What is it?

Attention Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder. In some children, they’re noticeable as early as three years of age. Children who have ADHD have higher levels of inattention, impulsivity, and/or hyperactivity than their peers.

What are the symptoms of ADHD in children?

There are three types of ADHD.

1. Inattentive. Most symptoms fall under inattention, distraction and disorganization.

• Trouble paying attention to details
• A tendency to make careless mistakes in schoolwork or other activities
• Difficulty staying focused on tasks or play activities
• Apparent problems with listening
• Difficulty following instructions
• Problems with organizing tasks or activities
• Avoidance or dislike of tasks that require mental effort
• A tendency to lose things like toys, notebooks, or homework
• Easily distracted
• Forgetfulness in daily activities, such as forgetting to do chores

Because children with this form of ADHD are less likely to disrupt the classroom or other activities, their symptoms may not be noticed as quickly.

2. Hyperactive-impulsive. Most symptoms are related to hyperactivity and impulsiveness.

• Fidgeting or squirming
• Difficulty remaining seated
• Excessive running or climbing
• Difficulty playing quietly
• Always seeming to be “on the go”
• Excessive talking
• Blurting out answers, interrupting the questioner
• Difficulty waiting for a turn or in line
• Problems with interrupting or intruding on others’ conversations, games or activities

2. Combined. It is a mix of many inattentive symptoms and hyperactive-impulsive symptoms.

The physical signs of ADHD cannot be detected by a lab test. Typical ADHD symptoms may overlap with those of other physical and psychological disorders.

ADHD doesn’t cause other psychological or developmental problems. However, children with ADHD are more likely than others to also have conditions such as:

• Learning disabilities, including problems with reading, writing, and math skills 
• Anxiety disorders 
• Depression
• Disruptive mood dysregulation disorder: severe irritability, anger, and frequent, intense temper outbursts
• Oppositional defiant disorder (ODD) 
• Conduct disorder 
• Bipolar disorder
• Tourette syndrome  

When is it time to seek professional help?

Young children with ADHD are more likely to experience difficulties in daycare or school, including problems with peer relationships, learning, and a higher risk of injuries. An early diagnosis is important so that the child can get the support they need to minimize challenges. 

Since the early years is a critical time for brain development, it is important for children to learn positive behaviours and for caregivers to learn how to support their unique individual needs, even for young children who are showing some symptoms of ADHD but do not have ADHD. It’s best to address problematic behaviours sooner rather than later. 

What can be done?

ADHD is best managed with a combination of medications and counselling. Effective treatment of childhood ADHD involves behavioural skills training, behavioural school intervention and medication. Behavioural skills training can help parents and caregivers develop a positive relationship with the child and encourage positive behaviour. Behavioural skills training has been shown to work as well as medication for ADHD in young children. 

Any good treatment plan will include follow-up and monitoring. In some cases, the symptoms of ADHD become less severe or change as the child grows older, particularly if the child’s environment is conducive to their development and their self-regulation skills improve. 

What makes some children more vulnerable to ADHD?

Many genetic studies indicate that ADHD runs in families. However, it is important to understand that ADHD is a complex disorder that is the result of many interacting genes as well as the result of genes interacting with the environment. Other risk factors for ADHD include exposure to environmental toxins (e.g. lead or pesticides) during pregnancy or childhood, premature birth or low birth weight or brain injury. 

Where can I access support? 

An early diagnosis is important so that the child can get the help that they need. Talk to the child’s family doctor or pediatrician. The child may be referred to specialists (e.g. psychologist, behavioural specialists, psychiatrist, neurologist, or developmental pediatrician). 

Talk to the child’s guardianship worker to explore what options are available for assessment so their diagnosis and treatment plan can be included in their Care Plan. The guardianship worker will help make appropriate referrals for specialized supports and services. 

Your local Child and Youth Mental Health team may be able to provide an assessment or refer the child to specialized resources in your community. Your local CYMH office offers a range of free and voluntary mental health services and supports for children from 0-18 years of age and their families. These services include assessments, therapy and treatment, education and referrals to specialized programs and resources. There are 100 intake clinics for children, youth and their families at convenient locations throughout BC. Please note that not all local Child and Youth Mental Health teams provide assessments and support for ADHD. Call your local Child and Youth Mental Health office first to ask if they provide this service.