This guide is for parents who are struggling to understand their child’s ADHD symptoms or diagnosis of ADHD. But it’s also for adults who grew up believing that something was wrong with them because their brains didn’t work like those of neurotypical kids. The ADHD mind has its own rules. When you know the rules, you can better advocate for your child – or for yourself. You can stop setting up the ADHD mind for failure, and instead build a roadmap of solutions – founded on unconditional love, informed support, and acceptance.
The ADHD mind is creative! And tenacious! And spirited! And fascinating! Thriveworks wanted to give you a glimpse of those virtues, as well as answer all your most important questions about this neurodevelopmental disorder, from “Is ADHD a disability?” to “How do you discipline a child with ADHD?” We wanted to present some of the latest neurological research, as well as offer practical parenting tips that will help you manage the significant challenges ahead. But most importantly, we wanted to show you that being different doesn’t mean being defective. As a society, we need to stop trying to fundamentally change neurodiverse children, and instead learn who they are, and how their minds operate, so we can all work together.
What Is ADHD?
What does ADHD stand for? ADHD stands for attention deficit/hyperactivity disorder. ADHD is a lifespan, neurodevelopmental disorder, which means it affects the nervous system and it begins to manifest in childhood. ADHD used to be called “attention deficit disorder” (ADD), and before that “minimal brain dysfunction,” and before that “hyperkinetic disorder.” Two doctors who have ADHD themselves, Ned Hallowell, MD, and John Ratey, MD, have proposed calling the condition “variable attention stimulus trait” (VAST), a name that reflects the benefits, not the pathology, of ADHD.
Globally, ADHD affects 5.9% of children and 2.5% of adults. It’s more common in boys than girls, at a ratio of about 2:1. Symptoms can sometimes diminish, evolve, or even resolve in the course of maturation, which isn’t fully accomplished in the brain’s frontal lobes until age 35.
Is ADHD a disability? Technically, yes. If someone has severe ADHD in the US, they might qualify for federal benefits under the Americans with Disabilities Act (ADA). You don’t get diagnosed with the disorder unless you’re at greater risk for harm or dysfunction. But ADHD is also the most commonly diagnosed mental health condition in children, according to the Centers for Disease Control and Prevention (CDC). Three out of four kids with ADHD in the US receive treatment for it, improving their long-term outcomes. And symptoms can run the gamut from borderline to very mild to severe. People with ADHD are successful artists, executives, athletes, doctors, politicians, and more. There’s no limit to what the ADHD mind can do when it’s engaged. Its hyperfocus can be a superpower, not a handicap.
If you don’t know much about ADHD, then you might have made assumptions about it in the past. You might even have misjudged or discriminated against people with the disorder. But this guide can help you make up for lost time. Going forward, these are the main things you need to know about ADHD:
- ADHD affects brain networks, or cognitive pathways. It’s not an IQ issue; it’s an internal communication issue. Functional imaging from PET scans and fMRIs shows that the ADHD mind struggles with top-down control, the executive signals that tell us what to pay attention to, and when. The ADHD brain has been called an “interest-based nervous system,” meaning it’s hard for its neural networks to stay on task when something distracting comes along. Dr. Ned Hallowell likens it to having “a race car brain with bicycle brakes.”
- When thinking about ADHD, age and environment are vitally important. For example, you wouldn’t expect a toddler to function well in a highly structured grade-school classroom, and you shouldn’t expect an immature nervous system to be able to perform the same tasks as neurotypical white matter. Russell Barkley, PhD, states that the maturity of the ADHD brain lags roughly 30% behind a neurotypical brain in “executive age.”
- ADHD isn’t consistent. William Dodson, MD, states, “The hallmark of the ADHD nervous system is not attention deficit, but inconsistent attention.” Someone with ADHD can be incredibly focused – when their mind is stimulated and engaged.
- You can’t expect people with ADHD to fulfill their potential in the same ways as neurotypical people. This means that barking orders at someone with ADHD may only exacerbate their cognitive challenges.
- ADHD should not be someone’s defining characteristic. It’s a quirk of how their brain functions, and it’s important, but it’s not who they are.
- ADHD is dimensional, not categorical. This means that there’s a broad spectrum of functionality within the condition, and diagnosing ADHD isn’t a matter of looking at black and white biological markers, but rather at a wide, eclectic range of symptoms (more on those below).
- People with ADHD are often more vulnerable than neurotypical people. They’re at higher risk for developing other psychiatric conditions like depression, for occupational impairments at school and work, for social difficulties, and for low self-esteem. Which means that we must begin advocating for them from a young age.
- ADHD can be treated successfully with safe medications and behavioral therapy. These evidence-based interventions must be tailored to each individual and their goals, but decades of research show that they work.
Why Is ADHD So Common in the US?
According to the World Federation of ADHD, ADHD is neither a new disorder, nor an American disorder. Descriptions of ADHD symptoms in scientific literature go back to 1775. And the condition is found throughout the world at similar rates.
But ADHD is more likely to be diagnosed now due to increased awareness in clinicians. Which means that ADHD is more recognized, not more prolific. Using the same objective, standardized criteria for ADHD diagnosis, experts cite the same prevalence across the globe. Some cultures, however, still stigmatize ADHD more than others. It’s also worth noting that Black youth in the US have an ADHD prevalence rate of 14.5% versus the collective 5.9%, likely due to misdiagnosis and lack of culturally appropriate care.
Is ADHD a Learning Disorder?
ADHD is more of a self-regulation disorder than a learning disorder, though it can cause learning challenges. ADHD and learning disorders/disabilities have a 45% comorbidity rate (when both conditions are present at the same time).
The DSM-5 describes three subtypes of specific learning disorder:
- Dyslexia (reading)
- Dysgraphia (writing)
- Dyscalculia (math)
In the US, the Individuals with Disabilities Education Act (IDEA) defines a specific learning disability (SLD) as “a disorder in one or more of the basic psychological processes involved in understanding or in using language, spoken or written, that may manifest itself in the imperfect ability to listen, think, speak, read, write, spell, or to do mathematical calculations, including conditions such as perceptual disabilities, brain injury, minimal brain dysfunction, dyslexia, and developmental aphasia.”
In American classrooms, children with SLDs and children with ADHD can be given special services and accommodations through individualized education programs (IEPs) and 504 plans. Through IEPs, parents and teachers can align about the best ways to help children succeed at school, whether that be through letting them sit on a balance ball rather than a chair when they’re at their desk, or giving them extra time for exams.
ADHD and Neurodiversity
Neurodiversity, short for neurological diversity, is a term used to describe natural variations in the human brain. ADHD, autism spectrum disorder (ASD), and dyspraxia (aka developmental co-ordination disorder or DCD) are all considered neurodiverse/neurodivergent conditions. Neurodiversity advocates believe that these conditions shouldn’t be pathologized as impairments or dysfunctions. Instead, we should focus on personal strengths (strength-based approach) and find ways to help neurodiverse people accomplish their goals.
A neurotypical person (or NT) is wired to :
- Interact successfully with peers
- Talk without major speech delays
- Tolerate change
- Not become overwhelmed by stimuli
- Regulate emotions
- Sustain attention
Someone with ADHD probably can’t do all those things consistently. But in a neurodiversity framework, you don’t have to be neurotypical to achieve well-being. Neurominorities have a sprawling range of abilities. And when they suffer, it’s not because anything is inherently wrong with them, but because their environment is a mismatch for their strengths and capacities.
ADHD Myths vs. ADHD Facts
Misconceptions about ADHD can drive stigma and discrimination, and cause lasting damage. In 2021 the World Federation of ADHD published an International Consensus Statement that made 208 conclusions about the disorder. The statement was ratified by 80 authors who hailed from 27 different countries and 6 different continents. And it stated the following:
“Stigmatizing attitudes toward ADHD are common and may play a role in socially and clinically important outcomes. These negative attitudes affect patients at all stages of their life. Such attitudes have been documented among individuals at all ages and in all groups, including family, peers, teachers, clinicians, and even individuals with ADHD themselves.”
Like all humans, people with ADHD need to be part of a community, and feel a sense of belonging and acceptance, in order to achieve optimal well-being.
Here are a few of the more enduring myths about ADHD:
- ADHD is made up. ADHD was not invented by Big Pharma to sell drugs. ADHD did not originate in competitive, Western countries. The World Federation’s Consensus Statement emphasizes that ADHD is a valid and useful diagnosis “that can be used around the world to improve the lives of the many people who suffer from the disorder and its complications.”
- ADHD is just a harmful, pejorative label for rambunctious kids. A diagnosis of ADHD is clinically useful because it steers interventions that help kids stay safe and be successful.
- Screen time causes ADHD. Screen time and watching too much TV can affect ADHD symptoms, but it does not cause the condition. Many kids with ADHD are drawn to video games because they’re incredibly engaging and offer immediate rewards.
- Bad parenting causes ADHD. ADHD is a neurodevelopmental disorder that’s primarily caused by nature, not nurture. Negative parenting styles and family stress can exacerbate symptoms, however. On the whole, parents of ADHD children face countless challenges in addition to rewards as they shepherd their neurodiverse children through the world. They deserve our respect and support.
- Too much sugar causes ADHD. Research does not show a direct link between sugar consumption and ADHD in youth.
- ADHD only affects kids. The stereotypical person with ADHD is a hyperactive child who can’t sit still in the classroom, but ADHD affects adults and seniors as well. Their symptoms may be internalized in the form of thoughts, not externalized in the form of behaviors.
- Medication alone controls ADHD symptoms. Medication is a useful tool in managing ADHD symptoms, but psychoeducation and behavioral therapy are also vital resources.
- People with ADHD lack willpower. The neural pathways responsible for motivation and self-regulation are different in people with ADHD. This means that the same incentives that work well for a neurotypical person may not work for someone with ADHD.
- People with ADHD are lazy. The ADHD brain is an interest-based nervous system, meaning it must be highly engaged to focus. Boredom has been described as the ADHD brain’s “kryptonite.”
- Food coloring causes ADHD. Studies show that some artificial food dyes can exacerbate ADHD symptoms. You can read more about their potential toxicity here (Center for Science in the Public Interest).
- Kids with ADHD aren’t as smart. Research shows no significant differences between the IQs of kids with ADHD and those of neurotypical kids. They might not excel in traditional academic arenas, but that’s not due to any deficits in intelligence.
What Causes ADHD?
Researchers are getting closer and closer to uncovering the precise causes of ADHD, but there’s still plenty that we don’t know. The ADHD origin story that everyone seems to agree on is “epigenetics.” Epigenetics is the term used to describe complex interactions between someone’s genes and their environment. ADHD has a significant polygenetic component, meaning the disorder is highly heritable (70-90%), but without one specific genetic marker. “ADHD genes” need to be triggered by features in someone’s pre- and post-natal environments. In some cases ADHD can also be caused by genetic mutations.
Currently, researchers have identified a few complex environmental factors that seem to influence the onset of ADHD:
- Low birth weight or premature birth
- Maternal smoking during pregnancy
- Maternal use of acetaminophen (Tylenol) during pregnancy
- Early childhood exposure to lead or pesticides
- Brain injury
- Maternal autoimmune disorders like type 1 diabetes, ulcerative colitis, and psoriasis
- Maternal obesity
- Maternal high blood pressure
- Grandparent exposure to specific pollutants
- Psychosocial adversities
- Prenatal exposure to alcohol
It’s important to remember that ADHD is no one’s fault. What parent can predict how their unique genome will interact with infinite environmental factors? All you can do is love and support the child you were given.
ADHD Differential Diagnoses and Co-Occurring Disorders
A 2016 parent survey from the Centers for Disease Control (CDC) determined that 6 in 10 children with ADHD had at least one additional mental disorder. In adults, it’s more like 8 in 10. When one diagnosis overlaps with another diagnosis, we call those conditions “comorbid.” And ADHD has one of the highest comorbidity rates of any psychiatric disorder.
According to the DSM-5, ADHD often overlaps with externalizing disorders. These disorders include oppositional defiant disorder (ODD) and conduct disorder (CD), both characterized by problematic behaviors. Adults with ADHD are sometimes diagnosed with borderline personality disorder (BPD) and antisocial personality disorder (ASPD), both characterized by emotional instability and difficulty in top-down regulation.
Other mental disorders associated with ADHD include the following:
- Learning and language disabilities
- Tic disorders and Tourette’s syndrome
- Bipolar disorder
- Generalized anxiety disorder (GAD)
- Major depression
- Substance use disorder
- Obsessive compulsive disorder (OCD)
- Sensory processing disorder (SPD)
- Binge eating disorder
- Post-traumatic stress disorder (PTSD)
Some of these comorbid conditions may share underlying mechanisms, based in cortical wiring, motor/coordination difficulties, or emotional dysregulation. Other mental health issues, like low self-esteem, may be secondary conditions brought on by the ADHD experience. In any event, comorbidities can make it harder to diagnose ADHD accurately, and can complicate treatment.
What Is an ADHD Person Like? How Does ADHD Affect Functioning?
The ADHD brain has been compared to a Ferrari with Model-T brakes; a sprinter, not a marathoner; a busy intersection with no streetlights; a butterfly, and a television with hundreds of channels… and someone else wielding the remote control. Many experts conceptualize ADHD as an executive function disorder affecting a number of cognitive and emotional domains, sometimes categorized as “hot” and “cold” pathways. Those domains are the following:
- Inhibition. Inhibition refers to someone’s ability to control one’s automatic responses. People with ADHD might have poor internal supervision, causing trouble with impulse control.
- Memory. The ADHD brain shows some impairments in working memory, which is related to executive function. If you can’t keep several things in your mind at once, then it can be harder to perform mental operations and make decisions. You can’t remember what you were supposed to be doing.
- Arousal. The ADHD brain might be hyperactive and sensation seeking due to “an unstable regulation of brain arousal.”
- Emotions. People with ADHD might become “flooded” with emotions. They’re also vulnerable to rejection sensitive dysphoria (RSD).
- Set shifting. Set shifting, or cognitive switching, involves behavioral flexibility–the ability to move between mental states. This flexibility can be impaired in ADHD.
- Motivation. People with ADHD may struggle with goal-directed behaviors. The neurotransmitter dopamine is intensely involved in motivation, and the ADHD brain has lower levels of dopamine. An individual with ADHD might also have a hard time conceptualizing long-term goals and planning accordingly.
- Temporal processing. The ADHD brain has issues with motor timing, time estimation, and temporal foresight. Someone with ADHD might also experience delay aversion, a sensitivity to delays prior to rewards or reinforcement. Immediate rewards are valued more than future rewards. This all relates to a different experience of time. In fact, ADHD has been called “time blindness,” with the condition creating a “nearsightedness to time.”
- Attention. The ADHD brain has trouble sustaining attention, especially when it comes to routine, boring tasks. Symptoms and impairments can come and go throughout the day
Another thing to highlight about the ADHD brain is that it’s often caught in the default mode network (DMN), the brain process responsible for daydreaming, mind wandering, and even ruminating. But if the ADHD brain gets super engaged in something task-positive that requires conscious attention, the DMN deactivates.
ADHD DSM-5 Criteria and ADHD DSM-5 Code 314.0X (F90.X)
What are three signs of ADHD? You probably know them by now:
But let’s flesh out these ADHD signs so you can see how they might manifest in the real world. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), published by the American Psychiatric Association, uses the following clinical criteria (verbatim) for diagnosing ADHD:
A. A persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development, as characterized by (1) and/or (2):
1. Inattention: Six (or more) of the following symptoms have persisted for at least 6 months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activities:
Note: The symptoms are not solely a manifestation of oppositional behavior, defiance, hostility, or failure to understand tasks or instructions. For older adolescents and adults (age 17 and older), at least five symptoms are required.
a. Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or during other activities (e.g., overlooks or misses details, work is inaccurate).
b. Often has difficulty sustaining attention in tasks or play activities (e.g., has difficulty remaining focused during lectures, conversations, or lengthy reading).
c. Often does not seem to listen when spoken to directly (e.g., mind seems elsewhere, even in the absence of any obvious distraction).
d. Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., starts tasks but quickly loses focus and is easily sidetracked).
e. Often has difficulty organizing tasks and activities (e.g., difficulty managing sequential tasks; difficulty keeping materials and belongings in order; messy, disorganized work; has poor time management; fails to meet deadlines).
f. Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (e.g., schoolwork or homework; for older adolescents and adults, preparing reports, completing forms, reviewing lengthy papers).
g. Often loses things necessary for tasks or activities (e.g., school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones).
h. Is often easily distracted by extraneous stimuli (for older adolescents and adults, may include unrelated thoughts).
i. Is often forgetful in daily activities (e.g., doing chores, running errands; for older adolescents and adults, returning calls, paying bills, keeping appointments).
2.Hyperactivity and impulsivity: Six (or more) of the following symptoms have persisted for at least 6 months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activities:
Note: The symptoms are not solely a manifestation of oppositional behavior, defiance, hostility, or a failure to understand tasks or instructions. For older adolescents and adults (age 17 and older), at least five symptoms are required.
a. Often fidgets with or taps hands or feet or squirms in seat.
b. Often leaves seat in situations when remaining seated is expected (e.g., leaves his or her place in the classroom, in the office or other workplace, or in other situations that require remaining in place).
c. Often runs about or climbs in situations where it is inappropriate. (Note: In adolescents or adults, may be limited to feeling restless.)
d. Often unable to play or engage in leisure activities quietly.
e. Is often “on the go,” acting as if “driven by a motor” (e.g., is unable to be or uncomfortable being still for extended time, as in restaurants, meetings; may be experienced by others as being restless or difficult to keep up with).
f. Often talks excessively.
g. Often blurts out an answer before a question has been completed (e.g., completes people’s sentences; cannot wait for turn in conversation).
h. Often has difficulty waiting his or her turn (e.g., while waiting in line).
i. Often interrupts or intrudes on others (e.g., butts into conversations, games, or activities; may start using other people’s things without asking or receiving permission; for adolescents and adults, may intrude into or take over what others are doing).
B. Several inattentive or hyperactive-impulsive symptoms were present prior to age 12 years.
C. Several inattentive or hyperactive-impulsive symptoms are present in two or more settings (e.g., at home, school, or work; with friends or relatives; in other activities).
D. There is clear evidence that the symptoms interfere with, or reduce the quality of, social, academic, or occupational functioning.
E. The symptoms do not occur exclusively during the course of schizophrenia or another psychotic disorder and are not better explained by another mental disorder (e.g., mood disorder, anxiety disorder, dissociative disorder, personality disorder, substance intoxication or withdrawal).
Types of ADHD, DSM-5
When mental health professionals diagnose ADHD, they consider both subtype and severity. Here’s how the DSM-5 describes those dimensions:
314.01 (F90.2) Combined presentation: If both Criterion A1 (inattention) and Criterion A2 (hyperactivity-impulsivity) are met for the past 6 months.
314.00 (F90.0) Predominantly inattentive presentation: If Criterion A1 (inattention) is met but Criterion A2 (hyperactivity-impulsivity) is not met for the past 6 months.
314.01 (F90.1) Predominantly hyperactive/impulsive presentation: If Criterion A2 (hyperactivity-impulsivity) is met and Criterion A1 (inattention) is not met for the past 6 months.
in partial remission: When full criteria were previously met, fewer than the full criteria have been met for the past 6 months, and the symptoms still result in impairment in social, academic, and occupational functioning.
Specify current severity:
Mild: Few, if any, symptoms in excess of those required to make the diagnosis are present, and symptoms result in no more than minor impairments in social or occupational functioning.
Moderate: Symptoms or functional impairment between “mild” and “severe” are present.
Severe: Many symptoms in excess of those required to make the diagnosis, or several symptoms that are particularly severe, are present, or the symptoms result in marked impairment in social or occupational functioning.
ADHD Criteria ICD-11 (6A05)
Symptoms of ADHD in the International Statistical Classification of Diseases and Related Health Problems, Eleventh Revision (ICD-11) are similar to those in the DSM-5. In the ICD-11, ADHD is no longer considered a hyperkinetic disorder as it was in ICD-10, and is instead grouped with its fellow neurodevelopmental disorders.
Why Do People with ADHD Talk So Much?
The world is full of people who ramble on, don’t pick up on your subtle cues that you’d like to escape the conversation, and frequently interrupt you when you’re speaking. This could be due to simple rudeness, but it might also be due to ADHD. Neurotypical people can quickly see warning signs that someone isn’t listening or responding positively to what they’re saying. Then they make a split-second decision to stop talking. But it takes the ADHD brain longer to switch gears. Someone with ADHD might also be excited, or seek verbal reassurance, which keeps them talking. Self-regulation issues and impulsivity could also lead to a person with ADHD blurting out something they shouldn’t.
What Is Included in an ADHD Test?
At the moment, there is no biomarker to determine whether or not someone has ADHD. The ADHD brain has structural differences from the neurotypical brain, but they’re not definitive enough for diagnosis. You can’t scan someone’s brain and pronounce whether or not they have ADHD. Instead, people need a thorough clinical assessment from a qualified mental health professional or physician. See the section below for details.
Do I Have ADHD?
All humans have executive traits that land somewhere on a continuum, but to be diagnosed with ADHD, those traits have to be so extreme that they impair functioning. So any ADHD evaluation and ADHD testing has to consider a considerable amount of information, from a wide variety of sources:
- Clinical interviews with patient, parents, teachers, and other relevant people
- Medical and psychiatric history
- Family dynamics
- Peer relationships
- School history
- Mental health of parents
- Family’s economic status
- Functional imaging
- Rating of behaviors on a questionnaire
- Psychological tests
- Physical tests to rule out other conditions
- Direct observation
Specific ADHD tests include:
- Vanderbilt Assessment Scale
- Stop Signal test
- Child Attention Profile (CAP)
- Behavior Assessment System for Children (BASC)
- Child Behavior Checklist/Teacher Report Form (CBCL)
- Conners Rating Scale
- Barkley Adult ADHD Rating Scale-IV (BAARS-IV)
- Brown Attention/Executive Function Scales
- Behavior Rating Inventory of Executive Function 2 (BRIEF-2)
- Neuropsychological Assessment Battery (NAB) Attention module
- Stroop test
- Wisconsin Card Sort Test (WCST)
- Continuous Performance Test
- Reward response tests
- Working memory tests
What Are the Risks of Not Treating ADHD?
By not seeking treatment for ADHD, a person runs a few risks.
- They may never gain a full understanding of who they are.
- They might lose faith in themselves. Untreated ADHD can lead to a negative feedback loop, where someone doesn’t try because they feel that they can’t succeed. They might become ashamed, frustrated, demoralized, depressed, anxious, or develop chronic self-esteem issues.
- People with undiagnosed ADHD or untreated ADHD might find ways to cope with their symptoms through self-medication. Some of those coping mechanisms aren’t necessarily unhealthy, like using intense exercise to achieve hours of focus. But other people might turn to drugs or alcohol.
- ADHD is associated with more frequent accidents, risky behaviors, and a reduction in life expectancy.
- Untreated ADHD can cause problems at school, at work, and in relationships.
Are There Any Benefits to Having ADHD?
Everyone with ADHD should know that their condition can be an asset. It’s especially helpful to kids to be given a positive framework in which to see themselves and their ADHD brains. Parents and caregivers can help children find a metaphor that feels good to them. For example, having a neurodevelopmental disorder is boring, but having a race car brain is awesome! Especially when you can help write the owner’s manual.
People with ADHD can be incredibly creative, especially when they find an outlet that really engages them. They can be great problem-solvers. They can be hyperfocused and energetic, bright and clever, spontaneous and adaptable. Everyone who has ADHD is unique, with their own personal strengths that aren’t always traditionally valued in society. Parents of kids with ADHD can help their children find those strengths – and amplify them.
How Does ADHD Present Across the Lifespan?
ADHD is a lifespan disorder, meaning it affects both kids and adults. But its symptoms can change drastically over the course of a lifetime. Some people even go into complete remission. Longitudinal studies show that 40-60% of children with ADHD will experience partial remission. They might be less impulsive or hyperactive, for example, but still have attention issues. Only 15% of children with ADHD will still meet all diagnostic criteria as adults.
So how does ADHD look across the lifespan? We’ll break it down in the sections below.
ADHD in Children
A neurotypical child’s development follows a predictable pattern, exhibiting age-appropriate skills and behaviors, on a steady course year after year. But a child with ADHD may struggle to regulate their thoughts, feelings, and impulses long after their peers have learned to exercise top-down control. This is because the ADHD brain does not mature in the same way, at the same rate, as a neurotypical brain. And in fact, research shows that kids who are young for their class get diagnosed with ADHD more often. Because it’s easy to confuse normal childhood immaturity with ADHD symptoms. An accurate diagnosis requires a mental health professional.
Their different wiring makes kids with ADHD more prone to disruptive behavior, excessive talking, fidgeting, emotional ups and downs, etc.–all the things that necessitate turning a good parent into a great parent. Because ADHD kids are challenging! But they’re also amazing. To thrive, they need supportive environments, and adults who are committed to looking out for their welfare.
How Do You Discipline a Child with ADHD? And Other Parenting Tips
Because kids with ADHD can have a hitch in their giddyup when it comes to motivation, parents, teachers, and other caregivers need to maximize their engagement in the task at hand. Get their brain firing on all cylinders. Redirect them. Give them immediate, positive reinforcement as they make incremental progress.
Parents can help kids with ADHD by freeing up their working memory. This is done by building predictable routines, by putting rules and processes on paper so children don’t have to remember all the steps, and by working with them in the moment rather than in the future–expecting them to have neurotypical foresight or hindsight. Because kids with ADHD have trouble with temporal processing, you can give them external visual aids like timers to help them keep track of time.
When it comes to discipline, parents must remember that for kids with ADHD, a carrot works better than a stick. In the ADHD brain, anticipation of a short-term reward generates dopamine, helping with operational thinking and self-regulation. Both positive and negative consequences need to be more immediate and frequent than with neurotypical kids. Essentially, you need to understand how your child’s brain works so you can help teach them, not punish them.
ADHD in Teens
Child psychology experts know that the adolescent and teenage years are an intense time. These years are packed with emerging sexuality, boundary-testing, academic challenges, peer pressure, first loves, and much more. And ADHD traits can make this intense time even more fraught. Teens with ADHD might engage in more risky and sensation-seeking behaviors. When they turn 16, their executive age could be years lower, and so it might be wise to delay their driver’s license until they can prove that they’ll be safe and attentive on the road.
ADHD in Adults
Academic or career success for an adult with ADHD might look a little different. Adults with ADHD have to perform in more complex environments than kids. They might have to find coping mechanisms to maintain their attention or prioritize tasks at work. They might not meet their deadlines. At home, adults with ADHD might procrastinate on paying bills or taxes. They may get into debt. They may have conflicts with their friends or family members because they’re always late. They might feel more sensitive to their spouse’s criticisms because they were criticized so much growing up. And they might have their own kids, who also have ADHD.
That being said, an adult with ADHD might achieve phenomenal success in a career that requires high levels of energy and multi-tasking. And their intimate understanding of how the ADHD brain works can make them more compassionate toward their own kids who may struggle with symptoms.
Even if an individual wasn’t diagnosed with ADHD as a child, it’s never too late to get help for the disorder.
ADHD in Women vs. ADHD in Men
Data from the CDC shows that boys are far more likely to be diagnosed with ADHD than their girl counterparts. But between 2003 and 2015, the number of women aged 15-44 who filled a prescription for an ADHD medication increased 344%.
Adult women with ADHD are often misdiagnosed with mood disorders. This is because ADHD can cause heightened emotionality. And other interesting things show up in research, like a study that showed women with higher levels of baseline irritability were likely to have more hyperactive and impulsive symptoms of ADHD after 18 months. This wasn’t the case for men.
What Are the Best Treatments for ADHD?
There are countless ways to alleviate the symptoms of ADHD, but experts tend to agree that the most effective ADHD treatment is a combination of medication and multimodal therapy. (Though the first-line treatment for kids under 5 with ADHD is therapy, not medication.)
The first step in ADHD treatment is planning. What are your or your child’s needs? More success at school? Increased productivity? Fewer behavioral issues and disruptions? Higher confidence? Better social skills? All your interventions should be person-centered and strength-based. They should also “respect and enhance those things that bring happiness and joy.” So think about your or your child’s goals, and go from there.
We’ll cover ADHD medications at more length below, but let’s start with multimodal therapy. The National Institutes of Health (NIH) lists seven types of ADHD therapy and psychosocial interventions:
- Behavioral therapy
- Cognitive behavioral therapy (CBT)
- Family therapy and marital therapy
- Parenting skills training (behavioral parent management training)
- Specific behavioral classroom management interventions and/or academic accommodations
- Stress management techniques
- Support groups
People have found success with these additional non-pharmacological ADHD supports as well:
- Healthy diets for healthy neurotransmitters
- Social and emotional learning (SEL)–social skills training
- Balance training
- Mindfulness meditation
- Computer-based cognitive training
- ADHD apps and timers
- Fidget devices
Everyone with ADHD can write their own manual. But what definitely doesn’t work to ease ADHD symptoms?
- Shame and humiliation
- Neurotypical self-control strategies
A Breakdown of ADHD Medications: Benefits and Side Effects
Doctors who specialize in ADHD treatment typically recommend that people respect medication, but not fear it. There are two types of ADHD medication:
- Stimulants: methylphenidate and amphetamine
- Non-stimulants: atomoxetine, extended release guanfacine, and extended release clonidine
While working closely with a physician or psychiatrist, it may take some trial and error to get the right prescription and dosage of ADHD medication. Until you find the ideal formulation, possible side effects may include sleep issues, abdominal pain, and changes in appetite. Some medications are also associated with small delays in height gains in children. Too much medication may cause “Zombie syndrome” or “Starbuck’s syndrome.”
Though ADHD medications are proven to be safe and effective for people with the disorder, controversy still stems from overprescription and misuse of stimulant medication. Drug “shopping” and drug diversion is particularly problematic among college students.
Future Directions for ADHD Research and ADHD Treatment
According to the American Medical Association, ADHD is one of the most, if not the most, researched disorders in medicine. So experts are continually coming up with novel and better ways to think about and treat ADHD. For example, there are now prescription video games for kids with ADHD. These game-based treatments capitalize on the ADHD brain’s need for stimulus in order to teach self-regulation and behavior modification. ADHD experts and computer experts have also collaborated on virtual reality (VR) games that can help people manage their attention.
Much of the latest neuroscientific research on ADHD explores the connections between neural circuits, otherwise known as white matter. White matter gets its name from the myelin sheath that covers the brain’s axons, or nerve fibers. Trigeminal nerve stimulation (TNS) is an FDA-approved ADHD treatment that directly targets nerves in the brain.
Trusted ADHD Resources and Further Reading
ADDitude Magazine: Inside the ADHD Mind
ADHD Parents’ Medication Guide from the the American Academy of Child and Adolescent Psychiatry (AACAP) and the American Psychiatric Association (APA)
Cohen Children’s Medical Center ADHD Medication Guide
Thriveworks child therapy for ADHD