What is ADHD in children?

ADHD in children is one of the most common reasons families come to see a paediatrician. ADHD stands for attention deficit hyperactivity disorder. It is a neurodevelopmental condition, which means it relates to how the brain develops, and it affects a child's attention, activity levels and ability to stop and think before acting.

If you are reading this because you are worried about your child, you are not alone, and you have not caused this. ADHD is not the result of parenting. This page explains what ADHD is, how it shows up in children, and what a diagnosis can and cannot do.

ADHD in children: the core features

ADHD is diagnosed when a child has significant difficulties with concentration, activity levels and impulsivity, and when those difficulties affect everyday life in more than one setting. For children, that usually means at home and at school.

Inattention

A child with inattentive symptoms may:

• be easily distracted and drift off during lessons or conversations
• seem not to listen when spoken to directly
• start tasks but struggle to finish them
• lose things they need, such as books, coats and pencils
• find organising homework or getting ready in the morning very hard

Hyperactivity and impulsivity

A child with hyperactive and impulsive symptoms may:

• fidget, squirm or find it hard to stay seated
• seem always on the go, as if driven by a motor
• talk a lot, interrupt or blurt out answers
• find waiting their turn very difficult
• act before thinking, sometimes in ways that are unsafe

Inattentive ADHD and hyperactive-impulsive ADHD

Some children have mainly concentration difficulties. Others are mainly hyperactive and impulsive. Most have a mix of both. Children with mainly inattentive ADHD, who are often girls, can be quiet and dreamy rather than disruptive, so their difficulties are easier to miss. You can read more in our guide to the types of ADHD in children and in ADHD in girls.

Many young children are energetic and easily distracted without having ADHD. Tiredness, worry and stress can look similar too. What matters is how strong, persistent and disruptive the difficulties are, and whether they show up across different parts of a child's life.

How common is ADHD in children?

ADHD is common. NICE's clinical summaries estimate that around 5% of children worldwide have ADHD, roughly 1 in 20. In a typical class of 30, that could be one or two children.

ADHD is diagnosed more often in boys than in girls. NICE says ADHD is thought to be under-recognised in girls, who are less likely to be referred for assessment and more likely to be given a different diagnosis first.

Strengths and challenges of ADHD

Children with ADHD often have real strengths. Many are creative, energetic, curious and excellent at thinking outside the box. Some are brilliant problem solvers, sociable and full of ideas, and many keep going when others would give up. We have a whole page on the many good things about ADHD.

When ADHD is not recognised or supported, though, life can be hard. Falling behind at school, being in trouble often, anxiety and low self-esteem are common. Children can start to believe they are lazy or naughty, when in fact they are working much harder than others to keep up.

Why an ADHD diagnosis can help

Teachers are more aware of ADHD than they used to be, but parents are still sometimes blamed for their child's difficulties. Dr Bozena Zoric has written a book on how mothers in particular can be wrongly blamed in ADHD pathways. You can read about it on our page when parents feel blamed in ADHD pathways.

A diagnosis gives a clear reason for the difficulties. Many children, and their parents, feel relieved to understand why things have been so hard. It also helps school understand what your child needs, and it opens the door to the right support.

How ADHD is diagnosed: no blood test or brain scan

ADHD is one of the most researched conditions in childhood. Even so, there is still no blood test or brain scan that can show whether a child has ADHD. Diagnosis is a careful clinical process.

NICE guidance says ADHD should be diagnosed by a specialist, such as a paediatrician or psychiatrist, with training in ADHD. A diagnosis should never be based on questionnaires or observation alone. The specialist looks at how often the difficulties happen, whether they show up in two or more settings, and how much they affect your child's learning, friendships and family life.

At BZ Clinic, both of our doctors are consultant paediatricians, so they also look at your child's general health and development. A private ADHD assessment for your child includes questionnaires from you, school and, where appropriate, your child, plus a QbCheck, a computer-based test of attention, activity and impulsivity. Our what to expect page walks you through the day. If you are not sure yet, our ADHD questionnaire can help you organise your thoughts, although it cannot give a diagnosis.

ADHD treatment and support

Not every child with ADHD needs medication. Support usually starts with understanding: helping your child, your family and school make sense of how your child's brain works. Practical changes at home and in class, such as clear one-step instructions, routines, short tasks with breaks and plenty of praise, can make a real difference.

For children aged 5 and over whose ADHD is still causing significant difficulties after those changes, NICE recommends that medication can be considered. Medication is always used alongside strategies for home and school, never instead of them. It is started and adjusted by a specialist, and some children need to try more than one medicine before finding the right one. Our guide to ADHD medication for children explains more.

Conditions that often come with ADHD

ADHD often sits alongside other conditions. These include autism, anxiety, low mood and depression, learning difficulties such as dyslexia, speech and language difficulties, and behaviour difficulties.

During an ADHD assessment, our doctors screen for other conditions such as autism, Tourette's syndrome, dyspraxia, dyslexia and other learning difficulties. BZ Clinic assesses ADHD only, so if something else may be going on, the doctor will explain this and signpost you to the right place for further assessment. Our guide to ADHD and related conditions and ADHD or autism explain the overlap.

Where to read next

• Signs of ADHD in children
• Does my child have ADHD?
• What causes ADHD in children?
• ADHD and school
• Trusted ADHD resources for families

If you would like to talk things through, Camille, our clinic manager, can answer your questions on 07957 909754 or at admin@bzclinic.org. You do not need a GP referral.