cases, they know the rule; they simply cannot stop themselves in the moment.
Other ADHD traits parents often notice
Beyond the three core groups, many families see other traits that often travel with ADHD:
- Big feelings. Quick frustration, tears or anger that flare up and pass, and a strong reaction to criticism.
- Sleep difficulties. Trouble switching off at night is common.
- Friendship strain. Missing social cues, interrupting, or being left out.
- Low self-esteem. Years of being told off can leave a child feeling they are "bad" or "stupid".
- Strengths too. Many children with ADHD are creative, energetic, curious and funny. Our page on the good things about ADHD is worth reading.
ADHD symptoms in children by age
Under 5
Toddlers and preschoolers are naturally busy, impulsive and distractible, so it is very hard to separate ADHD from normal development at this age. NHS guidance makes the point that many under-5s show these behaviours without having ADHD. See our guide to ADHD in young children.
Primary school (5 to 11)
This is when most children are first recognised, because school places new demands on attention and self-control. Teachers may notice a child who cannot stay on the carpet, is often out of their seat, rushes work, calls out, or takes much longer than others to get started. Inattentive children may be described as dreamy, slow, or not trying.
Secondary school and teenagers
The move to secondary school removes a lot of structure: more teachers, more rooms, more homework, more to remember. Children who coped in primary school may start to struggle. Common signs are lost homework, missed deadlines, late nights, arguments about screens, and falling grades. Hyperactivity often turns into restlessness, and impulsivity can show up as risk-taking. Our page on ADHD assessments for teenagers covers this age group.
Do the signs of ADHD look different in girls and boys?
They can. Boys are more often referred, partly because hyperactive behaviour is more noticeable in a classroom. Girls more often have the inattentive presentation, and may work very hard to hide their difficulties. NICE asks professionals to remember that ADHD is under-recognised in girls, and that girls may be given a different diagnosis instead. Read more in our guides to ADHD in girls and ADHD in boys.
What is not ADHD?
This is one of the most important parts of any assessment. Several things can produce attention or behaviour difficulties that look very like ADHD:
- Normal development. A child who is young for their school year may simply be less mature than their classmates.
- Tiredness and poor sleep. A child who is not sleeping well can be inattentive, irritable and restless.
- Hearing or vision problems. A child who cannot hear clearly may seem not to listen.
- Anxiety, low mood or stress. Worry takes up a lot of attention. Big changes at home or school can affect behaviour.
- Specific learning difficulties such as dyslexia, which can make a child avoid reading and writing tasks.
- Other neurodevelopmental conditions such as autism, tics or Tourette's syndrome, and dyspraxia.
Some of these can also exist alongside ADHD, so finding one does not rule ADHD out. Because our doctors are consultant paediatricians, they look at your child's general health as well as attention and behaviour, including sleep, hearing and other conditions. The doctor screens for autism, Tourette's syndrome, dyspraxia, dyslexia and other learning difficulties, and signposts you if needed.
ADHD is also not laziness, poor discipline or a parenting problem.
ADHD is not caused by parenting. Parents are often the first to see that something is different, and their observations are some of the most useful information a doctor has. You should be listened to, not blamed.
How do doctors decide whether it is ADHD?
There is no blood test or brain scan for ADHD. NICE guidance says a diagnosis should only be made by a specialist, such as a paediatrician or psychiatrist with training in ADHD, after:
- a full clinical and psychosocial assessment, covering behaviour in different settings
- a full developmental and mental health history
- reports from people who see the child, such as parents and teachers
The symptoms need to happen often, be present in at least two important settings (for children, usually home and school), and cause at least moderate difficulty with learning, friendships or family life. NICE is clear that questionnaires and rating scales help, but a diagnosis should never be based on them alone.
NICE also notes that prevalence estimates vary widely depending on the diagnostic criteria used, from around 1 to 2% of children under the strictest definition to higher figures under broader ones.
When should you get help?
It is worth seeking advice if the signs above have been there for a long time, show up both at home and at school, and are making life harder for your child or your family. A good first step is our free ADHD questionnaire, which lists the behaviours doctors ask about. It cannot diagnose ADHD, but it can help you put your concerns into words.
Before any appointment, it helps to gather a few things together:
- recent school reports, and any comments from teachers that keep coming up
- a note of when you first noticed the difficulties, and whether they have changed
- examples from everyday life: mornings, homework, mealtimes, bedtime, friendships
- anything relevant about pregnancy, birth, early development, sleep or general health
- whether anyone else in the family has ADHD or similar difficulties, as it often runs in families
None of this needs to be perfect. A paediatrician will ask questions to fill in the gaps, and will want to hear your child's own view too.
From there, you can speak to your child's teacher or the school SENCO, see your GP, or contact us directly. At BZ Clinic, a private ADHD assessment for your child is a 90-minute, face-to-face appointment in West Byfleet with a consultant paediatrician, for children and young people aged 5 to 18. It includes questionnaires from home and school and a QbCheck, a computer-based test of attention, activity and impulsivity. No GP referral is needed. Call Camille on 07957 909754 or email admin@bzclinic.org.
Questions parents ask
What are the first signs of ADHD in a child?
Parents often first notice a child who is far busier, more impulsive or more easily distracted than other children the same age, and that this does not settle with time or routine. In quieter children, the first sign may be a teacher saying they drift off, do not finish work or seem not to listen.
What are the 3 types of ADHD?
Doctors describe three presentations: mainly inattentive, mainly hyperactive-impulsive, and combined, where a child has both. Most children with ADHD have the combined presentation. The mainly inattentive kind is more often missed, especially in girls.
Can a child show ADHD traits and not have ADHD?
Yes. Every child is distractible, restless or impulsive at times. ADHD traits only add up to a diagnosis when they are frequent, more than expected for the child's age, seen in more than one setting, and getting in the way of learning, friendships or family life.
At what age do ADHD symptoms start?
Symptoms usually begin in early childhood. The DSM-5 diagnostic criteria, which NICE guidance draws on, say several symptoms should be present before age 12. They often become more noticeable once a child starts school, because school asks more of attention and self-control.
Are the symptoms of ADHD in children different from adults?
The core difficulties are the same, but they look different. Children tend to show more visible hyperactivity, while adults more often describe inner restlessness, disorganisation and trouble with time. This guide focuses on children and teenagers.