Dr Zana Marovic, Phd

Clinical Psychologist, Johannesburg

ADD/ADHD in Children

ADD/ADHD in Children

We all know kids who can’t sit still, who never seem to listen, who don’t follow instructions no matter how clearly you present them, who blurt out inappropriate comments at inappropriate times. Sometimes these children are labeled as troublemakers, or criticized for being lazy and undisciplined or day-dreamers. However, they may have ADD/ADHD.

ADHD stands for Attention Deficit Hyperactive Disorder, with the main symptoms being visible hyperactivity and/or impulsivity. ADD stands for Attention Deficit Disorder with the main symptoms being inattention.The signs and symptoms of ADD / ADHD typically appear before the age of 7. However, it can be difficult to distinguish between ADHD and normal “kid behavior.”

Just because a child has symptoms of inattention, impulsivity, or hyperactivity does not mean that he or she has ADD or ADHD. Many other things can cause symptoms that are identical to the symptoms of ADD / ADHD. Before an accurate diagnosis of ADD / ADHD can be made, it is important that you see a mental health professional to explore and rule out the following possible causes of the ADHD-like symptoms:

  • Major life events or traumatic experiences that have caused stress (e.g. a recent move, death of a loved one, bullying, illness, divorce).
  • Learning disabilities or problems with reading, writing, motor skills, or language.
  • Psychological problems including anxiety, depression, and bipolar disorder.
  • Behavioral disorders such as conduct disorder and oppositional defiant disorder.
  • Medical conditions, including thyroid problems, neurological conditions, epilepsy, and sleep disorders.

Signs and symptoms of ADD & ADHD

Symptoms of ADD in children
  • Doesn’t pay attention to details or makes careless mistakes
  • Has trouble staying focused; is easily distracted
  • Appears not to listen when spoken to
  • Has difficulty remembering things and following instructions
  • Has trouble staying organized, planning ahead, and finishing projects
  • Frequently loses or misplaces homework, books, toys, or other items

Children with ADD can pay attention when they’re doing things they enjoy or hearing about topics in which they’re interested. But when the task is repetitive or boring, they quickly tune out. Not paying close enough attention is another common problem. Children with ADD often bounce from task to task without completing any of them, or skip necessary steps in procedures. Organizing their schoolwork and their time is harder for them than it is for most children. Kids with ADD also have trouble concentrating if there are things going on around them; they usually need a calm, quiet environment in order to sustain attention.

Symptoms of ADHD in children
  • Constantly fidgets and squirms
  • Often leaves his or her seat in situations where sitting quietly is expected
  • Moves around constantly, often running or climbing inappropriately
  • Talks excessively, has difficulty playing quietly
  • Is always “on the go,” as if driven by a motor

The most obvious sign of ADHD is hyperactivity. While many children are naturally quite active, kids with ADHD are always moving. They may try to do several things at once, bouncing around from one activity to the next. Even when forced to sit still – which can be very difficult for them – their foot is tapping, their leg is shaking, or their fingers are drumming.

Impulsivity signs and symptoms of ADD / ADHD
  • Blurts out answers without waiting to be called on hear the whole question
  • Has difficulty waiting for his or her turn
  • Often interrupts others
  • Intrudes on other people’s conversations or games
  • Inability to keep powerful emotions in check, resulting in angry outbursts or temper tantrums

The impulsivity of children with ADD / ADHD can cause problems with self-control. Because they censor themselves less than other kids do, they’ll interrupt conversations, invade other people’s space, ask irrelevant questions in class, make tactless observations, and ask overly personal questions.

Children with impulsive signs and symptoms of ADD / ADHD also tend to be moody and to overreact emotionally. As a result, others may start to view the child as disrespectful, weird, or needy.


Positive aspects of ADD & ADHD in children

In addition to the challenges, there are also some positive traits associated with people who have ADD or ADHD:

  • Creativity – Children who have ADD / ADHD are usually very creative and imaginative. The child who daydreams and has ten different thoughts at once can become a master problem-solver, a fountain of ideas, or an inventive artist. Children with ADD may be easily distracted, but sometimes they notice what others don’t see.
  • Flexibility – Because children with ADD / ADHD consider a lot of options at once, they don’t become set on one alternative early on and are more open to different ideas.
  • Enthusiasm and spontaneity – Children with ADD / ADHD are rarely boring! They’re interested in a lot of different things and have lively personalities. In short, if they’re not exasperating you (and sometimes even when they are), they’re a lot of fun to be with.
  • Energy and drive – When kids with ADD / ADHD are motivated, they work or play hard and strive to succeed. It actually may be difficult to distract them from a task that interests them, especially if the activity is interactive or hands-on.
  • High IQ – Many children with ADD/ADHD are intellectually or artistically gifted.

Diagnosing ADD / ADHD in children

At present, no laboratory or imaging test exists to determine if your child has ADD / ADHD. Clinicians base their diagnosis on the signs and symptoms they observe and by ruling out other disorders. In order to get an accurate diagnosis, it is important to have a full medical and psychological evaluation. The doctor should interview you, your child, and any adults who can provide insight, such as teachers or nannies. Mental health professionals who can diagnose ADD / ADHD include psychologists, pediatricians, and psychiatrists.

Symptoms of ADD in children

The professional criteria for a diagnosis of ADD / ADHD requires the following:

  • Early onset – Symptoms must have been present before age 7.
  • Duration – A combination of symptoms must have been present for at least 6 months.
  • Settings – The symptoms must be present in two or more settings, such as home, school, and other social settings.
  • Impact – The symptoms must have a negative impact on the individual’s school, family, and/or social life.
  • Developmental level – The symptoms are not due to the child’s normal developmental level.
  • Alternative explanation The symptoms are not caused by another physical, mental or emotional disorder.

Helping a child with ADD / ADHD

Whether or not your child’s symptoms of inattention and hyperactivity are due to ADD / ADHD, they can cause many problems if left untreated. Children who can’t focus and control themselves may struggle in school, get into frequent trouble, and find it hard to get along with others or make friends. These frustrations and difficulties can lead to low self-esteem – as well as friction and stress for the whole family. But treatment can make a dramatic difference in your child’s symptoms. With the right support, your child can get on track for success in all areas of life.

Parenting tips

If your child is hyperactive, inattentive, or impulsive, it takes a lot of energy to get him or her to listen, finish a task, or sit still. The constant monitoring can be frustrating and exhausting. Sometimes you may feel like your child is running the show. While ADD / ADHD is not caused by bad parenting, good parenting strategies can go a long way in correcting problem behaviors. Children with ADHD need structure, consistency, clear communication, and rewards and consequences for their behavior. They also need lots of love, support, and encouragement.

There are many things parents can do to reduce the signs and symptoms of ADHD – without sacrificing the natural energy, playfulness, and sense of wonder unique in every child.

If you receive a diagnosis of ADD / ADHD, you can work with your child’s doctor, therapist, and school to make a personalized treatment plan that meets his or her specific needs. Effective treatment for childhood ADD / ADHD involves behavioral therapy, parent education and training, social support, and assistance at school. If medication is used – it should never be the sole ADD / ADHD treatment.

Attention Deficit and Hyperactivity Support Group of Southern Africa