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Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that affects around 9.8% of children. ADHD symptoms in kids include inattention, hyperactivity, and impulsivity. This condition is not always easy to diagnose, however, as many of the symptoms are commonly mistaken for "normal" childhood rambunctiousness.
Even physicians can have difficulty with diagnosis given that there is no single test that can diagnose ADHD. Ultimately, to make the distinction, pediatricians run through a checklist of characteristic symptoms to determine whether the child meets the criteria for ADHD as outlined in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
ADHD symptoms are typically grouped into two major categories: inattention (the inability to stay focused) and hyperactivity-impulsivity (impulsive behaviors that are excessive and disruptive). The determination of ADHD is largely based on whether behaviors in these categories are appropriate for the child's developmental age.
The range of symptoms can vary from child to child and lead to a variety of diagnoses broadly classified as follows:
According to the DSM-5, inattention can be diagnosed in children under age 16 if they exhibit six or more of the following symptoms (diagnosis only requires five or more symptoms for adolescents 17 and older):
Similarly, hyperactivity and impulsivity can be diagnosed in children if they exhibit six or more of the following symptoms (or five or more symptoms for individuals 17 and older):
ADHD often first appears in childhood and may persist into adulthood, although research suggests that only 17% of kids with ADHD still have the disorder as adults. Symptoms may also be different in adulthood. Hyperactivity is more common in children, for example, but more likely to present as restlessness in adulthood.
The combined type of ADHD is characterized by symptoms of both inattention and hyperactivity/impulsivity. Children with this type exhibit symptoms of inattention along with hyperactive and impulsive symptoms.
To be diagnosed with the combined type presentation of ADHD, children must exhibit six or more symptoms of inattention and six or more symptoms of hyperactivity/impulsivity. These symptoms must be present for at least six months and must not be caused by another condition.
Research suggests that ADHD often presents differently in girls and boys. While boys with ADHD are more likely to have hyperactive/impulsive or combined-type presentations, girls are more likely to have inattentive ADHD .
Boys are also more likely to exhibit externalizing symptoms associated with ADHD such as acting out and being aggressive. They may also have hyperactive or impulsive symptoms such as constantly moving, interrupting others, and engaging in physical actions at inappropriate times.
Conversely, girls with ADHD are more likely to experience inattentive symptoms such as not paying attention, not listening, being easily distracted, and losing focus. Other symptoms of ADHD in girls can include being withdrawn, disorganized, unmotivated, shy, and getting easily upset.
Because boys' symptoms tend to be more disruptive, they are often diagnosed with the condition more frequently than girls. Girls' symptoms such as shyness and daydreaming are often seen as personality characteristics, so they are often missed, making them less likely to get help.
If left untreated, ADHD can create issues later in life. For instance, one study found that when childhood ADHD persisted over time, females were more likely to engage in self-harm and faced impairments both socially and in their work.
For ADHD to be definitively diagnosed, symptoms must meet four key criteria:
If a child is diagnosed with ADHD, their healthcare provider can determine a treatment plan that is right for their needs. This treatment may include medication, psychotherapy, or a combination of the two. Other strategies can also be helpful, including behavioral approaches, parent training, and social skills training.
Parents may also find it beneficial to join a support group for parents of children with ADHD. It's also important to help the child learn more about their diagnosis and treatment plan.
Working with the child's physician or therapist, having conversations with the child, and looking for positive role models can be helpful. The child may find it helpful to know that there are many famous people with this condition, including celebrities and athletes. Help them recognize the strengths of people with ADHD.
Going through a checklist for ADHD can help us better understand some of the symptoms of ADHD in children. However, if ADHD is suspected, the next step is to talk to a healthcare professional for further evaluation, diagnosis, and treatment.
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
By Vincent Iannelli, MD
Vincent Iannelli, MD, is a board-certified pediatrician and fellow of the American Academy of Pediatrics. Dr. Iannelli has cared for children for more than 20 years.
