ADHD

ADHD, or Attention Deficit Hyperactivity Disorder, is one of the most prevalent neurodevelopmental disorders affecting children. It is estimated that about five percent of school children, around 1-2 students in every classroom, may be affected by ADHD.  

Until 1987, ADHD was known as attention deficit disorder (ADD). This term is now outdated but some adults may still use it.   

ADHD impacts children’s ability to regulate attention, impulses and energy levels. All young children can experience challenges with sitting still, paying attention, forgetfulness and following instructions. Generally, these challenges improve as children develop and grow. However, for children with ADHD, these challenges can be significant and persist beyond early childhood. 

Despite its prevalence, many people have questions about what exactly ADHD is, what causes it, and how it can affect children’s learning and development. This fact sheet will explore each of these and more to provide a comprehensive understanding of ADHD.

What is ADHD?

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental condition characterised by persistent difficulties with inattention and/or hyperactivity-impulsivity that impacts daily life. These difficulties do not reflect a child’s overall intelligence or learning potential but may affect a person’s ability to self-regulate, focus, remember information and plan – a group of cognitive skills known as executive functions.  

ADHD is present at birth but is difficult to identify before a child begins school. While ADHD symptoms may become more manageable as people age, it cannot be cured, and many people can experience challenges with paying attention, impulse control and regulating energy levels well into adulthood. Without appropriate support, this can result in low self-esteem, poor academic performance, difficulty making friends and difficulty with work and relationships later in life. If your child is consistently struggling with their attention, memory, emotions and behaviour, they may need additional support to cope.

Types of ADHD

ADHD is a complex condition that presents differently in all children. Some children display noticeable challenges with inattention but may not present with hyperactivity-impulsivity challenges. Others may experience challenges in both areas. ADHD can also present differently in girls than it does in boys. While each child experiences their own unique set of challenges, there are three main subtypes of ADHD. 

ADHD Inattentive type – characterised by challenges predominantly relating to concentration, memory, organisation and task initiation and completion. Individuals with ADHD inattentive symptoms may be more difficult to identify as the signs are not always as physically noticeable as signs of hyperactivity and impulsivity. 

ADHD Hyperactive-impulsive type – characterised by challenges predominantly in self-control, restlessness, waiting and sitting still. 

ADHD Combined type – characterised by challenges in a combination of inattentive and hyperactive-impulsive symptoms. 

Signs of ADHD in Children

The signs of ADHD are often recognised in children before the age of 12 years. ADHD symptoms may be identified from difficulties with executive functions, impacting various aspects of a child’s functioning. These signs are usually noticed across multiple settings such as at home, school and extra-curricular activities. 

 There are several signs and symptoms of ADHD to look out for. 

What Causes ADHD?

ADHD is a developmental disorder that often begins in early childhood and can persist into adulthood. The exact cause of ADHD is still unknown. However, studies have shown that a range of genetic, biological and environmental factors may contribute to the development of ADHD. 

Genetic factors: Evidence suggests ADHD is hereditary, meaning it can be passed down through families 

Biological factors: Research indicates that there are anatomical differences in the ADHD brain, which may cause imbalances in neurotransmitter activity (the chemicals that transmit signals) in the parts of the brain responsible for reflective thought and behaviour regulation.  

Environmental factors: Exposure to toxins such as lead and alcohol in utero may cause changes in brain development that may result in ADHD.  

How is ADHD Diagnosed?

There is currently no single definitive medical or psychological test to diagnose ADHD. 

Diagnosing ADHD requires a detailed assessment conducted by a paediatrician, psychiatrist or child psychologist. The professional conducting the assessment uses multiple methods and instruments to gather the information needed. 

A comprehensive ADHD assessment by a child psychologist or paediatrician may include:  

• Family Questionnaire: Gathering information about your child’s developmental history, family history of ADHD and any other medical conditions that may impact their learning, behaviour and executive functioning. 
• Interviews: Speaking with your child (if appropriate), family members, teachers and other professionals such as sports coaches to understand how your child’s difficulties manifest across multiple settings. 
• Cognitive Testing: Evaluating intellectual abilities, memory, and processing speed to rule out other potential causes of learning difficulties. 
• Academic or Educational assessment: Evaluating academic skills such as reading, writing, spelling, comprehension and mathematics. 
• Other Standardised Assessments: Using testing tools to specifically evaluate the behaviours and skills affected by ADHD. 
• Direct Observation: Watching your child in various settings to confirm an ADHD diagnosis. 

After collecting information from all these sources, the psychologist or paediatrician analyses the results to determine if a child’s behaviour meets the diagnostic criteria for ADHD outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR). 

Understand that it can take time to diagnose ADHD in children. To meet the diagnostic criteria, behaviour must be inconsistent with a child’s developmental level – it is not expected that a preschool-aged child is able to sustain attention or moderate their behaviours, for example. The behaviours must have appeared before twelve years of age, remained persistent for at least six months, been present in two or more settings, and not better explained by another condition. At least six symptoms in the inattention or hyperactivity domains need to be present for a diagnosis to be made. Oppositional Defiant Disorder, Postraumatic Stress Disorder (PTSD), Bipolar Disorder and other anxiety and mood disorders are some of the conditions that may need to be ruled out during assessment.  

Early diagnosis is essential. Early identification and evidence-based support can help to prevent negative outcomes for children with ADHD such as school failure, inappropriate social skills and deflated confidence. 

How does ADHD Affect Children? 

ADHD can cause mild to severe disruptions in a child’s life depending upon the severity of the behaviours and the effectiveness of support strategies. 

It is generally agreed that ADHD does not have a significant effect on an individual’s intelligence. Despite natural ability, a child’s inattentiveness, impulsivity and hyperactivity unfortunately can result in failing grades. An inability to control behaviour also increases the risk of school failure for any child. 

ADHD is not a learning disability but may co-exist with one and approximately 30% of individuals with ADHD have some type of learning disability. A student diagnosed with ADHD is highly likely to experience learning difficulties due to the influence of attention problems, their impulsivity and hyperactivity. 

Untreated, ADHD can lead to poor self-esteem and social adjustment. Children with ADHD commonly experience interpersonal difficulties, peer rejection and difficult relations with family members. 

How Can Parents Best Help Their Child? 

Children with ADHD experience difficulties in many aspects of their lives – at home, school, in peer relationships and social activities. While every child is unique with different needs, there are several ways you can support them: 

Set clear, firm expectations: Make sure your child understands the instructions you have given them but allow some flexibility. Break down tasks into smaller steps and goals to help them feel more achievable and less overwhelming.  

Create predictability and structure with routine: Establishing consistency around daily activities helps children build organisation and time management skills. Use visual schedules and timers to help them stay on task and build independence.  

Communicate frequently with your child’s teachers: Check on their progress in class, share information and strategies and find out what you can do at home to further support them. Advocate for your child if you feel that extra support or special teaching arrangements may help them. 

Build their Self-Esteem: Encourage them to pursue their interests and celebrate their successes to promote skills development through their passions.  

Stress Management Techniques: Teach your child a range of relaxation techniques such as deep breathing, mindfulness or yoga to provide practical ways to manage emotions and energy levels.  

Minimise potential distractions: Create a designated quiet and tidy study area to help your child stay focused on their homework tasks.  

Promote Consistent Sleep Routine: Sleep disorders can co-occur with ADHD so establishing regular sleep routines can help with symptom management.  

Common Myths About ADHD

Despite increased public awareness of ADHD, there are several ADHD myths that persist, which can lead to misunderstanding and stigma. Here are some common myths and the facts that dispel them: 

Myth 1: ADHD is not a real disorder. 

Fact: ADHD is a well-documented, legitimate medical condition recognised by major medical organisations including the Royal Australian College of Physicians (RACP) and the Australian Psychological Society. 

Myth 2: Children with ADHD just need more discipline. 

Fact: While consistent discipline is important for children, ADHD is a neurological disorder that requires a comprehensive treatment plan, including behavioural therapy and, in some cases, medication. 

Myth 3: ADHD only affects children. 

Fact: While ADHD is often diagnosed in childhood, symptoms can persist into adulthood. Many adults with ADHD were not diagnosed as children but continue to struggle with symptoms.  

Myth 4: ADHD only affects boys.  

Fact: There is a gender bias found the assessment of ADHD in children and adults, with twice as many males diagnosed with ADHD than females. However, greater awareness and understanding of the signs of ADHD in girls has put this data into question. More research is needed to better understand the prevalence of ADHD in girls.  

Myth 5: ADHD is caused by poor parenting. 

Fact: ADHD is a complex disorder caused by genetic and neurological factors. Parenting style does not cause ADHD, although positive parenting strategies can help manage symptoms. 

Myth 6: All people with ADHD are hyperactive. 

Fact: Not all people with ADHD are hyperactive. Some may primarily have symptoms of inattention without hyperactivity. 

Helpful Resources

ADHD Australia 

ADHD Australia is a volunteer run organisation that supports all Australians affected by ADHD through awareness, advocacy and research.