Hospital for Children

Parent Education - Caring for Kids

When To Worry About ADHD

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It is very normal for a child to be active, but when multiple adults rate a child as being overly active in different settings and a child is so active that his or her behavior is getting in the way of school or playing, then a child may have Attention Deficit Hyperactivity Disorder.

ADHD is a disorder caused by a problem in the brain, according to Dr. Linda Grossman, head of behavioral and developmental pediatrics at the University of Maryland Hospital for Children.

ADHD causes a child, or an adult, to have problems with paying attention to any one thing for very long (distractible), to rush into things before thinking first (impulsive), and to be very active and/or wiggly (hyperactive). Some people have more of one symptom or more of another but they must have these significantly more than would most people their age.

"Symptoms must occur in more than one setting, such as at school and at home or at home and at the supermarket. The symptoms also must cause significant problems for the child or be of significant concern to the adults taking care of the child," said Grossman.

A child may rate as inattentive or distractible, if he or she has at least 6 of the following:

Fails to attend to details, or makes careless mistakes
Has difficulty sustaining attention
Does not seem to listen
Does not follow instructions or fails to finish tasks
Has difficulty organizing tasks and activities
Avoids tasks that require sustained attention
Loses things
Is easily distracted by extraneous stimuli
Is often forgetful

A child may be considered hyperactive or impulsive, if he or she has at least 6 of the following:

Fidgets with hands of feet, squirms
Leaves seat
Run about of climbs excessively
Has difficulty playing quietly
Is "on the go" or "driven by a motor"
Talks excessively
Blurts out answers prematurely
Has difficulty waiting turns
Interrupts or intrudes on others

ADHD is diagnosed after a clinician collects information about the child's behavior from his parents, his school, and anyone else who spends a lot of time with him (such as a child care provider). The health care provider also collects information about the child's health and other medical problems.

He or she examines the child, including a neurological exam. This physical examination looks for other possible explanations for the symptoms. Using all of these pieces of information, the clinician will then decide if the child has ADHD.

For roughly 2/3 of children with ADHD, either one of their parents or one of their siblings also has ADHD. This suggests that ADHD may be inherited for these children. Other people get it from brain infections, head injuries, or exposure to substances that damage the brain (such as lead, alcohol prior to birth, drugs prior to birth, etc.).

For some people, no cause can be identified. Grossman said, "It is important to note that not caused by bad parenting, though these children often are very difficult to manage."

This page was last updated on: May 23, 2007.

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