ADHD

Page last reviewed: 13/07/2011

Attention deficit hyperactivity disorder (ADHD) is a group of behavioural symptoms that include inattentiveness, hyperactivity and impulsiveness. Attention deficit disorder (ADD) is a type of ADHD.

Common symptoms of ADHD include:

  • a short attention span
  • restlessness
  • being easily distracted
  • constant fidgeting

Many people with ADHD also have additional problems, such as sleep disorders or learning difficulties. However, ADHD has no effect on intelligence. See ADHD - Symptoms for a full list of possible symptoms and associated conditions.

Children naturally have a tendency towards the kind of behaviour that ADHD causes, but this behaviour should not be confused with ADHD. There are several criteria that must be met for a child to be diagnosed with ADHD (see ADHD - Diagnosis for more information). Adults are harder to diagnose because there is no definitive set of age-appropriate symptoms.

How common is ADHD?

ADHD is the most common behavioural disorder among children. It is estimated that the condition affects 3-9% of school-aged children and young people. Worldwide, around 2% of adults may be affected by ADHD.

Symptoms of ADHD tend to start at an early age, and they may become more noticeable when a child's circumstances change, such as starting school. ADHD is normally diagnosed between the ages of three to seven, although in some cases it may not be until much later. It is more commonly diagnosed in boys. 

It is still uncertain whether ADHD can occur in adults without first appearing in childhood.

Outlook

There is no cure for ADHD, but it can be managed using medication. This will be combined with psychological, educational and social therapies that aim to improve behaviour (see ADHD - Treatment for more information). 

ADHD can be a lifelong condition, and many children continue to have symptoms as a teenager and adult. It is estimated that nearly two-thirds of children with ADHD still have some symptoms at the age of 25. 

Hyperactivity
Hyperactivity is a higher than normal level of activity and restlessness.

Page last reviewed: 13/07/2011

The symptoms of attention deficit hyperactivity disorder (ADHD) can be categorised into two sets of behavioural problems:

  • symptoms of inattentiveness
  • symptoms of hyperactivity and impulsiveness

It is not fully understood whether these problems are an extreme form of normal behaviour, or part of a separate range of behaviour.

Types of ADHD

A person with ADHD usually has symptoms characteristic of one of the three subtypes of the condition. The subtypes are:

  • ADHD mainly inattentive
  • ADHD mainly hyperactive-impulsive
  • ADHD combined

If your child has symptoms of all three behavioural problems - inattentiveness, hyperactivity and impulsiveness - they may have ADHD combined, which is the most common subtype of ADHD.

Alternatively, if your child has symptoms of inattentiveness but not hyperactivity or impulsiveness, they may have ADHD mainly inattentive. This form of ADHD is also known as attention deficit disorder (ADD).

Childhood ADHD is more commonly diagnosed in boys than in girls, but this may be because disruptive behaviour, which the diagnosis may be partly based on, tends to be more common in boys than girls.

Girls with ADHD often have the mainly inattentive form of the condition, which may make them quiet and dreamy and can sometimes go unnoticed. It is therefore possible that ADHD could be underdiagnosed in girls, and could be more common than previously thought.

Symptoms in children and teenagers

The symptoms of ADHD in children and teenagers are well defined. The main symptoms of each behavioural problem are detailed below.

Inattentiveness

The main symptoms of inattentiveness are:

  • a very short attention span
  • being very easily distracted
  • making careless mistakes, for example in schoolwork 
  • appearing forgetful or losing things 
  • being unable to stick at tasks that are tedious or time consuming
  • being unable to listen to or carry out instructions
  • being unable to concentrate
  • constantly changing activity or task
  • having difficulty organising tasks

Hyperactivity

The main symptoms of hyperactivity are:

  • being unable to sit still, especially in calm or quiet surroundings
  • constantly fidgeting
  • being unable to settle to tasks
  • excessive physical movement
  • excessive talking

Impulsiveness

The main symptoms of impulsiveness are:

  • being unable to wait for a turn
  • acting without thinking
  • interrupting conversations
  • breaking any set rules
  • little or no sense of danger

If your child has ADHD, their symptoms usually become noticeable before the age of seven, with a diagnosis usually made between the ages of three and seven.

ADHD can cause problems in a child's life, and can often lead to underachievement at school, poor social interaction with other children and adults and problems with discipline.

Related conditions in children and teenagers

Although it is not always the case, your child may also have other problems or conditions alongside ADHD. These are explained below.

Anxiety disorder

Some children with ADHD may have an anxiety disorder that causes them to worry and be nervous most of the time. Your child may also have physical symptoms, such as a rapid heartbeat, sweating and dizziness. See the Health A-Z topic about Anxiety for more information.

Oppositional defiant disorder (ODD)

Oppositional defiant disorder (ODD) is common among children with ADHD. It is defined by negative and disruptive behaviour, particularly towards authority figures such as parents and teachers.

Conduct disorder

Children who have conduct disorder have a tendency towards highly antisocial behaviour, such as:

  • stealing
  • fighting
  • vandalism
  • harming people
  • harming animals

If your child is behaving in this way, book an appointment with your doctor as soon as possible.

Depression

It is possible for children with ADHD to become depressed as a result of their condition. See the Health A-Z topic about Depression for more information on this condition.

Sleep problems

Children with ADHD can be very hyperactive and find it difficult to sleep at night. They may experience irregular sleeping patterns.

Epilepsy

Epilepsy is a condition of the brain that causes seizures (fits). See the Health A-Z topic about Epilepsy for more information on this condition.

Tourette's syndrome

Tourette's syndrome is a condition of the nervous system (the nerves, brain and spinal cord) that causes involuntary movements and sounds. See the Health A-Z topic about Tourette's syndrome for more information.

Learning difficulties

It is thought that around a third of children with ADHD also have learning difficulties, such as dyslexia (difficulty reading and spelling words). However, it is important to remember that ADHD has no effect on intelligence.

Symptoms in adults

In adults, the symptoms of ADHD are more difficult to define. This is largely due to a lack of research into adults with ADHD.

It is still uncertain whether ADHD can occur in adults without it first appearing during childhood, although it is known that symptoms of ADHD often persist from childhood into the teenage years and adulthood. Any additional problems or conditions experienced by children with ADHD, such as depression or dyslexia, are also likely to carry on into adulthood.

By the age of 25, an estimated 15% of people diagnosed with childhood ADHD still have a full range of symptoms, and 65% still have some symptoms that affect their daily lives.

There is no definitive list of adult ADHD symptoms, and experts agree that simply applying the childhood symptoms to adults would not work. This is because the way in which inattentiveness, hyperactivity and impulsiveness affect adults is very different from the way they affect children.

For example, hyperactivity tends to decrease in adults, while inattentiveness tends to get worse as the pressure of adult life increases. Also, adult symptoms of ADHD tend to be far more subtle than childhood symptoms.

Below is a list of symptoms associated with adult ADHD:

  • carelessness and lack of attention to detail
  • continually starting new tasks before finishing old ones
  • poor organisational skills
  • inability to focus or prioritise
  • continually losing or misplacing things
  • forgetfulness
  • restlessness and edginess
  • difficulty keeping quiet and speaking out of turn
  • blurting responses, and poor social timing when talking to others
  • often interrupting others
  • mood swings
  • irritability and a quick temper
  • inability to deal with stress
  • extreme impatience
  • taking risks in activities, often with little or no regard for personal safety or the safety of others

As with ADHD in children and teenagers, ADHD in adults can appear alongside many related problems or conditions. One of the most common conditions is depression. Other conditions that adults may have alongside ADHD include:

  • personality disorders
  • bipolar disorder,a condition that affects your moods, which can swing from one extreme to another
  • obsessive-compulsive disorder,a condition that causes obsessive thoughts and compulsive behaviour, such as cleaning constantly 

Any problems you may have had as a child are likely to persist into adulthood, which can make life extremely difficult. For example, you may have problems:

  • finding and keeping employment
  • in relationships and social interactions
  • with drugs
  • with crime

Hyperactivity
Hyperactivity is a higher than normal level of activity and restlessness.

Depression
Depression is when you have feelings of extreme sadness, despair or inadequacy that last for a long time.

Page last reviewed: 13/07/2011

The exact cause of attention deficit hyperactivity disorder (ADHD) is not fully understood. It is thought that ADHD is caused by a mix of genetic (inherited) and environmental factors.

Genetics

ADHD tends to run in families and, in most cases, it is thought that inheriting the condition is the most likely cause. Research shows that both the parents and siblings of a child with ADHD are four to five times more likely to have ADHD themselves.

Brain function and anatomy

Although the exact cause of ADHD is still unclear, research shows that the way the brain works in people with ADHD differs from that of people who do not have the condition. It is thought that chemicals in the brain that carry messages, known as neurotransmitters, do not work properly in people with ADHD. Also, people with the condition seem to display less activity in the parts of their brains that control activity and attention.

Some research shows that the frontal lobes, which are the part of the brain that control decision-making, do not work as they should in people with ADHD. Other research indicates that they may have imbalances in the levels of certain chemicals, such as noradrenaline and dopamine.

Exposure to toxins during pregnancy

Women who smoke when they are pregnant are more likely to have a child with ADHD. Drinking alcohol and drug abuse can also increase the risks of ADHD in an unborn child.

Being male

Boys are more commonly diagnosed with childhood ADHD than girls, and more men are diagnosed with the condition than women. Research suggests this could be because diagnosis tends to pinpoint loud, disruptive behaviour, which is more noticeable and more common in males than in females.

It could also be that ADHD is missed in girls because they tend to have the form of the condition defined by inattentiveness (ADHD mainly inattentive, or attention deficit disorder).

Excessive exposure to television

There have been several studies that have looked at the relationship between children watching a lot of television at a very young age and the development of ADHD in later childhood.

There is not enough evidence to say that television is definitely a cause of ADHD, but allowing children up to the age of three to watch several hours a day could contribute to attention problems and ADHD in later life.

Food intolerance

Food intolerance is not a direct cause of ADHD, but some studies have suggested that there may be a link between childhood ADHD and common food allergens, such as:

  • milk
  • wheat
  • nuts

There is no evidence that sugar causes the symptoms of ADHD.

Other causes

Other possible causes of ADHD include:

  • being born prematurely (before week 37 of the pregnancy)
  • having a low birth weight
  • brain damage either in the womb or in the first few years of life
  • having a hearing impairment

Genetic
Genetic is a term that refers to genes. Genes are the characteristics inherited from a family member.

Neurotransmitters
These are the chemicals that carry messages between brain cells.

Uterus
The uterus (or womb) is a hollow, pear-shaped organ in a woman where a baby grows during pregnancy.

Page last reviewed: 13/07/2011

There is no simple test to determine whether you or your child has attention deficit hyperactivity disorder (ADHD). If you think that you or your child may have ADHD, book an appointment to visit your GP.

Visiting your GP

Your GP will ask:

  • what symptoms you or your child has
  • when the symptoms started
  • where the symptoms occur, for example at home or in school
  • how the symptoms affect your (or your child's) quality of life
  • if there have been any recent changes, for example a death or divorce in the family
  • if there is a family history of ADHD
  • any other problems, or symptoms of different health conditions

Functional impairment

Your GP will want to know if these symptoms are causing functional impairment. This means whether they are affecting day-to-day life. For example, a child may have functional impairment if:

  • They are unable to make or keep friends.
  • They are unable to wash or feed themselves.

Assessing children

If your child's symptoms are causing mild or moderate functional impairment, your GP may recommend "watchful waiting" for up to 10 weeks. This is seeing if their symptoms improve by trying to manage their behaviour better.

If you are a parent whose child may have ADHD, you may be offered parent training or an education programme to teach you to use behavioural techniques to help your child. See ADHD - Treatment for more information on these. 

Alternatively, if your child's symptoms are causing severe functional impairment, your GP will refer your child to another healthcare professional who will be able to diagnose ADHD.

Assessing adults

For adults with ADHD symptoms, your GP will assess your symptoms and may refer you to a specialist if:

  • You were not diagnosed with ADHD as a child, but your symptoms began during childhood and have been ongoing since then.
  • Your symptoms are not caused by another mental health condition.
  • Your symptoms are causing moderate or severe functional impairment; for example, you are underachieving at work or find intimate relationships difficult. 

You may also be referred to a specialist if you had ADHD as a child or young person and your symptoms are now causing moderate or severe functional impairment.

Referral

If your GP suspects that you or your child has ADHD, they may refer you to a specialist such as:

  • a child or adult psychiatrist (an expert in mental and emotional health)
  • a paediatrician (an expert in children's health)
  • the mental health services for children and young people

Who you are referred to will depend on your age and what is available in your local area.

Your specialist can make an accurate diagnosis after a detailed assessment that may include:

  • a physical examination, which will rule out other possible causes for the symptoms
  • several tests that can determine your (or your child's) short-term memory, concentration and problem-solving skills
  • a series of interviews with you or your child
  • interviews or reports from other significant people, such as partners, parents and teachers

Diagnosis in children and teenagers

Diagnosing ADHD in children depends on a set of strict criteria. To be diagnosed with ADHD, your child must have six or more symptoms of inattentiveness, or six or more symptoms of hyperactivity and impulsiveness. See ADHD - Symptoms for examples of such symptoms.

The type of ADHD your child will be diagnosed with will depend on the number of symptoms they have from each group. For example, if they have eight symptoms of hyperactivity and impulsiveness and only three symptoms of inattentiveness, they will be diagnosed with ADHD mainly hyperactive-impulsive.
 
To be diagnosed with ADHD, your child must also have:

  • been displaying symptoms continuously for at least six months
  • started to show symptoms before the age of seven - although in some cases a diagnosis can still be made if symptoms do not start until after this age
  • been showing symptoms in at least two different settings - for example, at home and at school, to rule out the possibility that the behaviour is just a reaction to certain teachers or to parental control
  • symptoms that make their lives considerably more difficult, on a social, academic or occupational level
  • symptoms that are not just part of a developmental disorder or difficult phase, and are not better accounted for by another condition

Diagnosis in adults

Diagnosing ADHD in adults is more difficult because there is no definitive list of symptoms that can be applied to an adult who potentially has the condition.

If your GP refers you to a specialist, they will ask you about your present symptoms. However, under the current diagnostic guidelines, a diagnosis of adult ADHD cannot be confirmed unless your symptoms have been present from childhood.

To help your specialist decide on your diagnosis, they may ask about your childhood and whether your symptoms were present then. If you find it difficult to remember, or you were not diagnosed with childhood ADHD, your specialist may wish to see your old school records or talk to your parents, teachers or anyone else who knew you well when you were a child.

For an adult to be diagnosed with ADHD, their symptoms should cause a moderate degree of impairment in different areas of their life. Examples of impairment could be:

  • underachieving at work or in education
  • driving dangerously
  • difficulty carrying out daily activities, such as shopping
  • difficultly making or keeping friends
  • difficulty in relationships with partners

If your problems are recent and did not occur regularly in the past, you are not considered as having adult ADHD.

Hyperactivity
Hyperactivity is a higher than normal level of activity and restlessness.

Psychiatrist
A qualified medical doctor who has done further training in treating mental health conditions.

Page last reviewed: 13/07/2011

There is no cure for attention deficit hyperactivity disorder (ADHD), but treatment can reduce your symptoms and make the condition much less of a problem in day-to-day life. ADHD can be treated using medications or therapy, but it is widely agreed that a combination of both forms of treatment is the best way to treat it.

The different ways of treating ADHD, and how they can be used for children, teenagers and adults, are outlined below. Treatment will usually be arranged by a specialist, such as a psychiatrist (an expert in mental and emotional health), although your condition may be monitored by your GP. 

Medication

Medications for ADHD produce a short-lived improvement after each dose, but they are not a permanent cure. They create a short period when someone who has ADHD can:

  • concentrate better
  • be less impulsive
  • feel calmer
  • learn and practise new skills

There are three types of medication for ADHD:

  • methylphenidate
  • dexamfetamine
  • atomoxetine

If you have been diagnosed with adult ADHD, your GP and specialist can discuss which medications and therapies may be suitable for you.

Medications for ADHD are controlled drugs, which means their availability and use are more closely controlled than other prescription medicines. If you or your child is prescribed one of these treatments, you will probably be given small dosages at first, which may then be gradually increased.

You or your child will need to return to your GP for regular check-ups to ensure that the treatment is still working effectively. If you or your child has shown an improvement and the condition appears stable, your GP may recommend a break from treatment, for example over a weekend or during school holidays. These breaks help to assess how you or your child can manage without the medicine.

Methylphenidate

Methylphenidate is known as a psychostimulant or central nervous system (CNS) stimulant. It is not completely clear how it works, but it is thought that it stimulates a part of the brain that changes mental and behavioural reactions.

Methylphenidate can be used by teenagers and children with ADHD who are over the age of six years. Although methylphenidate is not licensed for use in adults, it may be taken under close supervision from your GP and specialist.

Methylphenidate cannot be taken:

  • by women who are pregnant or breastfeeding
  • if you or your child has glaucoma (an eye condition that affects vision) 
  • if you or your child has severe depression

Methylphenidate should be used with caution:

  • if you or your child has a tic (a repeated involuntary movement or sound)
  • if you or your child has Tourette's syndrome  (a condition that causes involuntary movements or sounds)
  • if you or your child has epilepsy (a condition that causes fits) - if the frequency of the fits increases the medicine may need to be stopped 

Methylphenidate can be taken as either immediate-release tablets (small doses taken two to three times a day), or as modified-release tablets (taken once a day, usually in the morning, and they release the dose throughout the day).

Your GP and specialist may recommend a modified release tablet if you or your child need the treatment to last into the evening. It may also be convenient for children who may not be able to take multiple doses at school. However, the doses of methylphenidate in modified release tablets may be larger, and may not be suitable for young children.

Methylphenidate can cause side effects, which may include:

  • a small increase in blood pressure and heart rate
  • loss of appetite, which can lead to weight loss (if your child is prescribed methylphenidate, your GP will monitor their weight to ensure that they are growing properly)
  • trouble sleeping
  • dry mouth
  • headaches
  • stomach aches
  • mood swings

There are ways to ease these side effects. For example, loss of appetite may be avoided by taking the medication with a meal or snack. Teenagers and adults should avoid drinking alcohol during treatment because this can make the side effects worse.

Dexamfetamine

Dexamfetamine works in the same way as methylphenidate. It is also classed as a psychostimulant or CNS stimulant, and may be particularly effective in controlling hyperactivity.

Dexamfetamine can be used by teenagers and children with ADHD who are over three. Although it is not licensed for use in adults, it may be taken under close supervision from your GP and specialist.

Dexamfetamine cannot be taken:

Dexamfetamine should be used with caution:

  • if you or your child has epilepsy - if you are still having fits the medicine may need to be stopped
  • if you or your child has kidney problems

Dexamfetamine is usually taken as a daily tablet, and may have side effects that are similar to those of methylphenidate.

Atomoxetine

Atomoxetine works differently from methylphenidate and dexamfetamine.

Atomoxetine is known as a selective noradrenaline uptake inhibitor (it increases the amount of a chemical in the brain called noradrenaline). This chemical passes messages between brain cells, so by increasing the amount the atomoxetine aids concentration and helps to control impulses.

Atomoxetine can be used by teenagers and children over six. It is also licensed for use in adults who are continuing treatment after taking the medication as a teenager. It is not licensed for use in adults who have been newly diagnosed with ADHD, but your GP and specialist may prescribe it under their supervision.

Atomoxetine cannot be taken:

  • by women who are pregnant or breastfeeding
  • if you or your child has glaucoma

Like other medications, the use of atomoxetine must be closely monitored by your GP and specialist.

Some studies have shown that a small number of children and young people who take atomoxetine are more likely to think about suicide. If either you or your child begin to feel depressed or suicidal while taking this medication, see your GP to ask about switching to a different medication.

Also, in very rare cases, there is evidence that atomoxetine can cause liver damage. Arrange to see your GP regularly if you or your child is taking this medication.

Atomoxetine comes in tablet form that you or your child takes once or twice a day. The tablets are long-acting, so your child will not need to take them at school. It may be prescribed as an alternative to methylphenidate or dexamfetamine if you or your child has a tic or Tourette's syndrome.

Atomoxetine can cause side effects, which may include:

  • a small increase in blood pressure and heart rate
  • nausea (feeling sick)
  • waking early in the morning
  • dizziness
  • stomach aches
  • painful urination
  • irritability

If you or your child needs to be prescribed a medication for ADHD, your GP and specialist will take several factors into account before recommending a treatment.

These factors will include:

  • any other conditions that you or your child may have
  • the side effects of each treatment
  • whether or not the dosage times interfere with school or work

Therapy

As well as taking medication, different therapies can be useful in treating ADHD in children, teenagers and adults. Therapy is also effective in treating any additional problems, such as conduct or anxiety disorders, that may appear with ADHD.

The therapies outlined below can be carried out with the help of a number of healthcare professionals, including:

  • counsellors - experts trained to provide talking therapies that aim to help people cope better with their life and their mental health condition
  • psychiatrists - qualified medical doctors who have done further training in treating mental health conditions
  • psychologists - healthcare professionals who specialise in the assessment and treatment of mental health conditions
  • social workers - experts who are often used to bridge the gap between mental health services and the wider social service provision, and provide advice on a variety of practical issues

Psychotherapy

Psychotherapy is a type of talking therapy, which means that you or your child will be encouraged to discuss your ADHD and how it affects you. It can help children, teenagers and adults to make sense of being diagnosed with ADHD, and can help you to cope and live with the condition.

See the Health A-Z topic about Psychotherapy for more information on this type of treatment.

Behaviour therapy

Behaviour therapy provides support for carers of children with ADHD, and may involve teachers as well as parents. Behaviour therapy usually involves behaviour management, which uses a system of rewards and penalties to encourage your child to try and control their ADHD.

If your child has ADHD, you can identify types of behaviour that you want to encourage, such as sitting at the table to eat. Your child is then given some sort of small reward for good behaviour, and a small penalty for poor behaviour. For teachers, behaviour management involves learning how to plan and structure activities and to praise and encourage children for even very small amounts of progress.

Parent training and education programmes

If your child has ADHD, parent training and education programmes can help you learn specific ways of talking to your child and playing and working with them to improve their attention and behaviour. You may also be offered parent training before your child is officially diagnosed with ADHD.

These programmes are usually arranged in groups and can last several weeks. They aim to teach parents and carers about behaviour management (see above), while increasing your confidence in your ability to look after your child and improving the relationship between you and your child. 

Social skills training

Social skills training involves your child taking part in role-play situations, and aims to teach them how to behave in social situations by learning how their behaviour affects others.

Cognitive behavioural therapy (CBT)

Cognitive behavioural therapy (CBT) is an alternative form of therapy based on the idea that your problems are often created by you. It is not the situation itself that is causing problems, but how you think about it and how you react to it. A CBT therapist would try and change how your child feels about a situation, which would in turn change their behaviour.

See the Health A-Z topic about CBT for more information on this type of therapy. 

Other methods of treatment

There are other ways of treating ADHD that some people with the condition find helpful, such as cutting out certain foods and taking certain supplements. However, there is no medical evidence that these methods work, and they should not be attempted without medical advice.

Diet

People with ADHD should eat a healthy balanced diet. Do not cut out certain foods without medical advice.

Some people may notice a link between certain types of food and worsening ADHD symptoms. For example, sugar and caffeine are often blamed for aggravating hyperactivity, and some people may have intolerances to wheat or dairy products that may add to their symptoms.

If this is the case, keep a diary of what you eat and drink and what behaviour this causes. Discuss this with your GP, who may refer you to a dietitian (a healthcare professional who specialises in nutrition).

If there is a link to certain types of food, your GP may consider advising that you eliminate this type of food. But do not change your (or your child's) diet without medical advice.

Supplements

Some people consider certain supplements, such as omega 3 fatty acid, to be beneficial in people with ADHD. However, there is no medical evidence to support this. If you do wish to try using a supplement, always talk to your GP first, as some can react unpredictably with other medication or make it less effective.

Also remember that supplements should not be taken long-term, as they can build up to dangerous levels in your body.

Exercise

People with ADHD should take regular exercise.

Hyperactivity
Hyperactivity is a higher than normal level of activity and restlessness.

Nervous system
The brain, spinal cord and nerves.

Kidneys
Two bean-shaped organs that are located on either side of the body just underneath the ribcage and filter out waste products from the blood.

Depression
Depression is when you have feelings of extreme sadness, despair or inadequacy that last for a long time.

Liver
The liver is the largest organ in the body. Its main jobs are to secrete bile (to help digestion), detoxify the blood and turn food into energy.

 

Monitoring

If you or your child are prescribed medication for ADHD, you will be monitored regularly:

  • Your blood pressure and heart rate will be checked before and after your dose is changed, and every three months.
  • If you develop any chest pains or palpitations (an irregular heartbeat) you will be referred to a cardiologist (heart specialist).
  • Children and young people will have their height measured every six months.
  • Children and young people will have their weight measured three months after starting treatment, and then every six months.
  • Adults will have their body mass index measured three months after starting treatment, and then every six months.

Tips for parents

  • Be sure your GP or specialist helps you understand the difference between ADHD and any other problems that your child may also have.
  • Think about who else needs to know about your child’s ADHD, such as their school or nursery.
  • Find out the side effects of any medication your child takes.
  • Getting to know people at local support groups can stop you feeling isolated and unable to cope.

Page last reviewed: 13/07/2011

Living with a child who has attention deficit hyperactivity disorder (ADHD) can be draining. The impulsive, fearless and chaotic behaviours that are typical of ADHD can make normal everyday activities exhausting and stressful. There are many areas that bring about their own issues when your child has ADHD, including:

  • getting your child to sleep at night
  • arriving at school on time
  • listening to and carrying out instructions
  • social occasions
  • shopping

Ways to cope

It is difficult when things are going wrong, but it is important to remember that a child with ADHD cannot help their behaviour. People with ADHD find it difficult to suppress their impulses, which means that they do not stop to consider a situation or the consequences before they act.

Plan the day

Plan the day so that your child knows what to expect. Set routines can make a difference to how a child with ADHD copes with everyday life. If your child has to get ready for school, for example, break it down into structured steps so they know what the daily chores are.

Set clear boundaries

Make sure that everyone knows what behaviour is expected and reinforce positive behaviour with immediate praise or rewards. Be clear, using enforceable consequences if the boundaries are overstepped (such as taking away a privilege) and follow these through consistently.

Be positive

Give specific praise. Instead of saying a general, "Thanks for doing that," you could say, "You washed the dishes really well. Thank you." Your child will know that you are pleased, and why.

Giving instructions

If you are asking your child to do something, give brief instructions and be specific. Instead of asking, "Can you tidy your bedroom?" say, "Please put the Lego into the box and put the books back onto the shelf." This allows your child to achieve and creates opportunities for praise when they get it right. 

Incentive scheme

Set up your own incentive scheme using a points chart or star chart so that good behaviour can earn a privilege. For example, behaving well on a shopping trip will earn your child time on the computer or a game of something. Involve your child in it and allow them to help decide what the privileges will be.

These charts need regular changes or they become boring. Targets should be:

  • immediate (for example, daily)
  • intermediate (for example, weekly) 
  • long-term (for example, three-monthly)

Try to focus on just one or two behaviours at once. 

Intervene early

Keep an eye out for warning signs. If your child looks like they are becoming frustrated or overstimulated and are about to lose self-control, move in and intervene. If you can, distract your child by taking them away from the situation, which may calm your child down.

Social situations

Keep social situations short and sweet. Invite friends to play, but keep playtimes short so your child does not lose self-control. Do not aim to do this when your child is feeling low (for example, when they are feeling tired or hungry after a day at school).

Exercise

Make sure your child gets lots of physical activity during the day. Walking, skipping and playing sport can help your child wear themself out and improve their quality of sleep. Make sure they are not doing anything too strenuous or exciting near to bedtime. 

Eating

Keep an eye on what your child eats. If your child is more hyperactive after eating certain foods, such as that containing additives or caffeine, keep a diary of these and discuss this with your GP.

Bedtime

Stick to a routine. Make sure your child goes to bed at the same time each night and gets up at the same time in the morning. Avoid overstimulating activities in the hours before bedtime, such as computer games or watching TV.

Night time

Sleep problems and ADHD can be a vicious circle. ADHD can lead to sleep problems, which in turn can make ADHD symptoms worse. Many children with ADHD will repeatedly get up after being put to bed and have interrupted sleep patterns. Trying a sleep-friendly routine can help your child and make bedtime less of a battleground.

Content provided by NHS Choices www.nhs.uk and adapted for Ireland by the Health A-Z.

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