Dear NP

Dear NP,

My daughter struggled through school last year. Due to COVID, she was homeschooled for several months and I am worried about her focus. What are the signs of ADHD? M. L.

Dear M. L.,

ADHD stands for attention-deficit hyperactivity disorder and can be a major problem for children and adults alike. Over six million children are diagnosed with ADHD every year, so it is far from a rare problem.

However, many of the stereotypical behaviors of ADHD are things that all lively, energetic children do from time to time. So, it can be difficult to know when what you’re observing constitutes a problem. This is especially true during the COVID-19 pandemic, when we’ve all been feeling stressed and cooped-up.

ADHD has a few key components, and children with ADHD may express one or more of these:

Attention-deficit: inability to pay attention

Hyperactivity: inability to sit still or calm down

Impulsivity: inability to practice self-control.

All children show these characteristics every now and again – it’s part of being a kid. However, when these behaviors become the norm, or start to cause difficulties, it could be a sign your child has ADHD.

If you believe your child may have ADHD, look for some of the following signs. In general, symptoms usually appear before age 7.

Careless mistakes: ADHD makes it difficult for children to follow instructions and complete tasks correctly.

Unfinished tasks: Children with ADHD struggle to finish what they start.

Easily distracted: One of the hallmark symptoms of an attention deficit is failing to focus on one thing at a time.

Fidgeting: Part of hyperactivity is the inability to sit still.

Will not remain seated: Hyperactivity manifests readily in places like the classroom where sitting for long periods of time is required.

Always on the go: All children are energetic, but children with ADHD seem like they can’t stop, even if their body and mind are exhausted.

Acts without thinking: Children with ADHD often fail to think through the results of their actions. It’s act now, think later.

Can’t wait their turn: All children have to learn patience, but children with ADHD struggle especially hard with this.

If you’re observing these signs in your child, talk to your child’s teacher. ADHD is common enough that experienced teachers will have seen it many times over, and they spend so much time with your child that they’re likely to have noticed as well.

You should also talk to your child’s pediatrician. While there is not a specific test for ADHD, they can help you evaluate your child’s behaviors and figure out a potential solution. Health care providers can also rule out physical conditions that may be manifesting in ADHD behaviors, like trouble hearing leading to interrupting.

After diagnosis, some children with ADHD are prescribed medications, while other parents seek treatment through behavioral therapy. A combination of both chemical and behavioral treatments is also common and effective. Each family is different.

The underlying causes of ADHD are not entirely known. Some researchers have hypothesized external factors like vitamin deficiencies or excess sugar in the diet, but this is unproven.

ADHD has been observed to run in parents, so there is likely a strong genetic component as well. While this sounds like bad news, there is also some comfort in knowing there is at least some biological basis for ADHD, because it is far too often blamed on the child.

Do not be afraid to talk to your pediatrician or primary care provider if you feel your child may have ADHD. And do not feel as though it is your fault, or your child’s fault. It is a disorder and requires treatment like any other.

Dr. Wesley Davis is an Emergency Nurse Practitioner at Crook County Medical Services District and Coordinator of the Family and Emergency Nurse Practitioner program at the University of South Alabama. He encourages readers to send their questions to [email protected]