ADHD

Attention deficit hyperactivity disorder (ADHD) is a condition that affects people's behaviour. People with ADHD can seem restless, may have trouble concentrating and may act on impulse.

Symptoms of ADHD tend to be noticed at an early age and may become more noticeable when a child's circumstances change, such as when they start school.

Most cases are diagnosed when children are under 12 years old, but sometimes it's diagnosed later in childhood.

Sometimes ADHD was not recognised when someone was a child, and they are diagnosed later as an adult.

The symptoms of ADHD usually improve with age, but many adults who were diagnosed with the condition at a young age continue to experience problems.

People with ADHD may also have additional problems, such as sleep and anxiety disorders.

Many children go through phases where they're restless or inattentive. This is often completely normal and does not necessarily mean they have ADHD.

But you should discuss your concerns with your child's teacher, their school's special educational needs co-ordinator (SENCO) or a GP if you think their behaviour may be different from most children their age.

It's also a good idea to speak to a GP if you're an adult and think you may have ADHD, but were not diagnosed with the condition as a child.

The exact cause of ADHD is unknown, but the condition has been shown to run in families.

Research has also identified a number of possible differences in the brains of people with ADHD when compared with those without the condition.

Other factors suggested as potentially having a role in ADHD include:

being born prematurely (before the 37th week of pregnancy)
having a low birthweight
smoking or alcohol or drug abuse during pregnancy

ADHD can occur in people of any intellectual ability, although it's more common in people with learning difficulties.

For children with ADHD, although there's no cure, it can be managed with appropriate educational support, advice and support for parents and affected children, alongside medicine, if necessary.

For adults with ADHD, medicine is often the first treatment offered, although psychological therapies such as cognitive behavioural therapy (CBT) may also help.

Looking after a child with ADHD can be challenging, but it's important to remember that they cannot help their behaviour.

Some day-to-day activities might be more difficult for you and your child, including:

getting your child to sleep at night
getting ready for school on time
listening to and carrying out instructions
being organised
social occasions
shopping

Adults with ADHD

Adults with ADHD may find they have problems with:

organisation and time management
following instructions
focusing and completing tasks
coping with stress
feeling restless or impatient
impulsiveness and risk taking

Some adults may also have issues with relationships or social interaction.

The symptoms of attention deficit hyperactivity disorder (ADHD) can be categorised into 2 types of behavioural problems:

inattentiveness (difficulty concentrating and focusing)
hyperactivity and impulsiveness

Many people with ADHD have problems that fall into both these categories, but this is not always the case.

For example, around 2 to 3 in 10 people with the condition have problems with concentrating and focusing, but not with hyperactivity or impulsiveness.

This form of ADHD is also known as attention deficit disorder (ADD). ADD can sometimes go unnoticed because the symptoms may be less obvious.

ADHD is more often diagnosed in boys than girls. Girls are more likely to have symptoms of inattentiveness only, and are less likely to show disruptive behaviour that makes ADHD symptoms more obvious. This means girls who have ADHD may not always be diagnosed.

The symptoms of ADHD in children and teenagers are well defined, and they're usually noticeable before the age of 6. They occur in more than 1 situation, such as at home and at school.

Children may have symptoms of both inattentiveness and hyperactivity and impulsiveness, or they may have symptoms of just 1 of these types of behaviour.

Inattentiveness (difficulty concentrating and focusing)

The main signs of inattentiveness are:

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

Hyperactivity and impulsiveness

The main signs of hyperactivity and impulsiveness are:

being unable to sit still, especially in calm or quiet surroundings
constantly fidgeting
being unable to concentrate on tasks
excessive physical movement
excessive talking
being unable to wait their turn
acting without thinking
interrupting conversations
little or no sense of danger

These symptoms can cause significant problems in a child's life, such as underachievement at school, poor social interaction with other children and adults, and problems with discipline.

Although not always the case, some children may also have signs of other problems or conditions alongside ADHD, such as:

anxiety disorder – which causes your child to worry and be nervous much of the time; it may also cause physical symptoms, such as a rapid heartbeat, sweating and dizziness
oppositional defiant disorder (ODD) – this is defined by negative and disruptive behaviour, particularly towards authority figures, such as parents and teachers
conduct disorder – this often involves a tendency towards highly antisocial behaviour, such as stealing, fighting, vandalism and harming people or animals
depression
sleep problems – finding it difficult to get to sleep at night, and having irregular sleeping patterns
autistic spectrum disorder (ASD) – this affects social interaction, communication, interests and behaviour
dyspraxia – a condition that affects physical co-ordination
epilepsy – a condition that affects the brain and causes repeated fits or seizures
Tourette's syndrome – a condition of the nervous system, characterised by a combination of involuntary noises and movements (tics)
learning difficulties – such as dyslexia

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

As ADHD is a developmental disorder, it's believed it cannot develop in adults without it first appearing during childhood. But symptoms of ADHD in children and teenagers often continue into adulthood.

The way in which inattentiveness, hyperactivity and impulsiveness affect adults can be very different from the way they affect children.

For example, hyperactivity tends to decrease in adults, while inattentiveness tends to remain as the pressures of adult life increase.

Adult symptoms of ADHD also tend to be far more subtle than childhood symptoms.

Some specialists have suggested the following as a list of symptoms associated with ADHD in adults:

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 out responses and 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 – for example, driving dangerously

As with ADHD in children and teenagers, ADHD in adults can occur alongside several related problems or conditions.

One of the most common is depression. Other conditions that adults may have alongside ADHD include:

personality disorders – conditions in which an individual differs significantly from the average person in terms of how they think, perceive, feel or relate to others
bipolar disorder – a condition affecting your mood, which can swing from one extreme to another
obsessive compulsive disorder (OCD) – a condition that causes obsessive thoughts and compulsive behaviour

The behavioural problems associated with ADHD can also cause problems such as difficulties with relationships and social interaction.

The exact cause of attention deficit hyperactivity disorder (ADHD) is not fully understood, although a combination of factors is thought to be responsible.

ADHD tends to run in families and, in most cases, it's thought the genes you inherit from your parents are a significant factor in developing the condition.

Research shows that parents and siblings of someone with ADHD are more likely to have ADHD themselves.

However, the way ADHD is inherited is likely to be complex and is not thought to be related to a single genetic fault.

Research has identified a number of possible differences in the brains of people with ADHD from those without the condition, although the exact significance of these is not clear.

For example, studies involving brain scans have suggested that certain areas of the brain may be smaller in people with ADHD, whereas other areas may be larger.

Other studies have suggested that people with ADHD may have an imbalance in the level of neurotransmitters in the brain, or that these chemicals may not work properly.

Certain people are also believed to be more at risk of ADHD, including people:

who were born prematurely (before the 37th week of pregnancy) or with a low birthweight
with epilepsy
with brain damage – which happened either in the womb or after a severe head injury later in life

If you think you or your child may have attention deficit hyperactivity disorder (ADHD), speak to a GP. You can also speak to your child’s teacher or their school’s special educational needs co-ordinator (SENCO).

The GP cannot formally diagnose ADHD, but they can discuss your concerns with you and refer you for a specialist assessment, if necessary. Your school may also be able to arrange a specialist referral for your child.

When you see a GP, they may ask you:

about your symptoms or those of your child
when these symptoms started
where the symptoms occur – for example, at home, in school, college or university, or at work
whether the symptoms affect your or your child's day-to-day life – for example, if they make socialising difficult
if there have been any recent significant events in your or your child's life, such as a death or divorce in the family
if there's a family history of ADHD
about any other problems or symptoms of different health conditions you or your child may have

If the GP thinks your child may have ADHD, they may first suggest a period of "watchful waiting" – lasting around 10 weeks – to see if your child's symptoms improve, stay the same or get worse.

They may also suggest starting a group-based, ADHD-focused parent training or education programme. Being offered a parent training and education programme does not mean you have been a bad parent – it aims to teach you ways of helping yourself and your child.

See treating ADHD for more information.

If your child's behaviour does not improve, and both you and the GP believe it's affecting their day-to-day life, the GP should refer you and your child to a specialist for a formal assessment.

Adults

For adults with possible ADHD, the GP will assess your symptoms and may refer you for an assessment if:

you were not diagnosed with ADHD as a child, but your symptoms began during childhood and have been ongoing since
your symptoms cannot be explained by a mental health condition
your symptoms significantly affect your day-to-day life – for example, if you're 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.

You or your child may be referred to 1 of the following types of specialist for a formal assessment:

a specialist child or adult psychiatrist
a paediatrician – a specialist in children's health
an appropriately qualified healthcare professional with training and expertise in the diagnosis of ADHD

Who you're referred to depends on your age and what's available in your local area.

There's no simple test to determine whether you or your child has ADHD, but your specialist can make an accurate diagnosis after a detailed assessment. The assessment may include:

a physical examination, which can help rule out other possible causes for the symptoms
a series of interviews with you or your child
interviews or reports from other significant people, such as partners, parents and teachers

Diagnosing ADHD in children depends on a set of strict criteria. To be diagnosed with ADHD, your child must have 6 or more symptoms of inattentiveness, or 6 or more symptoms of hyperactivity and impulsiveness.

Methylphenidate

Methylphenidate is the most commonly used medicine for ADHD. It belongs to a group of medicines called stimulants, which work by increasing activity in the brain, particularly in areas that play a part in controlling attention and behaviour.

Methylphenidate may be offered to adults, teenagers and children over the age of 5 with ADHD.

The medicine can be taken as either immediate-release tablets (small doses taken 2 to 3 times a day) or as modified-release tablets (taken once a day in the morning, with the dose released throughout the day).

Common side effects of methylphenidate include:

a small increase in blood pressure and heart rate
loss of appetite, which can lead to weight loss or poor weight gain
trouble sleeping
headaches
stomach aches
feeling aggressive, irritable, depressed, anxious or tense

Lisdexamfetamine

Lisdexamfetamine is a medicine that stimulates certain parts of the brain. It improves concentration, helps focus attention and reduces impulsive behaviour.

It may be offered to teenagers and children over the age of 5 with ADHD if at least 6 weeks of treatment with methylphenidate has not helped.

Adults may be offered lisdexamfetamine as the first-choice medicine instead of methylphenidate.

Lisdexamfetamine comes in capsule form, taken once a day.

Common side effects of lisdexamfetamine include:

decreased appetite, which can lead to weight loss or poor weight gain
aggression
drowsiness
dizziness
headaches
diarrhoea
nausea and vomiting

Dexamfetamine

Dexamfetamine is similar to lisdexamfetamine and works in the same way. It may be offered to adults, teenagers and children over the age of 5 with ADHD.

Dexamfetamine is usually taken as a tablet 2 to 4 times a day, although an oral solution is also available.

Common side effects of dexamfetamine include:

decreased appetite
mood swings
agitation and aggression
dizziness
headaches
diarrhoea
nausea and vomiting

Atomoxetine

Atomoxetine works differently from other ADHD medicines.

It's a selective noradrenaline reuptake inhibitor (SNRI), which means it increases the amount of a chemical in the brain called noradrenaline.

This chemical passes messages between brain cells, and increasing it can aid concentration and help control impulses.

Atomoxetine may be offered to adults, teenagers and children over the age of 5 if it's not possible to use methylphenidate or lisdexamfetamine. It's also licensed for use in adults if symptoms of ADHD are confirmed.

Atomoxetine comes in capsule form, usually taken once or twice a day.

Common side effects of atomoxetine include:

a small increase in blood pressure and heart rate
nausea and vomiting
stomach aches
trouble sleeping
dizziness
headaches
irritability

Atomoxetine has also been linked to some more serious side effects that are important to look out for, including suicidal thoughts and liver damage.

If either you or your child begin to feel depressed or suicidal while taking this medicine, speak to your doctor.

Guanfacine

Guanfacine acts on part of the brain to improve attention, and it also reduces blood pressure.

It may be offered to teenagers and children over the age of 5 if it's not possible to use methylphenidate or lisdexamfetamine. Guanfacine should not be offered to adults with ADHD.

Guanfacine is usually taken as a tablet once a day, in the morning or evening.

Common side effects include:

tiredness or fatigue
headache
abdominal pain
dry mouth

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

Here are some of the therapies that may be used.

Psychoeducation

Psychoeducation means you or your child will be encouraged to discuss ADHD and its effects. It can help children, teenagers and adults make sense of being diagnosed with ADHD, and can help you to cope and live with the condition.

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 to encourage your child to try to control their ADHD.

If your child has ADHD, you can identify types of behaviour 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.

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, specially tailored 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 formally diagnosed with ADHD.

These programmes are usually arranged in groups of around 10 to 12 parents. A programme usually consists of 10 to 16 meetings, lasting up to 2 hours each.

Being offered a parent training and education programme does not mean you have been a bad parent – it aims to teach parents and carers about behaviour management, while increasing confidence in your ability to help your child and improve your relationship.

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)

CBT is a talking therapy that can help you manage your problems by changing the way you think and behave. A therapist would try to change how you or your child feels about a situation, which would in turn potentially change their behaviour.

CBT can be carried out with a therapist individually or in a group.

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

Diet

People with ADHD should eat a healthy, balanced diet. Do not cut out foods before seeking medical advice.

Some people may notice a link between types of food and worsening ADHD symptoms. If this is the case, keep a diary of what you eat and drink, and what behaviour follows. Discuss this with a GP, who may refer you to a dietitian (a healthcare professional who specialises in nutrition).

Supplements

Some studies have suggested that supplements of omega-3 and omega-6 fatty acids may be beneficial for people with ADHD, although the evidence supporting this is very limited.

It's advisable to talk to a GP before using any supplements, because some can react unpredictably with medicine or make it less effective.

You should also remember that some supplements should not be taken long term, as they can reach dangerous levels in your body.

If you're the parent of a child with ADHD:

be sure your GP or specialist helps you understand the difference between ADHD and any other problems your child may 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 medicine your child takes and what you need to look out for
getting to know people at local support groups can stop you feeling isolated and help you to cope

The charity AADD-UK has a list of support groups across the UK, including groups for adults, parents and carers.

Plan the day

Plan the day so your child knows what to expect. Set routines can make a difference to how a child with ADHD copes with everyday life.

For example, if your child has to get ready for school, break it down into structured steps, so they know exactly what they need to do.

Set clear boundaries

Make sure everyone knows what behaviour is expected, and reinforce positive behaviour with immediate praise or rewards. Be clear, using enforceable consequences, such as taking away a privilege, if boundaries are overstepped 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."

This will make it clear to your child that you're pleased and why.

Giving instructions

If you're asking your child to do something, give brief instructions and be specific. Instead of asking: "Can you tidy your bedroom?" say: "Please put your toys into the box and put the books back onto the shelf."

This makes it clearer what your child needs to do and creates opportunities for praise when they get it right.

Incentive scheme

Set up your own incentive scheme using a points or star chart, so good behaviour can earn a privilege. For example, behaving well on a shopping trip will earn your child time on the computer or some sort of game.

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, 3-monthly

Try to focus on just 1 or 2 behaviours at a time.

Intervene early

Watch for warning signs. If your child looks like they're becoming frustrated, overstimulated and about to lose self-control, intervene.

Distract your child, if possible, by taking them away from the situation. This may calm them 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 tired or hungry, such as 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 themselves out and improve their quality of sleep.

Make sure they're not doing anything too strenuous or exciting near to bedtime.

Read our physical activity guidelines for children and young people, which includes information on getting active, and how much activity you and your child should be doing.

Eating

Keep an eye on what your child eats. If your child is hyperactive after eating certain foods, which may contain additives or caffeine, keep a diary of these and discuss them with a 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 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.

Help at school

Children with ADHD often have problems with their behaviour at school, and the condition can negatively affect a child's academic progress.

Speak to your child's teachers or their school's special educational needs co-ordinator (SENCO) about any extra support your child may need.

If you're an adult living with ADHD, you may find the following advice useful:

if you find it hard to stay organised, then make lists, keep diaries, stick up reminders and set aside some time to plan what you need to do
let off steam by exercising regularly
find ways to help you relax, such as listening to music or learning breathing exercises for stress
if you have a job, speak to your employer about your condition, and discuss anything they can do to help you work better
if you're at college or university, ask about what adjustments can be made to support you, such as extra time to complete exams and coursework
talk to a doctor about your suitability to drive, as you'll need to tell the Driver and Vehicle Licensing Agency (DVLA) if your ADHD affects your driving
contact or join a local or national support group – these organisations can put you in touch with other people in a similar situation, and can be a good source of support, information and advice

Read about living with ADHD on the AADD-UK website. AADD-UK is a charity specifically for adults with ADHD.

AADD-UK also has a list of support groups across the UK, including groups for adults, parents and carers.

Our services

ADHD

Adults with ADHD

Inattentiveness (difficulty concentrating and focusing)

Hyperactivity and impulsiveness

Adults

Methylphenidate

Lisdexamfetamine

Dexamfetamine

Atomoxetine

Guanfacine

Psychoeducation

Behaviour therapy

Parent training and education programmes

Social skills training

Cognitive behavioural therapy (CBT)

Diet

Supplements

Plan the day

Set clear boundaries

Be positive

Giving instructions

Incentive scheme

Intervene early

Social situations

Exercise

Eating

Bedtime

Night time

Help at school

Patients and carers

Advice and support

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