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Attention Deficit Hyperactivity Disorder

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What is ADHD?

It is common for children to have challenges with attention, learning or behavior.

If these challenges cause problems for your child or teen with family, friends or school and last longer than 6 months, they may have attention deficit hyperactivity disorder (ADHD) or a related disorder, such as oppositional defiant disorder.

ADHD is the most common mental health problem in children. It affects up to 10% of youth.

 

Psychiatry and Behvioral Medicine at Seattle Children's

Seattle Children’s child and adolescent mental health providers offer a wide range of services — from prevention and early intervention programs to highly specialized treatments for chronic mental health and developmental challenges.

 

What are the symptoms of ADHD?

The signs and symptoms of ADHD in children and teens include:

  • Being hyperactive ("on the go" or restless)
  • Being impulsive (butts into conversations, acts without thinking)
  • Not paying attention (off-task, distractible, trouble completing schoolwork)

These behaviors don’t match what’s typical for someone their age.

To be diagnosed with ADHD, your child’s symptoms must:

  • Start before age 12
  • Last at least 6 months
  • Cause problems (may be mild to serious) at home, at school or with peers

Symptoms may lessen and change over time. About one-third of children with ADHD no longer have the condition as adults. About two-thirds still do. Though they may no longer meet the full diagnostic criteria for ADHD, many teens and young adults continue to have challenges with learning, attention or behavior.

Often, people with ADHD have other mental health, medical and learning problems too, so they may have other signs and symptoms.

What causes ADHD?

ADHD is a neurodevelopmental disorder. It happens because of a problem with how the brain or central nervous system grew or developed. The circuits related to motivation, attention, organization and reward are affected.

Genetics play a strong role. ADHD is often passed down in families. At least 25% of children with ADHD have a close family member with the disorder.

How is ADHD diagnosed?

A healthcare provider may diagnose ADHD after getting a detailed history about your child from many sources, such as you, your child and their teachers. The provider will also check if your child might have other conditions that can seem like ADHD or happen along with ADHD. They will identify your child’s strengths and weaknesses and develop a treatment plan.

There is no single "test" for ADHD. Usually, rating scales are used to screen for ADHD symptoms and other disorders. Often, providers will use scales during treatment too to see how well the treatment is working.

Many children with ADHD have other challenges, including learning or behavioral problems. It is important to diagnose and treat these issues as well.

How is ADHD treated?

Behavior therapy (also called behavior modification therapy) and medicine are the treatments that work best for youth with ADHD.

Behavior therapy

In behavior therapy, you (and sometimes your child’s teachers) are taught how to work with your child on:

  • Having more positive interactions
  • Using rewards to encourage good behaviors
  • Making clear rules and enforcing them all the time
  • Giving your child more structure at home and school
  • Giving clear and simple instructions
  • Withholding positive attention and rewards when a child behaves in a negative way in order to discourage the negative behavior
  • Using daily notes to communicate between school and home and motivate your child at school

Medicine

In most cases, providers prescribe 1 of these types of stimulant medicines to treat ADHD symptoms:

  • Methylphenidate products (such as Ritalin, Concerta and Daytrana)
  • Amphetamine products (such as Adderall and Vyvanse)

These medicines are approved by the U.S. Food and Drug Administration (FDA) for ADHD. They come in many forms. Some have effects that last almost 12 hours, while others last a shorter time.

There are also nonstimulant medicines approved by the FDA for ADHD. They act differently on the body and have different side effects.

Is ADHD treatment helpful?

Treatment is usually helpful for most children and teens with ADHD. Symptoms improve fastest by using behavior therapy and medicines together.

ADHD symptoms change as children grow. So, it’s important to check how your child’s treatment is working over time and to change it if needed.

Without treatment, teens with ADHD have a higher chance of failing in school and dropping out, having low self-esteem, feeling demoralized, abusing alcohol or other substances and breaking the law.

With treatment, many young people with ADHD attend college and become successful adults.

What should I do if I think my child has ADHD?

If you’re concerned about your child’s learning, behavior or attention, talk to your child’s primary care provider first. Many PCPs are comfortable diagnosing ADHD, or they can refer you to another provider for more evaluation.

If your child is 5 years old or younger, it’s a good idea to have their hearing and vision checked. Problems with hearing or vision could be the source of their challenges.

How can I help my child succeed at school?

Your child may be eligible for a 504 plan or individualized education program (IEP) to make sure they get the special services, support and accommodations they need to learn.

ADHD at Seattle Children’s

Seattle Children’s Psychiatry and Behavioral Medicine providers specialize in evaluating children who might have ADHD. We develop a treatment plan to fit your child’s needs. Then we work with you and your child’s primary care provider (PCP) to make sure your child gets ongoing care to help them succeed at home, at school and in the community.

  • The experts you need are here
    • Many children with ADHD or related challenges get a diagnosis and medicine from their PCP. For children with more complex needs — like ADHD that is hard to diagnose or affected by other issues — an evaluation at Seattle Children’s may be helpful. 
    • At Seattle Children’s, your child is cared for by a team that includes psychiatrists, psychologists, advanced registered nurse practitioners, pediatricians and mental health therapists with special training in ADHD, plus trainees from many areas of healthcare.
    • We do a thorough evaluation to get a complete picture of your child’s challenges and strengths. Then we talk with you about recommendations and next steps. Based on your child’s age, this visit could be with our Early Childhood Clinic or Behavior and Attention Management Program.
    • Our team works with your child’s PCP to offer evidence-based treatments tailored to your child. Treatment may include a range of options like parenting groups through the Behavior and Attention Management Program to teach you skills for dealing with ADHD, medicines for ADHD, suggestions for your child’s school and referrals to other Seattle Children’s clinics and community resources. 
  • Care from birth through young adulthood
    • Everyone on our team is specially trained to understand and meet the specific needs of children and teens. Our pediatric experts tailor care to your child’s age and developmental stage.
    • The Early Childhood Clinic sees children age 4 or younger who have behavior issues, anxiety, sleep problems, neurodevelopmental problems or prenatal (before birth) exposure to alcohol or drugs. We also see children who have other medical conditions along with a behavior or emotional problem.
    • The Behavior and Attention Management Program sees children and teens ages 5 to 15 with disruptive behavior or attention problems, like ADHD, and their families. We offer diagnostic evaluations for ADHD and consultation for children diagnosed with ADHD. We also offer classes; group training for caregivers; groups for caregivers and children or teens together; and groups just for teens to help with behavior, attention and learning.
  • Resources for your child and family

How to Get Services

We often have more requests from new patients than we have openings. To make an appointment for the Early Childhood Clinic or the Behavior and Attention Management Program, you need a referral from your child’s primary care provider. Learn more about how to get mental health services at Seattle Children’s.

If you have a referral, call 206-987-2164.

Providers, see how to refer a patient.

Related Links

In crisis?

If you, your child, family or friend needs help right away, call, chat or text 988. The free and confidential 988 Suicide & Crisis Lifeline is available 24 hours a day, 7 days a week in the United States to provide support for people in distress, as well as prevention and crisis resources.

Deaf and Hard of Hearing people can get help through 988 or the Deaf Crisis Line.

Seattle Children’s Psychiatric Urgent Care offers in-person and video visits for same-day mental health support for children and teens ages 4 through 17 who may not need the services of an emergency department.

Hotlines for Youth (PDF) provides other options for immediate help for children and teens. (Also available in Amharic, Arabic, Russian, Simplified Chinese, Somali, Spanish, Ukrainian and Vietnamese.)