What is ADHD?

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common and most studied neurodevelopmental disorders in children. Scientists have discovered there are differences in the brains, nerve networks and neurotransmitters of people with ADHD.

ADHD is a long-term (chronic) brain condition that causes executive dysfunction, which means it disrupts a person’s ability to manage their own emotions, thoughts and actions. ADHD makes it difficult for people to:

Manage their behaviour.
Pay attention.
Control overactivity.
Regulate their mood.
Stay organised.
Concentrate.
Follow directions.
Sit still.

Children usually receive a diagnosis during childhood and the condition often lasts into adulthood. However, effective treatment is available. Left untreated, ADHD can cause serious, lifelong complications.

Worldwide, 7.2% of children receive an ADHD diagnosis. Boys receive an ADHD diagnosis more than twice as often as girls. But this doesn’t mean more boys have ADHD. It just means they present more often with hyperactive-type symptoms and are therefore easier to diagnose.

Types of ADHD

There are four different ways ADHD can present itself. Providers use the kinds of symptoms your child displays to diagnose the condition in one of the following four ways.

Predominantly inattentive presentation

Children with this presentation have inattentive ADHD only. Providers previously called this type attention-deficit disorder (ADD). Children with inattentive presentation mainly have difficulty focusing, organizing and staying on track, and have fewer hyperactivity/impulsivity symptoms.

Predominantly hyperactive-impulsive presentation

Children with this presentation show issues with hyperactivity and impulsivity and may show less obvious trouble with paying attention. Hyperactivity means they may fidget, can’t sit still, have a lot of excess energy and are extremely talkative. Impulsivity means they may interrupt others and act without thinking it through first. This is the least common type and typically affects younger children.

Combined presentation

Children with this presentation show at least six symptoms from both of the other types. Symptoms of inattentiveness and hyperactivity-impulsivity present equally. This type is what people most commonly associate with ADHD. About 70% of cases fall under this type.

Unspecified presentation

In these cases, symptoms may be so severe that children clearly demonstrate dysfunction but don’t meet official symptom criteria for a diagnosis of ADHD inattentive, hyperactive/impulsive or combined type. In such cases, providers assign “unspecified ADHD” as the diagnosis.

What are the symptoms of ADHD?

The symptoms must have interfered with functioning in at least two areas of life (such as school and home) and have occurred for at least the past six months.

Providers use the signs of ADHD to diagnose and determine the type of condition: inattentive, hyperactive/impulsive, combined or unspecified.

Predominantly inattentive presentation

ADHD symptoms in kids with inattentive presentation include difficulty focusing, organising and staying on task. According to the DSM-5-TR, a child with this type must display at least six of the following nine behaviours. (The behaviours must pose a problem in daily activity, at school and at home — not just from time to time, as most children engage in these behaviours.)

Trouble paying attention to details or making careless mistakes.
Issues remaining focused on tasks and activities.
Difficulty listening well, daydreaming or seeming distracted.
Trouble with following instructions and/or finishing tasks.
Difficulty with organising tasks and activities.
Avoiding or disliking tasks that require continuous mental effort.
Losing things frequently.
Easily distracted by outside stimuli.
Forgetful in daily activities.

Predominantly hyperactive/impulsive presentation

People with hyperactive/impulsive type display the following ADHD symptoms. According to the DSM-5-TR, a child must display at least six of the following nine behaviours. These must pose problems in daily activity.

Fidgeting with or tapping hands or feet or squirming frequently.
Leaving their seat when remaining seated is expected.
Running or climbing when it’s not appropriate.
Trouble playing or engaging in leisure activities quietly.
Always seeming “on the go” or “driven by a motor.”
Talking too much.
Blurting out answers before questions are completed.
Frequent trouble waiting for their turn.
Often interrupting or intruding on others’ conversations or games.

Combined presentation

People with combined type display behaviours from both the inattentive and hyperactive/impulsive categories. According to the DSM-5, children must display at least 12 of the total behaviours (at least six inattentive behaviours and six hyperactive/impulsive behaviours).