The Facts about Attention Deficit Hyperactivity Disorder (ADHD)

Attention deficit hyperactivity disorder (ADHD) is a brain disorder that affects up to 10 percent of children. I sat down with pediatrician Kenneth W. Norwood, Jr., MD, to find out more about ADHD and how kids and parents can manage an ADHD diagnosis.

Since his days as a camp counselor and swimming coach, Norwood has always enjoyed working with kids. “I was always drawn to the kid who was the slow swimmer or out in right field, he says. “I wanted to help them.” This lead to his interest in pediatrics and specifically neurodevelopmental disabilities such as ADHD.

At UVA, Norwood works to help kids with ADHD succeed.

What makes a parent seek an ADHD diagnosis?

Behavioral problems in daycare or preschool prompt many parents to contact their pediatrician. There are three distinct ages when this happens, according to Norwood. The first two refer mainly to boys:

• In preschool or daycare, when behaviors like aggression or biting become an issue
• In early elementary school, when what seemed like being high energy or “all boy” starts to have academic consequences

Middle school is when girls with ADHD are often diagnosed, when it presents as spaciness or not being able to concentrate.

How can parents and kids manage ADHD symptoms?

A correct diagnosis is critical. At UVA, “it’s very personalized,” says Norwood. “We take time to get to know the child.”

First, rule out learning disabilities or other underlying problems. ADHD in both children and adults often coincides with anxiety and depression. “You have to treat the depression or the anxiety in order for the ADHD treatment to be effective,” Norwood says.

Developmental pediatricians recommend behavior therapy for children of all ages who develop ADHD symptoms. Unfortunately, behavior therapy is out of reach for many parents across the United States. “The wait for these services is often many months, even just for an evaluation,” Norwood says. Frequently, parents have to manage their child’s symptoms with very little support.

Concerned about ADHD?

Make an appointment with a pediatrician. 

Medication like stimulants can also be an option. In people with ADHD, the areas of the brain that deal with organization, or seeing the big picture, are under-stimulated. The stimulants prescribed to treat ADHD work with the brain’s neurotransmitters to stimulate these areas of the brain.

ADHD requires consistent treatment and sometimes medication over a lifetime, but with the correct diagnosis and support, the child with ADHD can learn to harness it.

Norwood thinks that we concentrate too much on the ADHD child adapting to the world, not the other way around. “The world has to be flexible, too,” he says. Individual educational plans (IEPs) can specify accommodations like standing at a desk, or letting the student move around, or having directions read out loud more than once.

“These kids are creative. Their brains go at 1,000 miles an hour,” says Norwood.

Is ADHD genetic? Will my child outgrow it?

ADHD is highly genetic. For any child with ADHD, there’s a 30 to 40 percent chance that one of the parents has it.

Norwood has frequently met parents who suspected that they had ADHD only after their child was diagnosed. “Parents who come in suspecting their child has ADHD may themselves have had undiagnosed ADHD his or her whole life,” he says. If it’s left untreated, a parent with ADHD might not be able to provide the structure that their ADHD child needs.

Few children outgrow ADHD. “Eighty percent of kids who have ADHD as children have it as adults,” Norwood explains. “The reason why it seems to subside with age is that the hyperactivity part lessens, but the other aspects persist into adulthood.”

What happens if ADHD goes untreated?

Adults with undiagnosed ADHD are at risk for:

• A higher prevalence of car accidents, especially teenagers
• Problems with relationships
• Trouble keeping jobs
• Self-medication (seeking out stimulants like caffeine, nicotine, or stronger drugs)

How does the child’s environment impact ADHD?

Consistent structure is essential to manage ADHD symptoms, and it’s more difficult now with work schedules and other circumstances that many parents struggle with today. Technology also has an impact. Some data indicate that exposure to screens under the age of two can contribute to ADHD.

One thing that definitely does not work to manage ADHD, says Norwood, is physical punishment: “It is documented: hitting makes symptoms worse.”

Watch this video of clinical psychologist Jennifer “Kim” Penberthy, MD, describing ADD and ADHD.