ADHD

Children with attention-deficit hyperactivity disorder (ADHD) are particularly inattentive, impulsive, and active. ADHD can have a significant impact on the lives of children and their families.

At a glance

  • ADHD predominantly affects children.
  • The symptoms markedly improve in adulthood or may even disappear.
  • It is assumed that the condition is caused by a combination of genetic predisposition and external influences.
  • Paediatricians, specialists in child and adolescent psychiatry, and psychotherapists are qualified to diagnose ADHD.

Note: The information in this article cannot and should not replace a medical consultation and must not be used for self-diagnosis or treatment.

ADHD: fingers twirling a fidget spinner.

What is ADHD?

ADHD is a neurodevelopmental disorder. Children with ADHD are particularly inattentive, impulsive, or “hyperactive”.

 But what exactly do these terms mean?

  • Children are classified as “inattentive” if they have poor concentration and are easily distracted.
  • An “impulsive” child behaves more irresponsibly, carelessly, impatiently, or thoughtlessly than his or her peers.
  • A “hyperactive” child is one who is extremely fidgety and restless.

Children with ADHD often stand out as exhibiting behavior that does not conform to the norm. Typically, they also find it hard to focus, which makes learning more difficult. Some children with this condition also suffer anxiety or depression.

Important: ADHD has been diagnosed with increasing frequency in recent years. However, critics suspect that some of these cases have been misdiagnosed and, for example, that children who are simply restless but otherwise healthy are being regarded as having a brain disorder.

What are the signs of ADHD?

It is normal for children to be occasionally inattentive and impulsive. The critical factor is how extreme and noticeable this behavior is. A potential diagnosis of ADHD is only a possibility if children or adolescents are significantly more inattentive, impulsive, and excessively active than others of the same age.

Laughing boy upside down holding onto a climbing frame with both hands and clinging on with his feet.

It is also important to distinguish between different sub-types of this condition. Children may be either predominantly inattentive or predominantly hyperactive and impulsive. If a child is inattentive but not hyperactive, this is known as attention deficit disorder, or ADD for short.

What causes ADHD?

Research into the precise causes of ADHD is still ongoing. It is assumed that a combination of genetic predisposition and external influences is at play.

However, reliable studies on the causes of the condition are still lacking. Consequently, many different possibilities are being discussed among experts.

An indication of genetic predisposition has been established in the nerve cells of the brain. It appears that a change occurs in how the neurotransmitter dopamine is transported to the areas of the brain responsible for memory and learning. Yet there are other biological factors which contribute to the development of ADHD.

Also, the role of societal developments remains unclear. Some researchers, for example, view ADHD as a consequence of or reaction to modern living, with children's brains being routinely exposed to an ever-increasing number of stimuli, while their bodies are also moving less – against the backdrop of great pressure to perform and changes in family structures.

Influences during pregnancy are not fully understood either. If an expectant mother smokes, drinks alcohol, or consumes recreational drugs, this increases the chance of her unborn child having ADHD. However, several studies have revealed that only a small proportion of children exposed to these risk factors are affected. In addition, the role of external influences on pregnancy has not yet been conclusively clarified. So these studies also do not offer any clear answers.

How common is ADHD?

Attention-deficit hyperactivity disorders are quite common according to statistics. Around 5 percent of children are diagnosed with ADHD. However, it is suspected that some children are being misdiagnosed, and a representative study on the prevalence of ADHD in Germany detected the condition among just one to two percent of children.

How does ADHD develop?

ADHD predominantly affects children. The symptoms markedly improve in adulthood or may even disappear.

ADHD typically appears in childhood.

Around half of those with the condition continue to show symptoms as adults. The symptoms may also change and manifest as inner turmoil or restlessness. Only about 15 percent of those affected have symptoms that meet the criteria for an ADHD diagnosis.

How is ADHD diagnosed?

A qualified diagnosis of ADHD can only be made by paediatricians, specialists in child and adolescent psychiatry, or psychotherapists for children and young people.

It is important that diagnosis involves an in-depth discussion to identify and exclude other possible reasons for the child's behavior. After all, difficulties with concentration, problems at school, and hyperactivity may have other causes, such as sleep disturbances, impaired vision or hearing, or hypothyroidism.

For more detailed information, e.g., on the diagnosis of ADHD, see gesundheitsinformation.de.

How is ADHD treated?

It is important that any type of treatment be preceded by a consultation detailing what exactly ADHD is and how to live with it. Teachers and educators may be involved at this stage too. At that point, it may be determined that there is no great need for treatment. The discussion must focus on ascertaining how severely the child and parents are impacted by the behavioral issues, how the child’s schooling and education are affected, and how the condition manifests in daily life, e.g., in terms of sleeping habits.

Important: With mild ADHD, parental training may be sufficient. ADHD training teaches parents how to deal with the condition. Moderate or severe ADHD may lead to social problems or issues with learning. Appropriate measures at school, or family or behavioral therapy may help.

Should ADHD be treated with medication?

The following questions should be considered:

  • How old is the child?
  • How pronounced is the ADHD?
  • Have any psychotherapeutic or pedagogical measures already been implemented?
  • What are the benefits and drawbacks of the medication?

The most frequently prescribed medications contain the active ingredient methylphenidate. Alternative active ingredients are atomoxetine, dexamphetamine, guanfacine, and lisdexamfetamine. 

When is treatment as an in-patient or day patient helpful?

For hyperactive and impulsive children and adolescents who find it difficult or impossible to manage daily life, a temporary stay in a psychosomatic or psychiatric clinic may be beneficial.

What can make everyday life easier?

A child with ADHD may present a challenge for the entire family. It is not only during school and leisure-time activities that problems occur, including conflict with other children. Within the family environment, parents are continually faced with the difficult task of supporting the child affected while also ensuring that siblings do not feel neglected.

Most parents develop their own strategies to deal with this situation over time. Having certain routines and clear rules in place has been shown to help. Contacting and exchanging information with others in a similar situation may also provide relief, e.g., in the context of a support group. It is important to remember that the child’s behavior is not intentional and that they themselves also suffer the consequences.

Where can I find support?

A wide range of personalized advice and support is available throughout Germany for those with ADHD. These are organized differently, depending on the region. For a list of contacts, visit gesundheitsinformation.de.

In cooperation with the Institute for Quality and Efficiency in Health Care (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen) (IQWiG). As at:

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