essay about adhd

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Breaking Barriers: My Battle with ADHD

In a prize-winning essay about overcoming obstacles, a child with attention deficit disorder explains the effects of adhd on his life. from enlisting the help of family members to keeping a journal, this is how jack prey manages his diagnosis..

Have you ever been working on something important, when a song pops into your head? Then that leads you to think of something in the song about flying, which leads you to play with your remote control glider? Next thing you know, it’s dinnertime, and you haven’t finished the homework you started two hours before.

That’s what it’s like to have Attention Deficit Disorder. I know because I’ve had ADHD for as long as I can remember. For me, ADHD means that I can’t focus whenever I really need to. It’s something I will live with for the rest of my life. And it’s no fun!

When I was younger, people told me I was really smart. But I never got good grades to show it. When I was at school, I would get bored really quickly. Then I would look for something more interesting to do. Sometimes I would try to help other kids with their work. The problem was, I didn’t finish my work, and that would lead to trouble. There were lots of days I even felt like quitting school.

My parents were confused. They knew I was smart, but I wasn’t showing it. My doctor suggested that I see a specialist. He gave me a bunch of tests. When it was all done, he told my parents that I had ADD . Now it’s called ADHD. The H stands for “hyper.” He said I didn’t really have the H , so I guess that was some good news.

To help me focus, the doctor gave me some tips to follow. One of them is to keep a special journal with me all the time to write down things, like what homework I have and when things are due. I try to keep the notebook with me wherever I go. It really helps.

[ Get This Free Download: 5 Powerful Brain Hacks for Focus & Productivity ]

I came up with another tip myself. When I have a test or a quiz, I challenge myself to get it done by a certain time. That keeps me focused on the test and not on the pretty girl sitting in front of me or the lizard in the aquarium. Ah, lizards. I really like lizards. Where was I again?

Oh yeah, my focus techniques. With the help of my parents and my older brother, I started doing some other things that help, like going to bed a little earlier so I can get a good night’s sleep.

My brother and I share a bedroom, and he has agreed to go to bed earlier to help me out. Another thing our whole family has started doing is eating a healthy diet. I used to eat a lot of junk food, but now I only eat a little bit. Ah, junk food. Oops, I’ll try not to do that again.

I’ve been working hard, using these focus techniques for the last year and guess what? My grades have started to go up! In fact, on my last report card I got five As and one B. That’s the best I’ve ever done!

[ Your Free Download: What Every Teacher Should Know About ADHD: A Poster for School ]

My teacher, Miss Ryan, suggested I write this essay. I’m not sure if I knew who Jackie Robinson was before this, but I did some checking. Turns out, he was a great man who had to overcome one of the worst things there is: racism. He did it using the values of courage, determination, teamwork, persistence, integrity, citizenship, justice, commitment, and excellence.

I have used some of these same values to help me overcome ADHD. For instance, I am committed to using my focus techniques, and I am determined to do better in school. Plus, my family has helped me, and that is being a team. Go, team! Also, when I focus, I am a good citizen and don’t bother my classmates as much. Last but not least, using these values has helped me to get almost all As on my report card, which is an example of excellence. Thanks for being such a good example, Jackie!

[ Read This Next: How I Came to Rock My ADHD ]

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ADHD is my superpower: A personal essay

A Story About a Kid

In 1989, I was 7 years old and just starting first grade. Early in the school year, my teacher arranged a meeting with my parents and stated that she thought that I might be “slow” because I wasn’t performing in class to the same level as the other kids. She even volunteered to my parents that perhaps a “special” class would be better for me at a different school.

Thankfully, my parents rejected the idea that I was “slow” out of hand, as they knew me at home as a bright, talkative, friendly, and curious kid — taking apart our VHS machines and putting them back together, filming and writing short films that I’d shoot with neighborhood kids, messing around with our new Apple IIgs computer!

The school, however, wanted me to see a psychiatrist and have IQ tests done to figure out what was going on. To this day, I remember going to the office and meeting with the team — and I even remember having a blast doing the IQ tests. I remember I solved the block test so fast that the clinician was caught off guard and I had to tell them that I was done — but I also remember them trying to have me repeat numbers back backwards and I could barely do it!

Being Labeled

The prognosis was that I was high intelligence and had attention-deficit disorder (ADD). They removed the hyperactive part because I wasn’t having the type of behavioral problems like running around the classroom (I’ll cover later why I now proudly identify as hyperactive). A week later, my pediatrician started me on Ritalin and I was told several things that really honestly messed me up.

I was told that I had a “learning disability” — which, to 7-year-old me, didn’t make any sense since I LOVED learning! I was told that I would take my tests in a special room so that I’d have fewer distractions. So, the other kids would watch me walk out of the classroom and ask why I left the room when tests were happening — and they, too, were informed that I had a learning disability.

As you can imagine, kids aren’t really lining up to be friends with the “disabled” kid, nor did they hold back on playground taunts around the issue.

These were very early days, long before attention deficit hyperactivity disorder (ADHD) was well known, and long before people had really figured out how to talk to kids with neurodiversities . And as a society, we didn’t really have a concept that someone who has a non-typical brain can be highly functional — it was a time when we didn’t know that the world’s richest man was on the autism spectrum !

Growing Past a Label

I chugged my way through elementary school, then high school, then college — getting consistent B’s and C’s. What strikes me, looking back nearly 30 years later, is just how markedly inconsistent my performance was! In highly interactive environments, or, ironically, the classes that were the most demanding, I did very well! In the classes that moved the slowest or required the most amount of repetition, I floundered.

Like, I got a good grade in the AP Biology course with a TON of memorization, but it was so demanding and the topics were so varied and fast-paced that it kept me engaged! On the opposite spectrum, being in basic algebra the teacher would explain the same simple concept over and over, with rote problem practice was torturously hard to stay focused because the work was so simple.

And that’s where we get to the part explaining why I think of my ADHD as a superpower, and why if you have it, or your kids have it, or your spouse has it… the key to dealing with it is understanding how to harness the way our brains work.

Learning to Thrive with ADHD

Disclaimer : What follows is NOT medical advice, nor is it necessarily 100% accurate. This is my personal experience and how I’ve come to understand my brain via working with my therapist and talking with other people with ADHD.

A Warp Speed Brain

To have ADHD means that your brain is an engine that’s constantly running at high speed. It basically never stops wanting to process information at a high rate. The “attention” part is just an observable set of behaviors when an ADHD person is understimulated. This is also part of why I now openly associate as hyperactive — my brain is hyperactive! It’s constantly on warp speed and won’t go any other speed.

For instance, one of the hardest things for me to do is fill out a paper check. It’s simple, it’s obvious, there is nothing to solve, it just needs to be filled out. By the time I have started writing the first stroke of the first character, my mind is thinking about things that I need to think about. I’m considering what to have for dinner, then I’m thinking about a movie I want to see, then I come up with an email to send — all in a second. 

I have to haullll myself out of my alternate universe and back to the task at hand and, like a person hanging on the leash of a horse that’s bolting, I’m struggling to just write out the name of the person who I’m writing the check to! This is why ADHD people tend to have terrible handwriting, we’re not able to just only think about moving the pen, we’re in 1,000 different universes.

On the other hand, this entire blog post was written in less than an hour and all in one sitting. I’m having to think through a thousand aspects all at once. My dialog: “Is this too personal? Maybe you should put a warning about this being a personal discussion? Maybe I shouldn’t share this? Oh, the next section should be about working. Should I keep writing more of these?”

And because there is so much to think through and consider for a public leader like myself to write such a personal post, it’s highly engaging! My engine can run at full speed. I haven’t stood up for the entire hour, and I haven’t engaged in other nervous habits I have like picking things up — I haven’t done any of it! 

This is what’s called hyperfocus, and it’s the part of ADHD that can make us potentially far more productive than our peers. I’ve almost arranged my whole life around making sure that I can get myself into hyperfocus as reliably as possible.

Harnessing What My Brain Is Built For

Slow-moving meetings are very difficult for me, but chatting in 20 different chat rooms at the same time on 20 different subjects is very easy for me — so you’ll much more likely see me in chat rooms than scheduling additional meetings. Knowing what my brain is built for helps me organize my schedule, work, and commitments that I sign up for to make sure that I can be as productive as possible.

If you haven’t seen the movie “Everything Everywhere All At Once,” and you are ADHD or love someone who is, you should immediately go watch it! The first time I saw it, I loved it, but I had no idea that one of its writers was diagnosed with ADHD as an adult , and decided to write a sci-fi movie about an ADHD person! The moment I read that it was about having ADHD my heart exploded. It resonated so much with me and it all made sense.

Practically, the only real action in the movie is a woman who needs to file her taxes. Now, don’t get me wrong — it’s a universe-tripping adventure that is incredibly exciting, but if you even take a step back and look at it, really, she was just trying to do her taxes.

But, she has a superpower of being able to travel into universes and be… everywhere all at once. Which is exactly how it feels to be in my mind — my brain is zooming around the universe and it’s visiting different thoughts and ideas and emotions. And if you can learn how to wield that as a power, albeit one that requires careful handling, you can do things that most people would never be able to do!

Co-workers have often positively noted that I see solutions that others miss and I’m able to find a course of action that takes account of multiple possibilities when the future is uncertain (I call it being quantum brained). Those two attributes have led me to create groundbreaking new technologies and build large teams with great open cultures and help solve problems and think strategically. 

It took me until I was 39 to realize that ADHD isn’t something that I had to overcome to have the career I’ve had — it’s been my superpower .

Published Jul 15, 2022

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162 ADHD Essay Topics & Examples

Looking for ADHD topics to write about? ADHD (attention deficit hyperactivity disorder) is a very common condition nowadays. It is definitely worth analyzing.

🔝 Top 10 ADHD Research Topics

🏆 best adhd essay examples, 💡 most interesting adhd topics to write about, 🎓 exciting adhd essay topics, 🔥 hot adhd topics to write about, 👍 adhd research paper topics, ❓ research questions about adhd.

In your ADHD essay, you might want to focus on the causes or symptoms of this condition. Another idea is to concentrate on the treatments for ADHD in children and adults. Whether you are looking for an ADHD topic for an argumentative essay, a research paper, or a dissertation, our article will be helpful. We’ve collected top ADHD essay examples, research paper titles, and essay topics on ADHD.

• ADHD and its subtypes
• The most common symptoms of ADHD
• The causes of ADHD: genetics, environment, or both?
• ADHD and the changes in brain structures
• ADHD and motivation
• Treating ADHD: the new trends
• Behavioral therapy as ADHD treatment
• Natural remedies for ADHD
• ADD vs. ADHD: is there a difference?
• Living with ADHD: the main challenges
• Everything You Need to Know About ADHD The frontal hemisphere of the brain is concerned with coordination and a delay in development in this part of the brain can lead to such kind of disorder.
• Learning Disabilities: Differentiating ADHD and EBD As for the most appropriate setting, it is possible to seat the child near the teacher. It is possible to provide instructions with the help of visual aids.
• Attention Deficit Hyperactivity Disorder (ADD / ADHD) Some critics maintain that the condition is a work of fiction by the psychiatric and pharmacists who have taken advantage of distraught families’ attempts to comprehend the behaviour of their children to dramatise the condition.
• Is Attention Deficit Hyperactivity Disorder Real? In fact, the existence of the condition, its treatment and diagnosis, have been considered controversial topics since the condition was first suggested in the medical, psychology and education.
• ADHD and Its Effects on the Development of a Child In particular, this research study’s focus is the investigation of the impact of household chaos on the development and behavior of children with ADHD.
• The History of ADHD Treatment: Drug Addiction Disorders Therefore, the gathered data would be classified by year, treatment type, and gender to better comprehend the statistical distribution of the prevalence of drug addiction.
• Attention Deficit Hyperactivity Disorder and Recommended Therapy The condition affects the motivational functioning and abnormal cognitive and behavioural components of the brain. Dysfunction of the prefrontal cortex contributed to a lack of alertness and shortened attention in the brain’s short-term memory.
• Rhetorical Modes Anthology on Attention Deficit Disorder It clearly outlines the origin and early symptoms of the disorder and the scientist who discovered attention deficit hyperactivity disorder. Summary & Validity: This article describes the causes of hyperactivity disorder and the potential factors […]
• Attention-Deficit Hyperactivity Disorder in a Young Girl The particular objective was to assist Katie in becoming more focused and capable of finishing her chores. The patient received the same amount of IR Ritalin and was required to continue taking it for an […]
• Similarities and Differences: SPD, ADHD, and ASD The three disorders, Sensory Processing Disorder, Attention Deficit Hyperactivity Disorder, and Autism Spectrum Disorder, are often confused with each other due to the connections and similarities that exist.
• Attention Deficit Hyperactivity Disorder Awareness According to Sayal et al, ADHD is common in young boys as it is easier to identify the problem. The disorder is well-known, and there is no struggle to identify the problem.
• Assessing the Personality Profile With ADHD Characteristics On the contrary, the study was able to understand significant changes in the emotional states and mood of the children when the observations and the tests ended.
• Aspects of ADHD Patients Well-Being This goal can be achieved through the help of mental health and behavioral counselors to enhance behavioral modification and the ability to cope with challenges calmly and healthily.
• ADHD and Problems With Sleep This is because of the activity of a person in the middle of the day and the condition around them. The downside of the study is that the study group included 52 adults with ADHD […]
• The Attention Deficit Hyperactivity Disorder Treatment It has been estimated that when medicine and therapy are applied as treatment together, the outcomes for children with ADHD are excellent.
• Attention Deficit Hyperactivity Disorder Organization’s Mission Children and Adults with Attention-Deficit/Hyperactivity Disorder is an organization that is determined to handle individuals affected by ADHD. The organization was founded in 1987 following the rampant frustration and isolation that parents experienced due to […]
• Case Conceptualization: Abuse-Mediated ADHD Patient The case provides insight into the underlying causes of James’s educational problems and the drug abuse of his parents. The case makes it evident that the assumption from the first case conceptualization about James’s ADHD […]
• Change: Dealing With Patients With ADHD In the current workplace, the most appropriate change would be the increase in the awareness of nurses regarding the methods of dealing with patients with ADHD.
• Dealing With Attention Deficit Hyperactivity Disorder Although my experience is not dramatic, it clearly shows how untreated ADHD leads to isolation and almost depression. However, the question arises of what is the norm, how to define and measure it.
• Parents’ Perception of Attending an ADHD Clinic The main principles of the clinic’s specialists should be an objective diagnosis of the neurological status of the child and the characteristics of his/her behavior, the selection of drug treatment only on the basis of […]
• ADHD: Mental Disorder Based on Symptoms The DSM-5 raised the age limit from 6 to 12 for qualifying the disorder in children and now requires five instead of six inattentive or hyperactive-impulsive symptoms.
• Understanding Attention-Deficit/Hyperactivity Disorder Thus, the smaller sizes of the reviewed brain structures associated with ADHD result in problems with attention, memory, and controlling movement and emotional responses.
• Effective Therapies for Attention Deficit Hyperactivity Disorder The problem at hand is that there is a need to determine which of the therapies administered is effective in the management of ADHD.
• Participants of “ADHD Outside the Laboratory” Study The participants in the testing group and those in the control group were matched for age within 6 months, for IQ within 15 points and finally for performance on the tasks of the study.
• Variables in “ADHD Outside the Laboratory” Study The other variables are the videogames, matching exercise and the zoo navigation exercise used to test the performance of the boys.
• Different Types of Diets and Children’s ADHD Treatment The last factor is a trigger that can lead to the development of a child’s genes’ reaction. Thus, diet is one of the factors that can help prevent the development of ADHD.
• Attention Deficit Hyperactivity Disorder in Children The consistent utilization of effective praises and social rewards indeed results in the behavioral orientation of the child following the treatment goals.
• Reward and Error Processing in ADHD: Looking Into the Neurophysiological and the Behavioral Measures The study was mainly concerned with looking into the neurophysiological and to some extent the behavioral measures utilized in self regulation particularly in children suffering from attention – deficit hyperactivity disorder and those who are […]
• Vyvanse – ADD and ADHD Medicine Company Analysis It is produced by Shire and New River Pharmaceuticals in its inactive form which has to undergo digestion in the stomach and through the first-pass metabolic effect in the liver into L-lysine, an amino acid […]
• Dealing With the Disruptive Behaviors of ADHD and Asperger Syndrome Students While teaching in a class that has students with ADHD and Asperger syndrome, the teacher should ensure that they give instructions that are simple and easy to follow.
• Behavioral Parenting Training to Treat Children With ADHD These facts considered, it is possible to state that the seriousness of ADHD accounts for the necessity of the use of behavioral parental training as the treatment of the disorder.
• Current Issues in Psychopharmacology: Attention-Deficit Hyperactivity Disorder This is the area that is charged with the responsibility for vision control as well as a regulation of one’s brain’s ability to go to aresynchronize’ and go to rest.
• Cognitive Psychology and Attention Deficit Disorder On top of the difficulties in regulating alertness and attention, many individuals with ADD complain of inabilities to sustain effort for duties.
• ADHD Symptoms in Children However, there are some concerns in identifying the children with ADHD.described in a report that support should be initiated from the parents in, recognizing the problem and seeking the help of the educational professionals.2.
• Adult and Paediatric Psychology: Attention Deficit Hyperactivity Disorder To allow children to exercise their full life potential, and not have any depression-caused impairment in the social, academic, behavioral, and emotional field, it is vital to reveal this disorder as early in life, as […]
• Attention-Deficit Hyperactivity Disorder: Biological Testing The research, leading to the discovery of the Biological testing for ADHD was conducted in Thessaloniki, Greece with 65 children volunteering for the research. There is a large difference in the eye movement of a […]
• Issues in the Diagnosis of Attention-Deficit Hyperactivity Disorder in Children Concept theories concerning the nature of attention-deficit/hyperactivity disorder influence treatment, the approach to the education of children with ADHD, and the social perception of this disease.
• Attention Deficit Hyperactivity Disorder Care Controversy The objective of this study was to assess the efficacy, in terms of symptoms and function, and safety of “once-daily dose-optimized GXR compared with placebo in the treatment of children and adolescents aged 6 17 […]
• Attention Deficit Hyperactivity Interventions The authors examine a wide range of past studies that reported on the effects of peer inclusion interventions and present the overall results, showing why further research on peer inclusion interventions for children with ADHD […]
• Sociodemographic and Cultural Factors of Attention Deficit Hyperactivity Disorder Children at this age have particular difficulties in retaining and concentrating attention and in controlling behavior, and this stage is sensitive to the development of these abilities. The general problem is the increase in prevalence […]
• Attention Deficit Hyperactivity Disorder (ADHD) in a Child A child counselor works with children to help them become mentally and emotionally stable. The case that is examined in this essay is a child with attention deficit hyperactivity disorder.
• Attention Deficit Hyperactivity Disorder: Drug-Free Therapy The proposed study aims to create awareness of the importance of interventions with ADHD among parents refusing to use medication. The misperceptions about ADHD diagnosis and limited use of behavioral modification strategies may be due […]
• Attention Deficit Hyperactivity Disorder: Psychosocial Interventions The mentioned components and specifically the effects of the condition on a child and his family would be the biggest challenge in the case of Derrick.
• The Diagnosis and Treatment of ADHD Cortese et al.state that cognitive behavioral therapy is overall a practical approach to the treatment of the condition, which would be the primary intervention in this case.
• The Attention Deficit Hypersensitivity Disorder in Education Since ADHD is a topic of a condition that has the potential to cripple the abilities of a person, I have become attached to it much.
• Attention Deficit Hyperactivity Disorder: Comorbidities Due to the effects that ADHD has on patients’ relationships with their family members and friends, the development of comorbid health problems becomes highly possible.
• Medicating Kids to Treat ADHD The traditional view is that the drugs for the disorder are some of the safest in the psychiatric practice, while the dangers posed by untreated ADHD include failure in studies, inability to construct social connections, […]
• Attention Deficit Hyperactivity Disorder: Signs and Strategies Determining the presence of Attention Deficit Hyperactivity Disorder in a child and addressing the disorder is often a rather intricate process because of the vagueness that surrounds the issue.
• Cognitive Therapy for Attention Deficit Disorder The counselor is thus expected to assist the self-reflection and guide it in the direction that promises the most favorable outcome as well as raise the client’s awareness of the effect and, by extension, enhance […]
• “Stress” Video and “A Natural Fix for ADHD” Article There certainly are some deeper reasons for people to get stressed, and the video documentary “Stress: Portrait of a Killer” and the article “A Natural Fix for A.D.H.D”.by Dr.
• Attention Deficit Disorder: Diagnosis and Treatment The patient lives with her parents and 12-year-old brother in a middle-class neighborhood. Her father has a small business, and her mother works part-time in a daycare center.
• Bright Not Broken: Gifted Kids, ADHD, and Autism It is possible to state that the book provides rather a high-quality review of the issues about the identification, education, and upbringing of the 2e children.
• Attention Deficit Hyperactive Disorder: Case Review On the other hand, Mansour’s was observed to have difficulties in the simple tasks that he was requested to perform. Mansour’s appears to be in the 3rd phase of growth.
• Treatment of Children With ADHD Because of the lack of sufficient evidence concerning the effects of various treatment methods for ADHD, as well as the recent Ritalin scandal, the idea of treating children with ADHD with the help of stimulant […]
• Attention Deficit Hyperactivity Disorder Medicalization This paper discusses the phenomenon of medicalization of ADHD, along with the medicalization of other aspects perceived as deviant or atypical, it will also review the clash of scientific ideas and cultural assumptions where medicalization […]
• Medication and Its Role in the ADHD Treatment Similar inferences can be inferred from the findings of the research conducted by Reid, Trout and Schartz that revealed that medication is the most appropriate treatment of the symptoms associated with ADHD.
• Children With Attention-Deficit Hyperactivity Disorder The purpose of the present research is to understand the correlation between the self-esteem of children with ADHD and the use of medication and the disorder’s characteristics.
• Psychology: Attention Deficit and Hyperactivity Disorder It is important to pay attention to the development of proper self-esteem in children as it can negatively affect their development and performance in the future.
• Natural Remedies for ADHD The key peculiarity of ADHD is that a patient displays several of these symptoms, and they are observed quite regularly. Thus, one can say that proper diet can be effective for the treatment of attention […]
• Cognitive Behavior Therapy in Children With ADHD The study revealed that the skills acquired by the children in the sessions were relevant in the long term since the children’s behaviors were modeled entirely.
• Is Attention Deficit Disorder a Real Disorder? When Medicine Faces Controversial Issues In addition, it is necessary to mention that some of the symptoms which the children in the case study displayed could to be considered as the ones of ADHD.
• Foods That Effect Children With ADHD/ ADD Therefore, it is the duty of parents to identify specific foods and food additives that lead to hyperactivity in their children.
• Toby Diagnosed: Attention Deficit Hyperactivity Disorder The symptoms of the disorder are usually similar to those of other disorder and this increases the risks of misdiagnosing it or missing it all together.
• Identifying, Assessing and Treating Attention Deficit Hyperactivity Disorder For these criteria to be effective in diagnosing a child with ADHD, the following symptoms have to be present so that the child can be labelled as having ADHD; the child has to have had […]
• ADHD Should Be Viewed as a Cognitive Disorder The manifestation of the disorder and the difficulties that they cause, as posited by the American Psychiatric Association, are typically more pronounced when a person is involved in some piece of work such as studying […]
• Attention Deficit Hyperactivity Disorder Influence on the Adolescents’ Behavior That is why the investigation was developed to prove or disprove such hypotheses as the dependence of higher rates of anxiety of adolescents with ADHD on their diagnosis, the dependence of ODD and CD in […]
• Stroop Reaction Time on Adults With ADHD The model was used to investigate the effectiveness of processes used in testing interference control and task-set management in adults with ADHD disorder.
• Attention Deficit Hyperactivity Disorder Causes Family studies, relationship studies of adopted children, twin studies and molecular research have all confirmed that, ADHD is a genetic disorder.
• Diagnosis and Treatment of ADHD The diagnosis of ADHD has drawn a lot of attention from scientific and academic circles as some scholars argue that there are high levels of over diagnosis of the disorder.
• Attention-Deficit Hyperactivity Disorder As it would be observed, some of the symptoms associated with the disorder for children would differ from those of adults suffering from the same condition in a number of ways.
• Working Memory in Attention Deficit and Hyperactivity Disorder (ADHD) Whereas many studies have indicated the possibility of the beneficial effects of WM training on people with ADHD, critics have dismissed them on the basis of flawed research design and interpretation.
• Attention-Deficit Hyperactivity Disorder: The Basic Information in a Nutshell In the case with adults, however, the definition of the disorder will be quite different from the one which is provided for a child ADHD.
• How ADHD Develops Into Adult ADD The development of dominance is vital in processing sensations and information, storage and the subsequent use of the information. As they become teenagers, there is a change in the symptoms of ADHD.
• Medical Condition of Attention Deficit Hyperactivity Disorder A combination of impulsive and inattentive types is referred to as a full blown ADHD condition. To manage this condition, an array of medical, behavioral, counseling, and lifestyle modification is the best combination.
• Effects of Medication on Education as Related to ADHD In addition, as Rabiner argues, because of the hyperactivity and impulsivity reducing effect of ADHD drugs, most ADHD suffers are nowadays able to learn in an indistinguishable class setting, because of the reduced instances of […]
• Attention Deficit Hyperactivity Disorder: Diagnosis and Treatment Generally the results indicate that children with ADHD had a difficult time in evaluating time concepts and they seemed to be impaired in orientation of time.
• The Ritalin Fact Book: Stimulants Use in the ADHD Treatment Facts presented by each side of the critical issue The yes side of the critical issue makes it clear that the drugs being used to control ADHD are harmful as they affect the normal growth […]
• Behavior Modification in Children With Attention Deficit Hyperactivity Disorder Introduction The objective of the article is to offer a description of the process of behavior modification for a child diagnosed with ADHD.
• What Is ADHD and How Does It Affect Kids
• The Benefits of Physical Activities in Combating the Symptoms of ADHD in Students
• The Effects of Exercise and Physical Activity as Intervention for Children with ADHD
• What Are the Effects of ADHD in the Classroom
• Are Children Being Diagnosed with ADHD too Hastily
• The Effectiveness of Cognitive Behavioral Therapy on ADHD
• Understanding ADHD, Its Effects, Symptoms, and Approach to Children with ADHD
• ADHD Stimulant Medication Abuse and Misuse Among U.S. Teens
• Severity of ADHD and Anxiety Rise if Both Develop
• The Best Approach to Dealing with Attention Deficit/Herpactivity Disorder or ADHD in Children
• An Analysis of the Potential Causes and Treatment Methods for Attention Deficit Hyperactivity Disorder (ADHD) in Young Children
• The Best Way to Deal with Your Child Who Struggles with ADHD
• Response Inhibition in Children with ADHD
• Behavioral and Pharmacological Treatment of Children with ADHD
• Symptoms And Symptoms Of ADHD, Depression, And Anxiety
• Bioethics in Intervention in the Deficit Attention Hyperkinetic Disorder (ADHD)
• The Effects of Children’s ADHD on Parents’ Relationship Dissolution and Labor Supply
• The Effects of Pharmacological Treatment of ADHD on Children’s Health
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• The Effects Of ADHD On Children And Education System Child
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• How to Increase Medication Compliance in Children with ADHD
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• Should Stimulants Be Prescribed for ADHD Children
• The Rise of ADHD and the an Analysis of the Drugs Prescribed for Treatment
• The Correlation Between Smoking During Pregnancy And ADHD
• Exploring Interventions Improving Workplace Behavior In Adults With ADHD
• The Promise of Music and Art in Treating ADHD
• The Struggle Of ADHD Medication And Over Diagnosis
• The Problems of Detecting ADHD in Children
• The Harmful Effects of ADHD Medication in Children
• The Symptoms and Treatment of ADHD in Children and Teenagers
• The Impact of Adult ADD/ADHD on Education
• The Experience of Having the ADHD Disorder
• The Young Children And Children With ADHD, And Thinking Skills
• The Use of Ritalin in Treating ADD and ADHD
• The Ethics Of Giving Children ADHD Medication
• The Importance of Correctly Diagnosing ADHD in Children
• The Rise in ADHD Diagnosis and Treatment within the United States of America
• The World of ADHD Children
• The Use of Drug Therapies for Children with ADHD
• What Are the Effects of ADHD in the Classroom?
• Does ADHD Affect Essay Writing?
• What Are the Three Main Symptoms of ADHD?
• How Does ADHD Medication Affect the Brain?
• What Can ADHD Lead To?
• Is ADHD Legitimate Medical Diagnosis or Socially Constructed Disorder?
• How Does Art Help Children With ADHD?
• What Are the Four Types of ADHD?
• Can Sports Affect Impulse Control in Children With ADHD?
• What Age Does ADHD Peak?
• How Can You Tell if an Adult Has ADHD?
• Should Antihypertensive Drugs Be Used for Curing ADHD?
• How Does ADHD Affect Cognitive Development?
• Is Adult ADHD a Risk Factor for Dementia or Phenotypic Mimic?
• How Are People With ADHD Seen in Society?
• Can Additional Training Help Close the ADHD Gender Gap?
• How Does School Systems Deal With ADHD?
• Are Children With Low Working Memory and Children With ADHD Same or Different?
• How Does ADHD Affect School Performance?
• Should Children With ADHD Be Medicated?
• How Does Society View Children With ADHD?
• What Do Researches Tell Us About Students With ADHD in the Chilean Context?
• Why Should Teachers Understand ADHD?
• Does DD/ADHD Exist?
• What Are Some Challenges of ADHD?
• Why Is ADHD an Important Topic to Discuss?
• Is ADHD Born or Developed?
• Can ADHD Cause Lack of Emotion?
• Does ADHD Affect Females?
• Is ADHD on the Autism Spectrum?
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Blog > Common App , Essay Advice , Personal Statement > How to Write a College Essay About ADHD

How to Write a College Essay About ADHD

Admissions officer reviewed by Ben Bousquet, M.Ed Former Vanderbilt University

Written by Ben Bousquet, M.Ed Former Vanderbilt University Admissions

Key Takeaway

ADHD and ADD are becoming more prevalent, more frequently diagnosed, and better understood.

The exact number of college students with ADHD is unclear with estimates ranging wildly from just 2% to 16% or higher.

Regardless of the raw numbers, an ADHD diagnosis feels very personal, and it is not surprising that many students consider writing a college essay about ADHD.

If you are thinking about writing about ADHD, consider these three approaches. From our experience in admissions offices, we’ve found them to be the most successful.

First, a Note on the Additional Information Section

Before we get into the three approaches, I want to note that your Common App personal statement isn’t the only place you can communicate information about your experiences to admissions officers.

You can also use the additional information section.

The additional information section is less formal than your personal statement. It doesn’t have to be in essay format, and what you write there will simply give your admissions officers context. In other words, admissions officers won’t be evaluating what you write in the additional information section in the same way they’ll evaluate your personal statement.

You might opt to put information about your ADHD (or any other health or mental health situations) in the additional information section so that admissions officers are still aware of your experiences but you still have the flexibility to write your personal statement on whatever topic you choose.

Three Ways to Write Your College Essay About ADHD

If you feel like the additional information section isn’t your best bet and you’d prefer to write about ADHD in your personal statement or a supplemental essay, you might find one of the following approaches helpful.

1) Using ADHD to understand your trends in high school and looking optimistically towards college

This approach takes the reader on a journey from struggle and confusion in earlier years, through a diagnosis and the subsequent fallout, to the present with more wisdom and better grades, and then ends on a note about the future and what college will hold.

If you were diagnosed somewhere between 8th and 10th grade, this approach might work well for you. It can help you contextualize a dip in grades at the beginning of high school and emphasize that your upward grade trend is here to stay.

The last part—looking optimistically towards college—is an important component of this approach because you want to signal to admissions officers that you’ve learned to manage the challenges you’ve faced in the past and are excited about the future.

I will warn you: there is a possible downside to this approach. Because it’s a clear way to communicate grade blips in your application, it is one of the most common ways to write a college essay about ADHD. Common doesn’t mean it’s bad or off-limits, but it does mean that your essay will have to work harder to stand out.

2) ADHD as a positive

Many students with ADHD tell us about the benefits of their diagnosis. If you have ADHD, you can probably relate.

Students tend to name strengths like quick, creative problem-solving, compassion and empathy, a vivid imagination, or a keen ability to observe details that others usually miss. Those are all great traits for college (and beyond).

If you identify a strength of your ADHD, your essay could focus less on the journey through the diagnosis and more on what your brain does really well. You can let an admissions officer into your world by leading them through your thought processes or through a particular instance of innovation.

Doing so will reveal to admissions officers something that makes you unique, and you’ll be able to write seamlessly about a core strength that’s important to you. Of course, taking this approach will also help your readers naturally infer why you would do great in college.

3) ADHD helps me empathize with others

Students with ADHD often report feeling more empathetic to others around them. They know what it is like to struggle and can be the first to step up to help others.

If this rings true to you, you might consider taking this approach in your personal statement.

If so, we recommend connecting it to at least one extracurricular or academic achievement to ground your writing in what admissions officers are looking for.

A con to this approach is that many people have more severe challenges than ADHD, so take care to read the room and not overstate your challenge.

Key Takeaways + An Example

If ADHD is a significant part of your story and you’re considering writing your personal statement about it, consider one of these approaches. They’ll help you frame the topic in a way admissions officers will respond to, and you’ll be able to talk about an important part of your life while emphasizing your strengths.

And if you want to read an example of a college essay about ADHD, check out one of our example personal statements, The Old iPhone .

As you go, remember that your job throughout your application is to craft a cohesive narrative —and your personal statement is the anchor of that narrative. How you approach it matters.

Liked that? Try this next.

The Incredible Power of a Cohesive College Application

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Thanks for the Memories: An Essay on Life with ADHD

• Posted by ADDA Editorial Team
• Categories ADHD in Real Life
• Date November 3, 2022
• Comments 2 comments

By Irene Grey

In a moment…it’s gone. The fully-formed sentence sprung from nowhere, a perfect start to a story that might unfold over hundreds of pages. By the time I found my pen, all that remained was a faint memory.

This is the downside of ADHD…falling in love with ideas, images, sounds, smells, and half-formed thoughts several times within one minute.

My thoughts are almost within reach, then slip somewhere I can’t access. As one thought slides away, it’s replaced by one, two or even three more, without order or sequence. The unease lingers.

As a self-employed adult woman recently diagnosed with ADHD, I consider myself moderately successful. I’ve started taking medication, which enables me to reach previously unknown levels of self-awareness.

Medication has given me a fresh perspective. There’s no prescribed way to live or think; it all depends on whom you ask.

The difficulties with ADHD come when you feel and act wildly out-of-step with the majority of society and can’t keep pace.

Originally published on July 13, 2016, this post was republished on November 03, 2022.

What’s It like to Have ADHD (for me):

I can relate to the impulsivity of the Road Runner cartoon. When the wolf runs off the cliff’s edge, his legs cycle rapidly while suspended mid-air. It’s only when he looks down and realizes the enormity of his situation that he plummets down the canyon.

I’ve always empathized with him. Propelling myself forward, and never looking back or down, probably saves me from descending permanently into my own canyon.

Having ADHD, energy, resourcefulness, and optimism fuel me, but mental chaos can overwhelm me, and I grind to a halt. Staring into space, dulled and unable to move without huge effort, the desire for order becomes as overwhelming as it is hopelessly unattainable.

It can last a few minutes, or occasionally all day. I really wouldn’t want it hanging around longer, as the more prolonged times reveal a bleaker view of life.

At least I can explain this now, after a lifetime of inarticulate thought. In the past, I’d try to rationalize what was happening, but if it didn’t make sense to me, what could I say?

I’d always assumed I was terrible at living a normal life. Teachers said, “Only boring people get bored.” They said a lot of other things which confirmed our suspicions I was rebellious, sweet, but slightly simple, and hopelessly forgetful.

I was eventually invited to leave school. The Girl Guides had extended the same invitation a couple of years prior. Friends say, “Remember when…?” I nod, but I don’t really remember.

Everything moves too fast. It’s one reason why I fidget. Trying hard to remember or prevent something which is slipping away is taxing.

I’d like to focus, hold some memories, and have the chance to reflect. These are the big things, although not without drawbacks.

Everyone has elements of their past they’d rather forget, but when you’ve never really learned from your mistakes, a glimpse in the rearview mirror at the mangled wreckage of destructive relationships, dreadful job experiences, and reckless choices can be shocking.

I’ll shift my viewpoint now to say ADHD can be fantastic. Every day offers endless possibilities. Life without self-imposed limits means freedom to go anywhere and speak to anyone.

It’s not so much fearlessness, as simply not considering possible consequences before plunging in.

I’m constantly amazed by what I find out and humbled by what people want to share. I’m trusted, probably because I’m non-threatening. Surrendering yourself, unwittingly or otherwise, to living in the moment attracts people who want to join in.

The irony is I’ve always been shy, so attracting strangers creates a tension that I struggle to overcome. It’s like having an all-access pass for life; it’s a gift you’re not sure you want.

On Relationships with Others:

Friendships are easily formed, and the tenacious ones survive. Constantly forgetting birthdays, meetings, and dinners takes its toll.

I always answer my texts, but often only in my head. It can lead people to think I don’t care about them or am shallow, selfish, and unfeeling. It’s an understandable impression, but couldn’t be further from the truth.

“I forgot” is met with instructions to get a diary (planner), set alerts on my phone, or find another way to get organised. After all, everyone forgets, so you can, too. You just have to focus, plan ahead, and generally get a grip.

How can you tell them you’ve lost your third diary (planner), and it’s only April? Your replacement phone is also gone and you thought today was Tuesday instead of Thursday.

Getting any kind of grip on the stuff sliding in and out of my head is quite tricky. So, to the people I’ve let down, I’d like to say, “It’s not you. It really is me.”

“I can’t believe I let you talk me into this” has been screamed at me more times than I could obviously hope to remember. The last time was halfway up a mountainside, sheltering in a pine forest from driving rain. It probably wasn’t the moment to confess that my car keys seemed to have gone.

Everything would be ok, and if we just retraced the last 10 miles, we’d definitely find them. I did find them, inside the unlocked car, so everything worked out well.

To that particular friend, I’d like to say that you always complain about wanting more exercise and, as I pointed out at the time, human skin is waterproof, so can we please move on?

I get blamed for quite a lot. When you’re the forgetful, accident-prone one, it comes with the territory. It can’t always be your fault, and small doses of support and understanding go a long way with those of us who think and operate a bit differently in the world.

I’m good at adventures and spontaneous decisions. I’m open to anything because I have few defenses. Although I generally believe what I’m told, which has got me into trouble.

Keeping secrets comes easily, but hiding my own is hard. I’m a magnet for children and animals and try to cherish and look after everyone around me.

Visitors are well-fed and listened to. I’m known for giving good, at times unorthodox, advice and cocooning those in need of understanding.

The problem comes when transferring this care to myself, or recognizing when I should ask for help. I’m not invincible, but the irrational, hopeful side still can’t quite shake the belief that I just might be.

Why not? I’ve been tremendously lucky so far.

On Seeking Treatment and Disclosing My Diagnosis:

I could continue living in the moment without planning ahead. Forgetting most of it, then starting over the next day.

It’s often great, but I’m tired of reacting and acting impulsively, searching for new ways to keep boredom at bay. I’m weary of losing track of time, thoughts, and people.

I want to build something solid that I can keep going back to. Seeing each day as a clean slate has got me this far, and it’s fascinating, if chaotic.

Endless curiosity feeds the cycle, but it’s all so temporary. I want to pick up where I left off.

These are the reasons why I wanted treatment. A bit of control over my rapid impulses, combined with the chance to focus and untangle the constant, shifting thoughts, has shown it to be the right decision for me.

I’ve told three of my closest friends about the diagnosis, and no one has been surprised, despite having the good grace to pretend otherwise. It seems each one suspected something wasn’t quite ‘right’ at times.

Realizing I’ve been quietly understood and cared for over the years is touching but also difficult to accept – especially as I like to believe I’m invincible.

My abrupt disappearances are par for the course, and those who know me well no longer expect an explanation. Instead, they gently inquire and don’t take it personally.

Like my diary (planner) and phone, I misplace my loved ones sometimes. They’ve all said they need me to stay the way I am, for the adventures and sheer living in the moment thing. Although I’ve always hidden the worst of it from them by retreating.

I’ve reassured them I wouldn’t take medication. It’s dishonest, but I didn’t want them to start preparing to miss the old me. What if I become unrecognizable, stunned into submission by a chemical taser?

The great news is they haven’t noticed anything different, although I have. I’m more focused, and my energy levels are now steady.

I no longer feel the sudden need to run down the street — something that can be alarming to other pedestrians, especially when you’re a grown woman in high heels. (It looks like you’re being chased.)

The sudden development of a verbal filter is a welcome relief after years of unintentionally insulting people who ask for an opinion. It turns out diplomacy doesn’t mean lying.

It’s more choosing words carefully that don’t eviscerate friends, family, or complete strangers. “But you asked me” isn’t a reasonable defense after all, especially for the many times they didn’t ask.

Sleeping well in bed is a new treat. Funnily enough, for me, slipping into unconsciousness in cinemas, theatres, and on all forms of public transport was never a problem.

Most welcome of all the improvements is my memory. I’m forgetting less and thinking more clearly.

I’ll always be a more flawed, impulsive wolf than a perfect, predictable roadrunner, but that’s okay now.

Recently I was gripped by a sudden fear that controlling my symptoms would mean the saturated technicolour that life can be would drain into a perfectly pleasant, slightly dull, black and white. Like a rainy-day film without much pace or plot.

Fortunately, finding a balance between the extremes of falling in love with everything, or disconnecting completely, leaves scope.

Depending on when in the day you ask, I might say that ADHD has been a constant, invasive shadow, falling across every aspect of my life.

Ask me again, and I might say it’s been a brilliantly illuminating shaft of sunlight, throwing everything it hits into stark relief. It can be blinding, but more often reveals the perfect, glorious detail that might have been missed.

Life is enhanced, elevated, and made rather lovely. It depends on your perspective. Who wouldn’t want a little bit of that?

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Wishing I could share this family members! Hearing with sensitive ears of even the unspoken word, sends me in self defeating thoughts. Some of my high achieving family can’t understand all that I go though to be heard or being ignored feels. This is my battle at this time. My understanding is that many of us suffering with ADHD also have Dislexia which I experience as well of being Ambedextrious, with Major Depression. Thank you for this article, it that the wrong out of my life, even if a few understand!

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How to Tackle an Essay (an ADHD-friendly Guide)

6 steps and tips.

Most of the college students I work with have one major assignment type that gets them stuck like no other: the dreaded essay. It has become associated with late nights, requesting extensions (and extensions on extensions), feelings of failure, and lots of time lost staring at a screen. This becomes immensely more stressful when there is a thesis or capstone project that stands between you and graduation.

The good news?

An essay doesn’t have to be the brick wall of doom that it once was. Here are some strategies to break down that wall and construct an essay you feel good about submitting.

Step 1:  Remember you’re beginning an essay, not finishing one.

Without realizing it, you might be putting pressure on yourself to have polished ideas flow from your brain onto the paper. There’s a reason schools typically bring up having an outline and a rough draft! Thoughts are rarely organized immediately (even with your neurotypical peers, despite what they may say). Expecting yourself to deliver a publishing-worthy award winner on your first go isn’t realistic. It’s allowed to look messy and unorganized in the beginning! There can be unfinished thoughts, and maybe even arguments you aren’t sure if you want to include. When in doubt, write it down.

Step 2: Review the rubric

Make sure you have a clear understanding of what the assignment is asking you to include and to focus on. If you don’t have an understanding of it, it’s better to find out in advance rather than the night before the assignment is due. The rubric is your anchor and serves as a good guide to know “when you can be done.” If you hit all the marks on the rubric, you’re looking at a good grade.

I highly recommend coming back to the rubric multiple times during the creative process, as it can help you get back on track if you’ve veered off in your writing to something unrelated to the prompt. It can serve as a reminder that it’s time to move onto a different topic - if you’ve hit the full marks for one area, it’s better to go work on another section and return to polish the first section up later. Challenge the perfectionism!

Step 3: Divide and conquer

Writing an essay is not just writing an essay. It typically involves reading through materials, finding sources, creating an argument, editing your work, creating citations, etc. These are all separate tasks that ask our brain to do different things. Instead of switching back and forth (which can be exhausting) try clumping similar tasks together.

For example:

Prepping: Picking a topic, finding resources related to topic, creating an outline

Gathering: reading through materials, placing information into the outline

Assembling: expanding on ideas in the outline, creating an introduction and conclusion

Finishing: Make final edits, review for spelling errors and grammar, create a title page and reference page, if needed.

Step 4: Chunk it up

Now we’re going to divide the work EVEN MORE because it’s also not realistic to expect yourself to assemble the paper all in one sitting. (Well, maybe it is realistic if you’re approaching the deadline, but we want to avoid the feelings of panic if we can.) If you haven’t heard of chunking before, it’s breaking down projects into smaller, more approachable tasks.

This serves multiple functions, but the main two we are focusing on here is:

• it can make it easier to start the task;
• it helps you create a timeline for how long it will take you to finish.

If you chunk it into groups and realize you don’t have enough time if you go at that pace, you’ll know how quickly you’ll need to work to accomplish it in time.

Here are some examples of how the above categories could be chunked up for a standard essay. Make sure you customize chunking to your own preferences and assignment criteria!

Days 1 - 3 : Prep work

• ‍ Day 1: Pick a topic & find two resources related to it
• Day 2: Find three more resources related to the topic
• Day 3: Create an outline

Days 4 & 5 : Gather

• ‍ Day 4: Read through Resource 1 & 2 and put information into the outline
• Day 5: Read through Resource 3 & 4 and put information into the outline

Days 6 - 8 : Assemble

• ‍ Day 6: Create full sentences and expand on Idea 1 and 2
• Day 7: Create full sentences and expand on Idea 3 and write an introduction
• Day 8: Read through all ideas and expand further or make sentence transitions smoother if need be. Write the conclusion

Day 9: Finish

• ‍ Day 9: Review work for errors and create a citation page

Hey, we just created an outline about how to make an outline - how meta!

Feel like even that is too overwhelming? Break it down until it feels like you can get started. Of course, you might not have that many days to complete an assignment, but you can do steps or chunks of the day instead (this morning I’ll do x, this afternoon I’ll do y) to accommodate the tighter timeline. For example:

Day 1: Pick a topic

Day 2: Find one resource related to it

Day 3: Find a second resource related to it

Step 5: Efficiently use your resources

There’s nothing worse than stockpiling 30 resources and having 100 pages of notes that can go into an essay. How can you possibly synthesize all of that information with the time given for this class essay? (You can’t.)

Rather than reading “Article A” and pulling all the information you want to use into an “Article A Information Page,” try to be intentional with the information as you go. If you find information that’s relevant to Topic 1 in your paper, put the information there on your outline with (article a) next to it. It doesn’t have to be a full citation, you can do that later, but we don’t want to forget where this information came from; otherwise, that becomes a whole mess.

By putting the information into the outline as you go, you save yourself the step of re-reading all the information you collected and trying to organize it later on.

*Note: If you don’t have topics or arguments created yet, group together similar ideas and you can later sort out which groups you want to move forward with.

Step 6: Do Some Self-Checks

It can be useful to use the Pomodoro method when writing to make sure you’re taking an adequate number of breaks. If you feel like the 25 min work / 5 min break routine breaks you out of your flow, try switching it up to 45 min work / 15 min break. During the breaks, it can be useful to go through some questions to make sure you stay productive:

• How long have I been writing/reading this paragraph?
• Does what I just wrote stay on topic?
• Have I continued the "write now, edit later" mentality to avoid getting stuck while writing the first draft?
• Am I starting to get frustrated or stuck somewhere? Would it benefit me to step away from the paper and give myself time to think rather than forcing it?
• Do I need to pick my energy back up? Should I use this time to get a snack, get some water, stretch it out, or listen to music?

General Tips:

• If you are having a difficult time trying to narrow down a topic, utilize office hours or reach out to your TA/professor to get clarification. Rather than pulling your hair out over what to write about, they might be able to give you some guidance that speeds up the process.
• You can also use (and SHOULD use) office hours for check-ins related to the paper, tell your teacher in advance you’re bringing your rough draft to office hours on Thursday to encourage accountability to get each step done. Not only can you give yourself extra pressure - your teacher can make sure you’re on the right track for the assignment itself.
• For help with citations, there are websites like Easybib.com that can help! Always double check the citation before including it in your paper to make sure the formatting and information is correct.
• If you’re getting stuck at the “actually writing it” phase, using speech-to-text tools can help you start by transcribing your spoken words to paper.
• Many universities have tutoring centers and/or writing centers. If you’re struggling, schedule a time to meet with a tutor. Even if writing itself isn’t tough, having a few tutoring sessions scheduled can help with accountability - knowing you need to have worked on it before the tutoring session is like having mini deadlines. Yay, accountability!

Of course, if writing just isn’t your jam, you may also struggle with motivation . Whatever the challenge is, this semester can be different. Reach out early if you need help - to your professor, a tutor, an ADHD coach , or even a friend or study group. You have a whole team in your corner. You’ve got this, champ!

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Both my sons have ADHD. When I was diagnosed at 52, I learned to be more empathetic with them.

• I was diagnosed with ADHD in 2016, at the age of 52.
• My sons both have ADHD and my diagnosis was a relief for them. 
• I gained a new understanding of my childhood, which made me a better parent and advocate. 

The psychiatrist chuckled and said, "Let me get this straight. You were filling out an ADHD evaluation for your son, recognized traits in yourself, and then decided to go through the evaluation again for yourself, and you scored high enough you made an appointment to see me?" And then proceeded to tell me that yes, I had ADHD too.

It was true. My 6-year-old son was struggling: He couldn't concentrate , couldn't sit still, and was impulsive and reactive. In a meeting with his school, we agreed that an evaluation for ADHD made sense. I filled out a questionnaire of behaviors he exhibited. A couple of questions in I began recognizing the behaviors in myself.

I'd always been quick to react, could only concentrate on things I was interested in, and when pursuing those things, was prone to hyperfocus. I'd rather wrestle with an essay on the nature of man's soul than mop the floor.

Seeing his echoes of my behavior gave me a newfound empathy for him, as well as for my parents and the teachers, who were infuriated by the disconnect between my intelligence and the quality of my schoolwork.

I worked with my kid's school

We began to work with his school in the form of a 504 plan and later an Individualized Education Program . In meetings, as his teachers expressed frustrations, they would acknowledge a "lack of executive function" in one breath but, in the next, say "He chose not to complete the assignment."

What they were telling me, without telling me, was his ADHD was tolerable until he didn't do the thing they wanted him to do, and at that point, they decided that the kid who lacked executive function had just exercised it in a way that was deliberately uncooperative.

Related stories

They complained that he needed to speak up when he became overwhelmed. I countered that when he's overwhelmed , he shuts down, and he doesn't have enough self-awareness yet to know he's overwhelmed. I know this is true for a simple reason: It's what I did. He needs help recognizing he is overwhelmed and he doesn't know how to ask for help.

ADHD makes some things harder for me

Having lived with ADHD now for 60 years, I've come to some conclusions about this condition. The first is I don't see it as a disability, and calling it a handicap smears kids for being wired differently.

Sure, ADHD has given me some serious challenges when it comes to adulting. Don't ask me how I budget for groceries. And don't ask me to organize that pile on my desk or the one next to it.

But ADHD isn't all deficits.

I believe that what is called hyperfocus in people with ADHD is a flow state by another name. That's my superpower; I disappear into my favorite activities, like cycling or writing, but I can also find flow in activities as mundane as doing dishes.

I draw upon those lessons as I teach both of my sons how to capitalize on that superpower, as well as how to manage the limitations that come with ADHD. Another of our challenges is that people with ADHD struggle with developing healthy self-esteem . I steer them into activities where they find flow so they learn the satisfaction that comes with being good at something, of facing a challenge and finding out they can succeed.

I'm more empathetic than I was 20 years ago

Had I become a parent in my 20s or 30s, I'd have lacked the self-awareness necessary to recognize my past in my son's behavior. Worse, I didn't yet know myself well enough to understand that flow was my superpower and not — as the nuns at my Catholic school called it — daydreaming.

At my age, I better understand how important it is for my sons to meet compassionate adults who see them. I'm watchful for the teachers who will help them succeed as well as the ones who will be an impediment. That's another skill I hope to teach my boys: How to identify allies.

And that psychiatrist? He wrote me a prescription for Wellbutrin, an antidepressant that gives a person with ADHD the patience not to yell at their rambunctious kids.

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6 Books for Adults Living With A.D.H.D.

Psychiatrists, counselors and researchers shared their recommendations.

By Hope Reese

Staying focused in a world of distractions can be incredibly challenging. But for people living with attention deficit hyperactivity disorder — a neurodevelopmental disorder often marked by difficulty maintaining attention, disorganization, hyperactivity and impulsivity — it can be even harder. Adults are diagnosed less often than children , but A.D.H.D. can still create problems at work and in friendships and romantic relationships .

Books can be “the entree into understanding whether you should consider getting a diagnosis and evaluation for A.D.H.D.,” said Melissa Orlov, the founder of A.D.H.D. and Marriage, a website and consulting company that provides resources for couples living with the condition.

Sharon Saline, author of “What Your A.D.H.D. Child Wishes You Knew: Working Together to Empower Kids for Success in School and Life,” says the right book can combat misinformation. It can also help people close to someone with A.D.H.D. by providing a “toolbox for engaging with them, supporting them and loving them,” she said.

To demystify the subject, we asked experts — psychiatrists, counselors and researchers — to recommend books on A.D.H.D., focused on adults.

1. Taking Charge of Adult A.D.H.D. , by Russell A. Barkley with Christine M. Benton

This book, first published in 2010, is full of information and practical tools from Dr. Barkley, “one of the leading, if not the leading expert on A.D.H.D. in the world,” Dr. Saline said. It’s a “combo workbook/info book, which is great for people to get a better sense of who they are,” she said.

“No one knows more about A.D.H.D. or does a better job of integrating all the research on it,” said Ari Tuckman, a psychologist in West Chester, Pa., who specializes in A.D.H.D.

2. Your Brain’s Not Broken , by Tamara Rosier

If you want a book that’s both current and personal, this 2021 title might fit the bill. Dr. Rosier is “in touch with modern A.D.H.D.,” said Margaret H. Sibley, a professor of psychiatry and behavioral sciences at the University of Washington.

Dr. Rosier and some of her family members have A.D.H.D., and she shares her story with “a lot of warmth, a lot of humor,” Dr. Saline said.

She also offers a “really positive” perspective and provides tips for people with A.D.H.D. to assess and organize information, Ms. Orlov explained, “which is a huge part of being a successful adult.”

3. A Radical Guide for Women With A.D.H.D. , by Sari Solden and Michelle Frank

“A.D.H.D. manifests differently in women,” Dr. Saline said, “and young women are often not diagnosed or diagnosed later on.” That’s because symptoms like “dreaminess or low self-esteem or anxiety” are often incorrectly diagnosed as anxiety or depression, she said.

This 2019 workbook addresses those issues, tackling the specific ways that women experience A.D.H.D. and the ways they can learn to live with the condition.

“It’s a very relatable and practical guide,” Dr. Tuckman said.

4. The Couple’s Guide to Thriving With A.D.H.D. , by Melissa Orlov and Nancie Kohlenberger

A.D.H.D. can pose unique roadblocks for couples. For example, distracted behavior might be misinterpreted by a partner as lack of care. This 2014 title, which Dr. Saline calls “a classic,” was written by Ms. Orlov and Ms. Kohlenberger, a licensed marriage and family therapist. (Ms. Orlov was one of the sources for this piece, but several experts also said hers is the top book for couples.)

It includes useful information to help partners understand the signs and symptoms of A.D.H.D. and how to work together to resolve issues that arise. Dr. Tuckman, who works with couples, said his clients have “found it eye-opening.”

“A.D.H.D. can have a big impact on one’s relationship that can leave both partners unhappy and feeling powerless,” he said. “This book explains that impact and normalizes the struggles that couples fall into and the common dynamics that result.”

5. A.D.H.D. 2.0 , by Dr. Edward M. Hallowell and Dr. John J. Ratey

This 2021 title is a follow-up to “Driven to Distraction,” by the same authors, published in 1992. It offers “important updates about recent research on A.D.H.D.,” Dr. Saline said, along with advice that people with A.D.H.D. can use to “alter their environments to serve them better and reduce negativity.”

Ms. Orlov noted that this book illustrates “how a person with A.D.H.D. can really focus a lot on things like a phone or a video game or even their work, and not be able to focus on things that are less interesting.”

6. Outside the Box , by Thomas E. Brown

This 2017 title “hits the sweet spot,” Dr. Tuckman said. “It’s definitely driven by the research, and sophisticated, but it’s accessible. It helps illustrate what A.D.H.D. looks like at various stages of development, which can be helpful for those with A.D.H.D., family members of people with the condition and educators.”

“Brown’s approach to A.D.H.D. and executive functioning is very helpful,” Dr. Saline said. She likes “Outside the Box” because, in contrast with other workbooks, it offers “an informational narrative” without exercises. “He has a lot of research,” she said, “but this is also a book you can just sit back and read.”

Understanding A.D.H.D.

The challenges faced by those with attention deficit hyperactivity disorder can be daunting. but people who are diagnosed with it can still thrive..

Millions of children in the United States have received a diagnosis of A.D.H.D . Here is how their families can support them .

The condition is also being recognized more in adults . These are some of the behaviors  that might be associated with adult A.D.H.D.

Since a nationwide Adderall shortage started, some people with A.D.H.D. have said their medication no longer helps with their symptoms. But there could be other factors at play .

Everyone has bouts of distraction and forgetfulness. Here is when psychiatrists diagnose it as something clinical .

The disorder can put a strain on relationships. But there are ways to cope .

Though meditation can be beneficial to those with A.D.H.D., sitting still and focusing on breathing can be hard for them. These tips can help .

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Trusted Health Information from the National Institutes of Health

ADHD across the lifespan: What it looks like in adults

For a long time, people thought only children could have adhd. we now know that it can continue into adulthood..

ADHD can affect people of all ages, including adults.

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition (a condition that affects how the brain develops and works). ADHD is often diagnosed in childhood, but can continue into adulthood.  

Living with ADHD as an adult

ADHD does not magically disappear when you grow up. Even with treatment, many people with ADHD continue to have symptoms in adulthood—though those symptoms may look and feel a little different. 

For many adults with ADHD, losing the structure and support they had at home and in school when they were younger can make it harder to manage symptoms later in life. The responsibilities and challenges of adulthood can also trigger new symptoms and make existing ones worse.

Symptoms and patterns

Adults with ADHD may struggle with daily tasks, relationships, and work. These challenges can lead to feelings of frustration and underachievement. They may struggle to manage their time, stay on top of their finances, meet deadlines, and maintain stable home and social lives. This can look like:

• Always losing important items (such as keys, wallets, and phones)
• Struggling to listen closely, follow instructions, or pay attention to details
• Forgetting appointments, not returning calls, or neglecting to pay bills
• Fidgeting or feeling restless and being unable to sit still for a long time
• Interrupting others or answering someone’s question before they’ve finished asking it

Find more information about ADHD in adults .

Managing symptoms

If you have ADHD, these strategies and tools can help you manage your symptoms. 

• Prioritize physical and mental health. Taking care of physical and mental health is important for everyone and especially for people with ADHD. Getting enough sleep, eating healthy foods, and exercising regularly can help reduce your stress, improve your mood, and better manage your symptoms. 
• Establish structure and routine. A regular routine can help adults with ADHD stay on track and manage their time more effectively. Set specific times for daily activities such as waking up, eating meals, working, exercising, and going to bed. 
• Tackle “time blindness.” ADHD affects how people perceive and manage time, which can make it tough to estimate how long tasks will take and stick to schedules. While calendars and planners are helpful for some people, they can also be tricky for ADHD brains. Try setting frequent, attention-grabbing timers with sounds or colorful visuals, or experiment with reminder apps and alarms to stay on top of deadlines. The key is to find a tool that grabs your attention and keeps you on track.
• Seek professional help. Working with a trained professional can help people who are struggling to manage their ADHD symptoms. These professionals can help with your specific needs and challenges, including developing strategies to address them.
• Reach out to others . Connecting with friends, family, or colleagues can help people with ADHD find support, advice, and a sense of community. There are also many ADHD support groups and online forums. 

The first and most important step is getting an accurate diagnosis. The next is finding the best treatment and support. 

• Learn more about ADHD
• Discover what ADHD looks like in children and teens
• Support someone who has ADHD

National Institute of Mental Health, MedlinePlus

April 02, 2024

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What is ADHD?

Signs and symptoms.

• Managing Symptoms

ADHD in Adults

More information.

ADHD is one of the most common neurodevelopmental disorders of childhood. It is usually first diagnosed in childhood and often lasts into adulthood. Children with ADHD may have trouble paying attention, controlling impulsive behaviors (may act without thinking about what the result will be), or be overly active.

It is normal for children to have trouble focusing and behaving at one time or another. However, children with ADHD do not just grow out of these behaviors. The symptoms continue, can be severe, and can cause difficulty at school, at home, or with friends.

A child with ADHD might:

• daydream a lot
• forget or lose things a lot
• squirm or fidget
• talk too much
• make careless mistakes or take unnecessary risks
• have a hard time resisting temptation
• have trouble taking turns
• have difficulty getting along with others

Learn more about signs and symptoms

Get information and support from the National Resource Center on ADHD

There are three different ways ADHD presents itself, depending on which types of symptoms are strongest in the individual:

• Predominantly Inattentive Presentation: It is hard for the individual to organize or finish a task, to pay attention to details, or to follow instructions or conversations. The person is easily distracted or forgets details of daily routines.
• Predominantly Hyperactive-Impulsive Presentation: The person fidgets and talks a lot. It is hard to sit still for long (e.g., for a meal or while doing homework). Smaller children may run, jump or climb constantly. The individual feels restless and has trouble with impulsivity. Someone who is impulsive may interrupt others a lot, grab things from people, or speak at inappropriate times. It is hard for the person to wait their turn or listen to directions. A person with impulsiveness may have more accidents and injuries than others.
• Combined Presentation: Symptoms of the above two types are equally present in the person.

Because symptoms can change over time, the presentation may change over time as well.

 Learn about symptoms of ADHD, how ADHD is diagnosed, and treatment recommendations including behavior therapy, medication, and school support.

Causes of ADHD

Scientists are studying cause(s) and risk factors in an effort to find better ways to manage and reduce the chances of a person having ADHD. The cause(s) and risk factors for ADHD are unknown, but current research shows that genetics plays an important role. Recent studies link genetic factors with ADHD. 1

In addition to genetics, scientists are studying other possible causes and risk factors including:

• Brain injury
• Exposure to environmental risks (e.g., lead) during pregnancy or at a young age
• Alcohol and tobacco use during pregnancy
• Premature delivery
• Low birth weight

Research does not support the popularly held views that ADHD is caused by eating too much sugar, watching too much television, parenting, or social and environmental factors such as poverty or family chaos. Of course, many things, including these, might make symptoms worse, especially in certain people. But the evidence is not strong enough to conclude that they are the main causes of ADHD.

Download and Print this fact sheet [PDF – 473 KB]

Deciding if a child has ADHD is a process with several steps. There is no single test to diagnose ADHD, and many other problems, like anxiety, depression, sleep problems, and certain types of learning disabilities, can have similar symptoms. One step of the process involves having a medical exam, including hearing and vision tests , to rule out other problems with symptoms like ADHD. Diagnosing ADHD usually includes a checklist for rating ADHD symptoms and taking a history of the child from parents, teachers, and sometimes, the child.

Learn more about the criteria for diagnosing ADHD

In most cases, ADHD is best treated with a combination of behavior therapy and medication. For preschool-aged children (4-5 years of age) with ADHD, behavior therapy, particularly training for parents, is recommended as the first line of treatment before medication is tried. What works best can depend on the child and family. Good treatment plans will include close monitoring, follow-ups, and making changes, if needed, along the way.

Learn more about treatments

Managing Symptoms: Staying Healthy

Being healthy is important for all children and can be especially important for children with ADHD. In addition to behavioral therapy and medication, having a healthy lifestyle can make it easier for your child to deal with ADHD symptoms. Here are some healthy behaviors that may help:

• Developing healthy eating habits  such as eating plenty of fruits, vegetables, and whole grains and choosing lean protein sources
• Participating in daily  physical activity based on age
• Limiting the amount of daily screen time from TVs, computers, phones, and other electronics
• Getting the recommended amount of sleep each night based on age

If you or your doctor has concerns about ADHD, you can take your child to a specialist such as a child psychologist, child psychiatrist, or developmental pediatrician, or you can contact your local early intervention agency (for children under 3) or public school (for children 3 and older).

The Centers for Disease Control and Prevention (CDC) funds the National Resource Center on ADHD , a program of CHADD – Children and Adults with Attention-Deficit/Hyperactivity Disorder. Their website has links to information for people with ADHD and their families. The National Resource Center operates a call center (1-866-200-8098) with trained staff to answer questions about ADHD.

For more information on services for children with special needs, visit the Center for Parent Information and Resources.  To find the Parent Center near you, you can visit this website.

ADHD can last into adulthood. Some adults have ADHD but have never been diagnosed. The symptoms can cause difficulty at work, at home, or with relationships. Symptoms may look different at older ages, for example, hyperactivity may appear as extreme restlessness. Symptoms can become more severe when the demands of adulthood increase. For more information about diagnosis and treatment throughout the lifespan, please visit the websites of the National Resource Center on ADHD  and the National Institutes of Mental Health .

• National Resource Center on ADHD
• National Institute of Mental Health (NIMH)
• Faraone, S. V., Banaschewski, T., Coghill, D., Zheng, Y., Biederman, J., Bellgrove, M. A., . . . Wang, Y. (2021). The World Federation of ADHD International Consensus Statement: 208 evidence-based conclusions about the disorder. Neuroscience & Biobehavioral Reviews. doi:10.1016/j.neubiorev.2021.01.022

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ADHD and Graduate Writing

What this handout is about.

This handout outlines how ADHD can contribute to hitting the wall in graduate school. It describes common executive function challenges that grad students with ADHD might experience, along with tips, strategies, and resources for navigating the writing demands of grad school with ADHD.

Challenges for graduate students with ADHD

Many graduate students hit the wall (lose focus, productivity, and direction) when they reach the proposal, thesis, or dissertation phase—when they have a lot of unstructured time and when their external accountability system is gone. Previously successful strategies aren’t working for them anymore, and they aren’t making satisfactory progress on their research.

In many ways, hitting the wall is a normal part of the grad school experience, but ADHD, whether diagnosed or undiagnosed, can amplify the challenges of graduate school because success depends heavily on executive functioning. ADHD expert Russell Barkley explains that people with ADHD have difficulty with some dimensions of executive function, including working memory, motivation, planning, and problem solving. For grad students, those difficulties may emerge as these kinds of challenges:

• Being forgetful and having difficulty keeping things organized.
• Not remembering anything they’ve read in the last few hours or the last few minutes.
• Not remembering anything they’ve written or the argument they’ve been developing.
• Finding it hard to determine a research topic because all topics are appealing.
• Easily generating lots of new ideas but having difficulty organizing them.
• Being praised for creativity but struggling with coherence in writing, often not noticing logical leaps in their own writing.
• Having difficulty breaking larger projects into smaller chunks and/or accurately estimating the time required for each task.
• Difficulty imposing structure on large blocks of time and finishing anything without externally set deadlines.
• Spending an inordinate amount of time (like 5 hours) developing the perfect plan for accomplishing tasks (like 3 hours of reading).
• Having trouble switching tasks—working for hours on one thing (like refining one sentence), often with no awareness of time passing.
• Conversely, having trouble focusing on a single task–being easily distracted by external or internal competitors for their attention.
• Being extremely sensitive to or upset by criticism, even when it’s meant to be constructive.
• Struggling with advisor communications, especially when the advisors don’t have a strict structure, e.g., establishing priorities, setting clear timelines, enforcing deadlines, providing timely feedback, etc.

If you experience these challenges in a way that is persistent and problematic, check out our ADHD resources page and consider talking to our ADHD specialists at the Learning Center to talk through how you can regain or maintain focus and productivity.

Strategies for graduate students with ADHD

Writing a thesis or dissertation is a long, complex process. The list below contains a variety of strategies that have been helpful to grad students with ADHD. Experiment with the suggestions below to find what works best for you.

Reading and researching

Screen reading software allows you to see and hear the words simultaneously. You can control the pace of reading to match your focus. If it’s easier to focus while you’re physically active, try using a screen reader so you can listen to journal articles while you take a walk or a run or while you knit or doodle–or whatever movement helps you focus. Find more information about screen readers and everything they can do on the ARS Technology page .

Citation management systems can help you keep your sources organized. Most systems enable you to enter notes, add tags, save pdfs, and search. Some allow you to annotate pdfs, export to other platforms, or collaborate on projects. See the UNC Health Sciences Library comparison of citation managers to learn more about options and support.

Synthesis matrix is a fancy way of saying “spreadsheet,” but it’s a spreadsheet that helps you keep your notes organized. Set the spreadsheet up with a column for the full citations and additional columns for themes, like “research question,” “subjects,” “theoretical perspective,” or anything that you could productively document. The synthesis matrix allows you to look at all of the notes on a single theme across multiple publications, making it easier for you to analyze and synthesize. It saves you the trouble of shuffling through lots of highlighted articles or random pieces of paper with scribbled notes. See these example matrices on Autism , Culturally Responsive Pedagogy , and Translingualism .

Topic selection

Concept maps (also called mind maps) represent information visually through diagrams, flowcharts, timelines, etc. They can help you document ideas and see relationships you might be interested in pursuing. See examples on the Learning Center’s Concept Map handout . Search the internet for “concept-mapping software” or “mind-mapping software” to see your many choices.

Advisor meetings can help you reign in all of the interesting possibilities and focus on a viable, manageable project. Try to narrow the topics down to 3-5 and discuss them with your advisor. Be ready to explain why each interests you and how you would see the project developing. Work with your advisor to set goals and a check-in schedule to help you stay on track. They can also help you sort what needs to be considered now and what’s beyond the scope of the dissertation—tempting though it may be to include everything possible.

Eat the elephant one bite at a time. Break the dissertation project down into bite-sized pieces so you don’t get overwhelmed by the enormity of the whole project. The pieces can be parts of the text (e.g., the introduction) or the process (e.g., brainstorming or formatting tables). Enlist your advisor, other grad students, or anyone you think might help you figure out manageable chunks to work on, discuss reasonable times for completion, and help you set up accountability systems.

Tame perfectionism and separate the processes . Writers with ADHD will often try to perfect a single sentence before moving on to the next one, to the point that it’s debilitating. Start with drafting for ideas, knowing that you’re going to write a lot of sentences that will change later. Allow the ideas to flow, then set aside times to revise for ideas and to polish the prose.

List questions you could answer as a way of brainstorming and organizing information.

Make a slideshow of your key points for each section, chapter, or the entire dissertation. Hit the highlights without getting mired in the details as you draft the big picture.

Give a presentation to an imaginary (or real) audience to help you flesh out your ideas and try to articulate them coherently. The presentation can be planned or spontaneous as a brainstorming strategy. Give your presentation out loud and use dictation software to capture your thoughts.

Use dictation software to transcribe your speech into words on a screen. If your brain moves faster than your fingers can type, or if you constantly backspace over imperfectly written sentences, dictation software can capture the thoughts as they come to you and preserve all of your phrasings. You can review, organize, and revise later. Any device with a microphone (like your phone) will do the trick. See various speech to text tools on the ARS Technology page .

Turn off the monitor and force yourself to write for five, ten, twenty minutes, or however long it takes to dump your brain onto the screen. If you can’t see the words, you can’t scrutinize and delete them prematurely.

Use the Pomodoro technique . Set a timer for 25 minutes, write as much as you can during that time, take a five-minute break, and then do it again. After four 25-minute segments, take a longer break. The timer puts a helpful limit on the writing session that can motivate you to produce. It also keeps you aware of the passage of time, helping you stay focused and keeping your time more structured.

Sprints or marathons? Some people find it helpful to break down the writing process into smaller tasks and work on a number of tasks in smaller sprints. However, some people with ADHD find managing a number of tasks overwhelming, so for them, a “marathon write” may be a good idea. A marathon write doesn’t have to mean last-minute writing. Try to plan ahead, stock up on food for as many days as you plan to write, and think about how you’ll care for yourself during the long stretch of writing.

Minimize distractions . Turn off the internet, find a suitable place (quiet, ambient noise, etc.), minimize disruptions from other people (family, office mates, etc.), and use noise-canceling headphones or earplugs if they help. If you catch your thoughts wandering, write down whatever is distracting and you can attend to it later when you finish.

Seek feedback for clarity . Mind-wandering is a big asset for people with ADHD as it boosts creativity. Expansive, big-picture thinking is also an asset because it allows you to imagine complex systems. However, these things can also make graduate students with ADHD struggle with maintaining logical coherence. When you ask for feedback, specify logical coherence as a concern so your reader has a focus. If you’d like to look at your logic before you seek feedback, see our 2-minute video on reverse outlining .

Seek feedback for community . Talking to people about your ideas for writing will help you stay connected at a time when it’s easy to fade into a dark hole. Check out this handout on getting feedback .

Time management and accountability

Enlist your advisor . Graduate students with ADHD might worry about the perception that they’re “gaming the system” if they disclose their ADHD. Or they might struggle with an advisor with a more hands-off mentoring style. It will be helpful to be explicit about your neurodiversity and your potential need for a structure. Ask your advisor to clarify the expectations specifically (even quantify them), and work with them to come up with a clear timeline and a regular check-in schedule.

Enlist other mentors . Your advisor may be less understanding and/or may not be able to provide enough structure, or you may think it’s a good idea to have more than one person on your structure team. Look for other mentors on your faculty (inside or outside of your committee), and talk to senior grad students about their strategies.

Pay attention to your body rhythms . When do you feel most creative? Most focused? Most energetic? Or the least creative, focused, energetic? What activities could you engage in during those times? How can you do them consistently?

Think about task vs. time . It can be difficult to estimate how long a task is going to take, so think about setting a time limit for working on something. Set a timer, work for that amount of time, and change tasks when the time is over.

Tame hyperfocus . If you have trouble switching tasks, ask a friend or colleague to “interrupt” you, or figure out a system you can use to interrupt yourself. For example, when you find yourself trying to fix a sentence for 30 minutes, you can call a friend for a brief conversation about another topic. People with ADHD often find this helps them to look at the work from a more objective perspective when they return to it.

Set SMART goals . Check out the handout on setting SMART goals to help you set up a regular research and writing routine.

Set up a reward system . Tie your research or writing goal to an enjoyable reward. Note that it can also be pre-ward – something you do beforehand that will help you feel refreshed and motivated to work.

Find accountability buddies . These can be people you update on your progress or people you meet with to get work done together. Oftentimes, the simple presence of other people is able to motivate and keep us focused. This “body-doubling” strategy is particularly helpful for people with ADHD. Look for events like the Dissertation Boot Camp or IME Writing Wednesdays .

Find virtual accountability partners . There are a number of online platforms to connect you with virtual work partners. See this article on strategies and things to consider.

Use productivity and focus apps . Check out some recommendations among the Learning Center’s ADHD/LD Resources . To find the best options for you, try Googling “Apps for focus and productivity” to find reviews of timers and other focus apps.

Learn more about accountability . See the Learning Center’s Accountability Strategies page for great information and resources.

Works consulted

We consulted these works while writing this handout. This is not a comprehensive list of resources on the handout’s topic, and we encourage you to do your own research to find additional publications. Please do not use this list as a model for the format of your own reference list, as it may not match the citation style you are using. For guidance on formatting citations, please see the UNC Libraries citation tutorial . We revise these tips periodically and welcome feedback.

Barkley, R. (2022, July 11). What is executive function? 7 deficits tied to ADHD . ADDitude: Inside the ADHD Mind. https://www.additudemag.com/7-executive-function-deficits-linked-to-adhd/

Hallowell, E. and Ratey, J. (2021). ADHD 2.0: New science and essential strategies for thriving with distraction—from childhood through adulthood . Random House Books.

You may reproduce it for non-commercial use if you use the entire handout and attribute the source: The Writing Center, University of North Carolina at Chapel Hill

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Home — Essay Samples — Nursing & Health — Psychiatry & Mental Health — Adhd

ADHD ( Attention Deficit Hyperactivity Disorder) Essay Examples

Adhd essay topics and outline examples, essay title 1: understanding adhd: causes, symptoms, and treatment.

Thesis Statement: This research essay aims to provide a comprehensive understanding of Attention-Deficit/Hyperactivity Disorder (ADHD), including its possible causes, common symptoms, and various treatment approaches.

• Introduction
• Defining ADHD: An Overview
• Possible Causes of ADHD: Genetic, Environmental, and Neurological Factors
• Symptoms and Diagnosis: Recognizing ADHD in Children and Adults
• Treatment Options: Medication, Behavioral Therapy, and Lifestyle Interventions
• The Impact of ADHD on Daily Life: School, Work, and Relationships
• Current Research and Future Directions in ADHD Studies
• Conclusion: Enhancing Understanding and Support for Individuals with ADHD

Essay Title 2: ADHD in Children: Educational Challenges and Supportive Strategies

Thesis Statement: This research essay focuses on the educational challenges faced by children with ADHD, explores effective strategies for supporting their learning, and highlights the importance of early intervention.

• Educational Implications of ADHD: Academic, Social, and Emotional Impact
• Supportive Classroom Strategies: Individualized Education Plans (IEPs) and 504 Plans
• Teacher and Parent Collaboration: Creating a Supportive Learning Environment
• Alternative Learning Approaches: Montessori, Waldorf, and Inclusive Education
• ADHD Medication in the Educational Context: Benefits and Considerations
• Early Intervention and the Role of Pediatricians and School Counselors
• Conclusion: Nurturing Academic Success and Well-Being in Children with ADHD

Essay Title 3: ADHD in Adulthood: Challenges, Coping Strategies, and Stigma

Thesis Statement: This research essay examines the often overlooked topic of ADHD in adults, discussing the challenges faced, coping mechanisms employed, and the impact of societal stigma on individuals with adult ADHD.

• ADHD Persisting into Adulthood: Recognizing the Symptoms
• Challenges Faced by Adults with ADHD: Work, Relationships, and Self-Esteem
• Coping Strategies and Treatment Options for Adult ADHD
• The Role of Mental Health Support: Therapy, Coaching, and Self-Help
• ADHD Stigma and Misconceptions: Impact on Diagnosis and Treatment
• Personal Stories of Triumph: Overcoming ADHD-Related Obstacles
• Conclusion: Raising Awareness and Providing Support for Adults with ADHD

Understanding ADHD: a Comprehensive Analysis

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The Effect of ADHD on The Life of an Individual

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ADHD: The Child/teacher Struggle

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How Fidgeting Actually Contributes to a Lack of Focus in Students

Diagnosing dyscalculia and adhd diagnosis in schools, the issue of social injustice of misdiagnosed children with adhd.

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by excessive amounts of inattention, carelessness, hyperactivity (which evolves into inner restlessness in adulthood), and impulsivity that are pervasive, impairing, and otherwise age-inappropriate.

The major symptoms are inattention, carelessness, hyperactivity (evolves into restlessness in adults), executive dysfunction, and impulsivity.

The management of ADHD typically involves counseling or medications, either alone or in combination. While treatment may improve long-term outcomes, it does not get rid of negative outcomes entirely. Medications used include stimulants, atomoxetine, alpha-2 adrenergic receptor agonists, and sometimes antidepressants. In those who have trouble focusing on long-term rewards, a large amount of positive reinforcement improves task performance.ADHD stimulants also improve persistence and task performance in children with ADHD.

Relevant topics

• Mental Health
• Stress Management
• Schizophrenia
• Eating Disorders

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How to Identify and Diagnose Adult ADHD

The signs and symptoms of adult ADHD can be hard to spot. This makes awareness and diagnosis important for people struggling with the condition. Britt Holmes, PsyD , an ADHD assessment expert at University of Utah Health and Huntsman Mental Health Institute, offers her advice on when and how to seek medical advice, the role of psychological assessments, and the misconceptions that may delay diagnosis and treatment.

Episode Transcript

Interviewer: For people who may suspect that they have attention deficit hyperactivity disorder, the path to recognizing it and diagnosing it in adulthood can often be filled with challenges. Today, we're uncovering some of the steps and the struggles and triumphs that are involved in getting diagnosed with adult ADHD.

We're joined by Doctor of Psychology Britt Holmes , with University of Utah Health and Huntsman Mental Health Institute and an expert in the field of ADHD assessment.

Now, Dr. Holmes, what are some of the key symptoms that a patient might be experiencing that might warrant further investigation and maybe even a diagnosis of ADHD?

Recognizing Adult ADHD Symptoms and Diagnosis

Dr. Holmes: For an adult with concern for ADHD, some of the most prominent symptoms will be things that the person experiences internally: becoming easily distracted, having trouble paying attention, having trouble following through with a task or activity, spacing out during a conversation.

Some may be more evident to others, like if you can't finish a task at work, for example, or you're very fidgety, or you interrupt other people or blurt things out.

If you're someone who may have noticed some of the problems with inattention or getting easily distracted yourself, or then if you also have others in your life who are noticing some of these outward signs, those may be situations to consider whether that is actually a disorder, a condition, or then the other question, is that a result of life stress or day-to-day situations where we may have more or less trouble with those things.

Diagnostic Process for Adult ADHD

Interviewer: So if a person or a listener maybe suspects they might have something like this, they're experiencing some of these symptoms, what is that journey to diagnosis? Where does it start, and how do you get to that final step?

Dr. Holmes: I think the first step is speaking with your doctor. If you already have a mental health provider, you're seeing a therapist, a psychiatrist, or a nurse practitioner, that is where I would start.

If not, I would start with a primary care doctor and say these are the symptoms that you notice or the things that are causing you challenges. Coming to your healthcare provider with a list of the symptoms you notice, when they're causing problems, what makes them better or worse, that's going to be really crucial information for them in helping determine, "Is this actually a disorder? Is there a life stress cause? Is this ADHD or is it something else?"

They'll also be considering things like the possibility of a sleep problem causing inattention. We all have more trouble paying attention when we haven't gotten a good night's sleep. If we're stressed about something, if we have pain, if we have a medical condition that's causing pain, that can make it very difficult to pay attention too.

And so considering those pieces will be very important for your doctor or therapist in exploring the possibility of ADHD.

They may have someone complete different checklists or forms that rate their symptoms. Often, it's on a scale of 1 to 4, how common the person experiences that.

Some of those may be asking questions about childhood. So it's really helpful if you can provide any information about whether you had these problems growing up.

Maybe you even have teachers who made comments to your parents and your parents can provide that information. "Yes, teachers were always saying that you had these difficulties, or you struggled in certain subjects because you couldn't pay attention." That is all very, very helpful to look at the possibility of ADHD and differentiate it from other conditions. 

The final step that isn't always needed, but sometimes can be helpful, would be getting a formal assessment, doing neuropsychological tests that are aimed at looking at attention or memory, and your overall cognitive strengths and weaknesses.

It's not necessary for most people, and it does take a while to do. Often there are long waitlists, but in some cases, that's a necessary part to help determine if someone may have ADHD. 

Common Barriers to Diagnosis: Misconceptions and Challenges

Interviewer: Got you. So you start your conversation with one of your providers and there are a lot of different steps. And again, you don't need that formal assessment necessarily.

But when you're trying to get a diagnosis as an adult, sometimes there can be misconceptions, challenges, and certain barriers that can stop a person from actually getting the diagnosis that could get them the help they need. What are some of these barriers and what are some of the ways we can maybe overcome them?

Dr. Holmes: I think the number one barrier is that there are providers who believe that certain tests or assessments are mandatory to make a diagnosis. It's a common misconception, but it can lead people to end up on a lengthy waitlist before they can get even a diagnosis, and then often they're waiting after that to get treatment.

I understand the hesitance of some providers. They don't want to prescribe certain medicines unless they're absolutely sure. Mental health providers, because they have more expertise in general, are going to feel more confident in a diagnosis without extra testing than a primary care provider.

Costs can be a factor. Some insurances will cover certain types of assessments or visits with your doctors, but not others. They may cover certain medications and not others for barriers to treatment. 

Self-Advocacy and Seeking Second Opinions

Interviewer: As a patient, sometimes it feels strange when a doctor tells you one thing, but maybe your research says otherwise. I mean, what role does, say, self-advocacy kind of play when we are talking about getting the diagnosis and treatment that you need?

Dr. Holmes: I do think it's important to advocate for yourself as a patient in any situation in which you're feeling you have a problem and you may feel dismissed. Maybe the doctor isn't as familiar with adult ADHD. And so getting a second opinion in that case may be really helpful.

If a doctor doesn't feel that it's ADHD and it isn't, and that doctor is providing an accurate, comprehensive diagnosis, they're talking with you about all your symptoms, they're really hearing you try to sort through this, that doctor should also be explaining the reasoning. 

And so if you feel that you are not getting kind of as much information about why the doctor does not think that this is ADHD, I think it's important to advocate for yourself and ask those questions to better understand.

Maybe the doctor is saying your depression is actually the cause of attention problems. Depression can mimic ADHD. We see fidgeting with depression sometimes. We see trouble concentrating. Anxiety, maybe your doctor says it's that you have anxiety. You have a different condition, and that's the root cause. I'd mentioned sleep. You have a sleep problem, something else.

But it's important for you to understand that reasoning, and so I would ask for that. Ultimately, if you feel what the doctor was explaining didn't make sense to you, or you felt that they maybe didn't actually hear all of the concerns that you had, maybe they didn't understand it the way you do, seeing a second provider to get a second opinion may be a good idea.

Post-Diagnosis: Exploring Treatment Options and Next Steps

Interviewer: So now the patient has got their diagnosis. What's next?

Dr. Holmes: I think it's very different for different people. Some people want to pursue some type of treatment. That might be consideration of medicines, and they would want to talk with their doctor, whether that's the primary care doctor or someone who's a psychiatric specialist, psychiatrist, or nurse practitioner.

Some people might be more interested in therapy to learn techniques to manage ADHD. That could be done one-on-one with a therapist or in a group, and that can be more helpful.

And I recommend thinking through those things or talking with a professional, even if someone wants to talk about medicine, because many of those strategies and techniques will be helpful even with a medicine that may also provide benefit.

For some people, the next step would be getting accommodations in school or work if needed. Maybe they don't want to do other types of interventions, but having that diagnosis then means that they're able to access more resources or more accommodations.

But I do think it's very dependent on the individual what feels best for them. How problematic is ADHD for that person in that stage of life? Maybe they only need certain interventions at certain times, so you have to kind of think through what would be most impactful for you and choose from those options to look at interventions. 

Resources and Support for Adult ADHD

Interviewer: Now, for that adult who maybe is curious about getting a diagnosis, or maybe even someone who has just freshly, newly got their diagnosis, what resources or support is available for them to get more information?

Dr. Holmes: I would encourage people to focus on getting resources from places that are research-focused or based. So the National Institute of Health or the CDC has information both about the diagnosis of ADHD and some about treatment. I would say maybe less on treatment, but it's a good place to start. ADD.org also has fairly reliable information about ADHD and some ideas for interventions. 

Many people look to social media for tips and tricks to manage ADHD. I definitely caution against relying too much on social media because there's misinformation out there. There's a lot of misinformation.

On the other hand, if you happen to see someone say, "I have ADHD and this works for me," and it's kind of a daily life hack that's not going to cause a problem for you to test drive, there's no reason not to. What works for one person might work for someone else. Just always take anything you see on social media with a grain of salt.

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South East Bay Pediatric Medical Group | Fremont, CA

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2191 mowry ave. #600c, fremont ca 94538, mon-fri: 8:45 am – 5pm, sat/sun/holiday: call at 8 am for appointment, an introduction to attention deficit hyperactivity disorder (adhd).

Almost all children have times when their behavior veers out of control. They may speed about in constant motion, make noise nonstop, refuse to wait their turn, and crash into everything around them. At other times they may drift as if in a daydream, failing to pay attention or finish what they start.

However, for some children, these kinds of behaviors are more than an occasional problem. Children with attention-deficit/hyperactivity disorder (ADHD) have behavior problems that are so frequent and/or severe that they interfere with their ability to live normal lives. These children often have trouble getting along with siblings and other children at school, at home, and in other settings. Those who have trouble paying attention usually have trouble learning. Some have an impulsive nature and this may put them in actual physical danger. Because children with ADHD have difficulty controlling their behavior, they may be labeled as “bad kids” or “space cadets.” Left untreated, more severe forms of ADHD can lead to serious, lifelong problems such as poor grades in school, run-ins with the law, failed relationships, substance abuse and the inability to keep a job.

What is ADHD?

ADHD is a condition of the brain that makes it difficult for children to control their behavior. It is one of the most common chronic conditions of childhood. It affects 4% to 12% of school-aged children. About 3 times more boys than girls are diagnosed with ADHD.

What are the symptoms of ADHD?

ADHD includes 3 behavior symptoms: inattention, hyperactivity, and impulsivity. A child with inattention symptoms may have the following behaviors:

• Has a hard time paying attention, daydreams
• Does not seem to listen
• Is easily distracted from work or play
• Does not seem to care about details, makes careless mistakes
• Does not follow through on instructions or finish tasks
• Is disorganized
• Loses a lot of important things
• Forgets things
• Does not want to do things that require ongoing mental effort

A child with hyperactivity symptoms may have the following behaviors:

• Is in constant motion, as if “driven by a motor”
• Cannot stay seated
• Squirms and fidgets
• Talks too much
• Runs, jumps, and climbs when this is not permitted
• Cannot play quietly (video games do not count)

A child with impulsivity symptoms may have the following behaviors:

• Acts and speaks without thinking
• May run into the street without looking for traffic first
• Has trouble taking turns
• Cannot wait for things
• Calls out answers before the question is complete
• Interrupts others

What is the difference between ADD vs. ADHD?

ADD stands for Attention Deficit Disorder. This is an old term that is now officially called Attention Deficit Hyperactivity Disorder, Inattentive Type. More on this will discussed below.

Are there different types of ADHD?

Children with ADHD may have one or more of the 3 main symptoms categories listed above. The symptoms usually are classified as the following types of ADHD:

• Inattentive type (formerly known as attention-deficit disorder [ADD])—Children with this form of ADHD are not overly active. Because they do not disrupt the classroom or other activities, their symptoms may not be noticed. Among girls with ADHD, this form is most common.
• Hyperactive/Impulsive type—Children with this type of ADHD show both hyperactive and impulsive behavior, but can pay attention.
• Combined Inattentive/Hyperactive/Impulsive type—Children with this type of ADHD show all 3 symptoms. This is the most common type of ADHD.

How can I tell if my child has ADHD?

Remember, it is normal for all children to show some of these symptoms from time to time. Your child may be reacting to stress at school or home. She may be bored or going through a difficult stage of life. It does not mean he or she has ADHD. Sometimes a teacher is the first to notice inattention, hyperactivity, and/or impulsivity and bring these symptoms to the parents’ attention. Sometimes questions from your pediatrician can raise the issue. Parents also may have concerns such as behavior problems at school, poor grades, difficulty finishing homework and so on. If your child is 6 years of age or older and has shown symptoms of ADHD on a regular basis for more than 6 months, discuss this with your pediatrician.

What causes ADHD?

ADHD is one of the most studied conditions of childhood but the cause of ADHD is still not clear at this time. The most popular current theory of ADHD is that ADHD represents a disorder of “executive function.” This implies dysfunction in the prefrontal lobes so that the child lacks the ability for behavioral inhibition or self-regulation of such executive functions as nonverbal working memory, speech internalization, affect, emotion, motivation, and arousal. It is believed that children with ADHD lack the right balance of neurotransmitters, which are specific chemicals in their brains, that help them to focus and inhibit impulses.

Research to date has shown the following:

• ADHD is a biological disorder, not just “bad behavior.” In a child with ADHD, the brain’s ability to properly use important chemical messengers (neurotransmitters) is impaired.
• A lower level of activity in the parts of the brain that control attention and activity level may be associated with ADHD.
• ADHD appears to run in families. Sometimes a parent is diagnosed with ADHD at the same time as the child.
• Environmental toxins can play a role in the development of ADHD, but that is extremely rare.
• Very severe head injuries may cause ADHD in rare cases.

There is no significant evidence that ADHD is caused by the following:

• Eating too much sugar
• Food additives
• Immunizations

Your pediatrician will determine whether your child has ADHD using standard guidelines developed by the American Academy of Pediatrics. Unfortunately, there is no single test that can tell whether your child has ADHD. The diagnosis process requires several steps and involves gathering a lot of information from multiple sources. You, your child, your child’s school, and other caregivers should be involved in assessing your child’s behavior.

Generally, if your child has ADHD:

• Some symptoms will occur in more than one setting, such as home, school, and social events
• The symptoms significantly impair your child’s ability to function in some of the activities of daily life, such as schoolwork and relationships with family and friends
• They will start before your child reaches 7 years of age
• They will continue for more than six months
• They will make it difficult for your child to function at school, at home, and/or in social settings

In addition to looking at your child’s behavior, your pediatrician will do a physical examination. A full medical history will be needed to put your child’s behavior in context and screen for other conditions that may affect your child’s behavior.

One of the challenges in diagnosing ADHD is that many disorders can look a lot like ADHD – including depression, anxiety, visual and hearing difficulties, seizures, learning disorders and even improper sleep quality. These conditions can show the same type of symptoms as ADHD. For example if your child has sleep apnea, a condition that involves disordered breathing during sleep, he may show signs of inattention and inability to focus that can sometimes be similar to a child with ADHD. Another example is a child that may have a learning disability. He/she may not pay attention in class due to inability to process that information and therefore be labeled with “inattention”. The same child may also be frustrated because he can’t process the material being taught in the classroom and therefore disturbs the classroom and acts as if he/she is “hyperactive.” In the case of this child with a learning disability, all the effort needs to be focused on the actual underlying problem, which again is the learning disability, and not on immediately trying to treat ADHD. Similarly, in our child with sleep apnea, parents need to address the sleeping problem first and not rush to place their child on medication for ADHD. As you will read below, it is possible to have ADHD with other conditions, so children who do have sleep apnea or learning disabilities MAY ALSO have ADHD and may eventually require treatment for both conditions.

The diagnosis of ADHD takes time, and the evaluation process usually takes at least 2-3 visits before the diagnosis can be made. Occasionally the process can take longer if referrals to psychologists or psychiatrists are warranted. Blood tests may or may not be indicated, and this will be discussed during your visit.

Coexisting conditions

• Oppositional defiant disorder or conduct disorder —Up to 35% of children with ADHD also have oppositional defiant disorder or conduct disorder. Children with oppositional defiant disorder tend to lose their temper easily and annoy people on purpose and are defiant and hostile toward authority figures. Children with conduct disorder break rules, destroy property, and violate the rights of other people. Children with coexisting conduct disorder are at much higher risk for getting into trouble with the law than children who have only ADHD. Studies show that this type of coexisting condition is more common among children with the primarily hyperactive/impulsive and combination types of ADHD. Your pediatrician may recommend counseling for your child if she has this condition.
• Mood disorders/depression —About 18% of children with ADHD also have mood disorders such as depression. There is frequently a family history of these types of disorders. Coexisting mood disorders may put children at higher risk for suicide, especially during the teenage years. These disorders are more common among children with inattentive and combined types of ADHD. Children with mood disorders or depression often require a different type of medication than those normally used to treat ADHD.
• Anxiety disorders —These affect about 25% of children with ADHD. Children with anxiety disorders have extreme feelings of fear, worry, or panic that make it difficult to function. These disorders can produce physical symptoms such as racing pulse, sweating, diarrhea, and nausea. Counseling and/or medication may be needed to treat these coexisting conditions.
• Learning disabilities —Learning disabilities are conditions that make it difficult for a child to master specific skills such as reading or math. ADHD is not a learning disability. However, ADHD can make it hard for a child to do well in school. Diagnosing learning disabilities requires evaluations such as IQ and academic achievement tests.
• Target outcomes for behavior
• Follow-up activities
• Education about ADHD
• Team work among doctors, parents, teachers, caregivers, other healthcare professionals, and the child

Behavior therapy

• Parent training
• Individual and family counseling

Treatment for ADHD uses the same principles that are used to treat other chronic conditions like asthma or diabetes. Long-term planning is needed because these conditions continue or recur for a long time. Families must manage them on an ongoing basis. In the case of ADHD, schools and other caregivers must also be involved in managing the condition. Educating the people involved with your child about ADHD is a key part of treating your child. As a parent, you will need to learn about ADHD. Read about the condition and talk to people who understand it. This will help you manage the ways ADHD affects your child and your family on a day-to-day basis. It will also help your child learn to help himself.

For most children, stimulant medications are a safe and effective way to relieve ADHD symptoms. As glasses help people focus their eyes to see, these medications help children with ADHD focus their thoughts better and ignore distractions. This makes them more able to pay attention and control their behavior. Stimulants may be used alone or combined with behavior therapy. Studies show that about 80% of children with ADHD who are treated with stimulants improve a great deal.

Different types of stimulants are available, in both short-acting (immediate-release) and long-acting forms. Short- acting forms usually are taken every 4 hours when the medication is needed. Long-acting medications usually are taken once in the morning. Children who use long-acting forms of stimulants can avoid taking medication at school or after school.

It may take some time to find the best medication, dosage, and schedule for your child. Your child may need to try different types of stimulants. Some children respond to one type of stimulant but not another. The amount of medication (dosage) that your child needs also may need to be adjusted. Realize that the dosage of the medicine is not based solely on your child weight. Our goal is for your child to be on the dose that is helping her to maximize her potential with the least amount of side effects.

The medication schedule also may be adjusted depending on the target outcome. For example, if the goal is to get relief from symptoms at school, your child may take the medication only on school days and none during weekends, summer time, and vacations if desired. Your child will have close follow up initially and once the optimal medication and dosage is found she will be seen every 2-3 months to monitor progress and possible side effects.

What side effects can stimulants cause?

Side effects occur sometimes. These tend to happen early in treatment and are usually mild and short-lived. The most common side effects include the following:

Decreased appetite/weight loss.

• Sleep problems
• Stomachaches

Some less common side effects include the following:

• Jitteriness
• Social withdrawal
• Rebound effect (increased activity or a bad mood as the medication wears off)
• Transient tics

Very rare side effects include the following:

• Increase in blood pressure or heart rate
• Growth delay

Most side effects can be relieved using one of the following strategies:

• Changing the medication dosage
• Adjusting the schedule of medication
• Using a different stimulant

There are many forms of behavior therapy, but all have a common goal— to change the child’s physical and social environments to help the child improve his behavior. Under this approach, parents, teachers, and other caregivers learn better ways to work with and relate to the child with ADHD. You will learn how to set and enforce rules, help your child understand what he needs to do, use discipline effectively, and encourage good behavior. Your child will learn better ways to control his behavior as a result.

Behavior therapy has 3 basic principles:

• Set specific goals. Set clear goals for your child such as staying focused on homework for a certain time or sharing toys with friends.
• Provide rewards and consequences. Give your child a specified reward (positive reinforcement) when she shows the desired behavior. Give your child a consequence (unwanted result or punishment) when she fails to meet a goal.
• Keep using the rewards and consequences. Using the rewards and consequences consistently for a long time will shape your child’s behavior in a positive way.

Behavior therapy recognizes the limits that having ADHD puts on a child. It focuses on how the important people and places in the child’s life can adapt to encourage good behavior and discourage unwanted behavior. It is different from play therapy or other therapies that focus mainly on the child and his emotions. Specific behavior therapy techniques that can be effective with children with ADHD include:

• Positive reinforcement: Parents provide rewards or privileges in response to desired behavior. For example, your child completes an assignment and he is permitted to play on the computer.
• Time-out: one removes access to desired activity because of unwanted behavior. For example, your child hits a sibling and, as a result, must sit for 5 minutes in the corner of the room.
• Response cost: Parents withdraw rewards or privileges because of unwanted behavior. For example, your child loses free-time privileges for not completing homework.
• Token economy: Combining reward and consequence. The child earns rewards and privileges when performing desired behaviors. He loses the rewards and privileges as a result of unwanted behavior. For example, you child can earn stars for completing assignments and loses stars for getting out of seat. Then, he cashes in the sum of her stars at the end of the week for a prize.

Tips for helping your child control his behavior

• Keep your child on a daily schedule . Try to keep the time that your child wakes up, eats, bathes, leaves for school, and goes to sleep the same each day.
• Cut down on distractions . Loud music, computer games, and television can be over-stimulating to your child. Make it a rule to keep the TV or music off during mealtime and while your child is doing homework. Whenever possible, avoid taking your child to places that may be too stimulating, like busy shopping malls.
• Organize your house . If your child has specific and logical places to keep his schoolwork, toys, and clothes, he is less likely to lose them. Save a spot near the front door for his school backpack so he can grab it on the way out the door.
• Reward positive behavior . Offer kind words, hugs, or small prizes for reaching goals in a timely manner or good behavior. Praise and reward your child’s efforts to pay attention.
• Set small, reachable goals . Aim for slow progress rather than instant results. Be sure that your child understands that he can take small steps toward learning to control himself.
• Help your child stay “on task.” Use charts and checklists to track progress with homework or chores. Keep instructions brief. Offer frequent, friendly reminders.
• Limit choices . Help your child learn to make good decisions by giving your child only 2 or 3 options at a time.
• Find activities at which your child can succeed. All children need to experience success to feel good about themselves and boost their self-confidence.
• Use calm discipline. Use consequences such as time-out, removing the child from the situation, or distraction. Sometimes it is best to simply ignore the behavior. Physical punishment, such as spanking or slapping, is not helpful. Discuss your child’s behavior with him when both of you are calm.

How can I help my child control her behavior?

Taking care of yourself also will help your child. Being the parent of a child with ADHD can be tiring and trying. It can test the limits of even the best parents. Parent training and support groups made up of other families who are dealing with ADHD can be a great source of help. Learn stress-management techniques to help you respond calmly to your child. Seek counseling if you feel overwhelmed or hopeless.

Ask us to help you find parent training, counseling, and support groups in your community. Under the resources section we will leave the link of a few handouts published by the NICHQ (National Initiative for Children’s Healthcare Quality) including:

• How to Establish a School-Home Daily Report Card

Unproven treatments

You may have heard media reports or seen advertisements for “miracle cures” for ADHD. Carefully research any such claims. Consider whether the source of the information is valid. At this time, there is no scientifically proven cure for this condition. The following methods have not been proven to work in scientific studies:

• Optometric vision training (asserts that faulty eye movement and sensitivities cause the behavior problems)
• Megavitamins and mineral supplements
• Anti–motion-sickness medication (to treat the inner ear)
• Treatment for candida yeast infection
• EEG biofeedback (training to increase brain-wave activity)
• Applied kinesiology (realigning bones in the skull)

Always tell your pediatrician about any alternative therapies, supplements, or medications that your child is using. These may interact with prescribed medications and harm your child.

Frequently asked questions

Will my child outgrow adhd.

ADHD continues into adulthood in most cases. However, by developing their strengths, structuring their environments, and using medication when needed, adults with ADHD can lead very productive lives. In some careers, having a high-energy behavior pattern can be an asset.

Are stimulant medications “gateway drugs” leading to illegal drug or alcohol abuse?

People with ADHD are naturally impulsive and tend to take risks. But those with ADHD who are taking stimulants are actually at lower risk of using other drugs. Children and teenagers who have ADHD and also have coexisting conditions may be at high risk for drug and alcohol abuse, regardless of the medication used.

Are children getting high on stimulant medications?

There is no evidence that children are getting high on stimulant drugs used to treat ADHD. These drugs also do not sedate or tranquilize children and have no addictive properties. Stimulants are classified as Schedule II drugs by the US Drug Enforcement Administration. There are recent reports of abuse of this class of medication, especially by college students who trying to obtain an edge during exam times to stay up and study more. 
If your child is on medication, it is always best to supervise the use of the medication closely.

Why do so many children have ADHD?

The number of children who are being treated for ADHD has risen. It is not clear whether more children have ADHD or more children are being diagnosed with ADHD. ADHD is now one of the most common and most studied conditions of childhood. Because of more awareness and better ways of diagnosing and treating this disorder, more children are being helped.

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The lived experiences of adults with attention-deficit/hyperactivity disorder: A rapid review of qualitative evidence

Callie m. ginapp.

1 Yale School of Medicine, Yale University, New Haven, CT, United States

Grace Macdonald-Gagnon

2 Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States

Gustavo A. Angarita

3 Connecticut Mental Health Center, New Haven, CT, United States

Krysten W. Bold

Marc n. potenza.

4 Connecticut Council on Problem Gambling, Wethersfield, CT, United States

5 Child Study Center, Yale School of Medicine, New Haven, CT, United States

6 Department of Neuroscience, Yale University, New Haven, CT, United States

7 Wu Tsai Institute, Yale University, New Haven, CT, United States

Associated Data

Attention-deficit/hyperactivity disorder (ADHD) is a common condition that frequently persists into adulthood, although research and diagnostic criteria are focused on how the condition presents in children. We aimed to review qualitative research on lived experiences of adults with ADHD to characterize potential ADHD symptomatology in adulthood and provide perspectives on how needs might be better met. We searched three databases for qualitative studies on ADHD. Studies ( n = 35) in English that included data on the lived experiences of adults with ADHD were included. These studies covered experiences of receiving a diagnosis as an adult, symptomatology of adult ADHD, skills used to adapt to these symptoms, relationships between ADHD and substance use, patients’ self-perceptions, and participants’ experiences interacting with society. Many of the ADHD symptoms reported in these studies had overlap with other psychiatric conditions and may contribute to misdiagnosis and delays in diagnosis. Understanding symptomatology of ADHD in adults may inform future diagnostic criteria and guide interventions to improve quality of life.

Introduction

Attention-deficit/hyperactivity disorder (ADHD) has an estimated prevalence of 7% among adults globally ( 1 ). ADHD has historically been considered a disorder of childhood; however, 40–50% of children with ADHD may meet criteria into adulthood ( 2 ). Diagnostic criteria for ADHD include symptoms of inattention, hyperactivity, and impulsiveness present since childhood ( 3 ). These criteria are largely based on presentations in children, although diagnostic criteria have changed over time to better but not completely encompass considerations of experiences of adults ( 3 , 4 ).

Although adult ADHD is highly treatable with stimulant medication ( 5 ), adults with ADHD often have unmet needs. Substance use disorders (SUDs) are approximately 2.5-fold more prevalent among adults with versus without ADHD ( 6 , 7 ). Adults with ADHD are particularly likely to be incarcerated, with 26% of people in prison having ADHD ( 8 ). As diagnosis of ADHD has increased considerably in recent decades ( 9 ), there are likely many adults with ADHD who were not originally diagnosed as children. In more recent years, ADHD is still frequently underdiagnosed or misdiagnosed as other psychiatric conditions such as mood or personality disorders ( 10 ). Even when patients are diagnosed with ADHD as children, many patients lose access to resources when transitioning from child to adult health services ( 11 ) which may contribute to less than half of people with ADHD adhering to stimulant medication ( 12 ).

Non-pharmacological interventions such as cognitive behavioral therapy (CBT) have shown promise with helping adults manage their ADHD symptoms, although such symptoms are not completely ameliorated by therapy ( 13 – 15 ). A more thorough understanding of the symptoms adults with ADHD experience and the effects that these symptoms have on their lives may allow for more efficacious or targeted therapeutic interventions.

Qualitative research may provide insight into lived experiences, and findings from such studies may direct future research into potential symptoms and therapeutic interventions. The aim of this review is to describe the current qualitative literature on the lived experiences of adults with ADHD. This review may provide insight into the symptomatology of adult ADHD, identify areas where patient needs could be better met, and define gaps in understanding.

Search strategy

Using rapid review methodology ( 16 ), PubMed, PsychInfo, and Embase were searched on October 11th, 2021 with no date restrictions. The search terms included “ADHD” and related terms as well as “qualitative methods” present in the titles or abstracts. The full search ( Supplementary Appendix 1 ) was conducted with the help of a clinical librarian. The search yielded 417 articles which were uploaded to Endnote X9 where 111 duplicates were removed. The remaining 307 articles were uploaded to Covidence Systematic Review Management Software for screening, with one additional duplicate removed. The search also yielded a previous review on the lived experiences of adults with ADHD ( 17 ). The ten articles present in this review were also uploaded to Covidence where two duplicates were removed resulting in 314 unique articles.

Study selection

Studies reporting original peer-reviewed qualitative data on the lived experience of adults with ADHD, including mixed-methods studies, were eligible for inclusion. “Adult” was defined as being 18 years of age or older; studies that included adolescent and young adult participants were only included if results were reported separately by age. Studies that included some participants without ADHD were included if results were reported separately by diagnosis. Any studies with adult participants who were exclusively reflecting on their childhood experiences with ADHD were considered outside this study’s scope, as were studies on family members, medical providers, or other groups commenting on adults with ADHD. Articles could be from any country, but needed to have been published in English. Individual case studies were not included due to concerns with generalizability.

Twenty percent of titles and abstracts were screened by two reviewers for meeting the inclusion criteria. Studies were not initially excluded based on participants’ ages as many titles and abstracts did not specify age. One reviewer screened the remaining abstracts; a second reviewer screened all excluded abstracts. For full-text screening, ten articles were screened by both reviewers to ensure consistency. One reviewer screened the remaining articles; a second reviewer screened all excluded articles.

Quality appraisal

Quality appraisal was completed by one reviewer using the Joanna Briggs Institute critical appraisal checklist for qualitative research ( 18 ). Half of included studies did not state philosophical perspectives, two-thirds did not locate researchers culturally or theoretically, nearly one-third did not include specific information about ethics approval, and only two studies commented on reflexivity ( Supplementary Appendix 2 ). Given the varied quality appraisal results and the small body of literature, all studies were included regardless of methodological rigor.

Data extraction

Data extracted included general study characteristics and methodology, participant characteristics (sample size, demographics, and country of residence), study aims, and text excerpts of qualitative results. Study characteristics were entered into a Google Sheets document. PDFs of all studies were uploaded into NVivo 12, and results sections were coded using grounded theory ( 19 ). One reviewer extracted and coded data; a second reviewed extracted data for thematic consistency.

Study characteristics

One-hundred-and-seventy-three articles were deemed relevant in title and abstract screening. Of these, 35 were included after the full-text review ( Figure 1 ). Articles were published between 2005 and 2021, and methodology mostly consisted of individual interviews (91%), with other studies utilizing focus groups (14%). Eight studies focused on young adults (18–35 years), and three were specific to older adults (>50 years). Two had exclusively male participants, and three had exclusively female participants. Nineteen were conducted in Europe, nine in North America, and three in Asia. No studies included participants from Africa, South America, or Oceania. In six studies, participants had current or prior SUDs, six studies focused on college students, four included participants diagnosed in adulthood, and two included highly educated/successful participants ( Table 1 ).

PRISMA flow diagram showing the search strategy for identifying qualitative studies on the lived experience of adult attention-deficit/hyperactivity disorder (ADHD).

Article characteristics of included studies.

1 Ages not reported consistently across studies.

2 Substance use disorder.

An overview of the identified themes is described in Figure 2 , and Table 2 provides a summary of main findings. Several of the themes overlap with each other, and such areas are identified in the main text.

Schematic diagram of the domains of features linked to the lived experiences of adults with ADHD.

Summary of results.

Adult diagnosis

Assessment and diagnosis of adult ADHD were reported as laborious and included prior misdiagnoses ( 20 – 22 ), lack of psychiatric resources ( 23 ), and physicians’ stigma regarding adult ADHD ( 24 ). Participants were often diagnosed only after their children were diagnosed ( 23 , 24 ). However, after receiving a diagnosis, relief was commonly reported initially. Adults noted that receiving a diagnosis helped explain previously seemingly inexplicable symptoms and feelings of being different, and allowed for participants to blame themselves less for perceived shortcomings ( 24 – 31 ).

Identity changes were another reported finding after diagnosis, both positive and negative. Some participants reported experiencing existential questioning of their identities ( 25 , 26 ); others reported feeling increased levels of self-awareness ( 26 , 28 ). Some participants reported having initial doubts about the validity of their diagnoses ( 26 , 28 ). Some reported experiencing emotional turmoil and concerns about the future ( 25 , 26 , 29 ). A commonly reported late step involved acceptance, both of themselves and their diagnoses, sometimes coupled with increased interest in researching ADHD ( 24 , 25 , 28 , 29 , 32 ). A ubiquitous finding was participant regret that they had not been diagnosed earlier, largely because of the many years they had gone without understanding their condition or receiving treatment ( 22 , 24 , 26 – 30 ). In one study, participants who had been diagnosed as children had better emotional control and self-esteem ( 33 ). No studies reported participant regret about their ADHD diagnosis.

Symptomatology of attention-deficit/hyperactivity disorder

Inattention, impulsivity, and hyperactivity.

Consistent with current diagnostic conceptualizations, difficulties with attention and concentration were described. These difficulties hindered completion of daily life tasks at home, school, and work ( 24 , 27 , 28 , 32 , 34 – 37 ). Some participants reported not experiencing a pervasive deficit of attention, but rather only struggling when the topic was not of personal interest and could sustain attention on interesting tasks for long periods of time ( 33 , 38 – 42 ). Attention could be influenced by the environment; for example, attention worsened in distracting environments or improved in intense, stimulating environments ( 40 , 41 ).

Impulsivity was widely reported and reflected in risk-taking including reckless driving, unprotected sex, and extreme sports ( 20 , 24 , 28 , 33 , 36 , 43 ). Impulsive spending was noted ( 20 , 36 – 38 , 44 ). Impulsive speech (“blurting out”) was common and often led to strained interpersonal relationships ( 24 , 32 , 33 , 36 , 37 , 40 ).

Fewer studies described participants’ struggles with hyperactivity, such as with staying still or not being constantly busy ( 24 , 34 , 36 ). Hyperactivity was reported as an internal symptom by some participants, noted as inner feelings of restlessness ( 22 , 36 , 37 , 39 ), or described as resulting in excessive talking ( 36 ). This more subtle hyperactivity was mostly reported by women or older adults.

Chaos, lack of structure, and emotions

Living in chaos was often reported, whether involving internal feelings of being unsettled ( 28 ), or external aspects such as turbulent schedules or disorganized living spaces ( 22 , 24 , 27 , 36 ). Participants often struggled with maintaining structure in daily routines, resulting in irregular sleeping and eating, difficulty completing household tasks, and strained social lives ( 36 – 38 , 43 , 44 ). Increased autonomy in adulthood was often perceived as difficult to manage compared to more highly structured childhoods.

Although lacking from current diagnostic criteria, emotional dysregulation was often noted. Participants reported experiencing extreme emotional reactions to interpersonal conflicts such as terminations of romantic relationships or receiving negative feedback at work ( 24 , 34 , 38 , 40 ). Negative feelings of anxiety and agitation were common ( 22 , 24 , 29 , 31 , 33 , 34 , 36 , 38 , 44 ), as was difficulty with controlling, recognizing, naming, and managing emotions ( 30 , 40 , 41 , 44 ). One study noted that emotional lability has positive aspects since participants’ emotional highs were higher ( 45 ).

Positive aspects of attention-deficit/hyperactivity disorder

Not all aspects of ADHD were perceived as negative. Impulsivity was reported by some as fun and spontaneous ( 26 , 37 , 45 ), struggles with attention were reported as promoting creativity and motivating focus on details ( 21 , 33 , 40 , 41 , 45 ), and hyperactivity was described as providing energy to pursue one’s passions ( 40 , 45 ). Learning to live with ADHD-related impairments was reported as promoting resilience and humanity ( 45 ), and increased tendencies to keep calm in chaotic settings ( 40 ). Ability to maintain focus for extended periods on topics of personal interest was sometimes seen as helpful, although unpredictable ( 33 ).

Adapting to symptoms

Coping skills.

Participants reported compensatory organizational strategies that increased structure in their daily lives. Creating regimented sleeping, eating, working, and relaxing schedules ( 30 , 35 , 42 , 44 , 46 ), and keeping to-do lists or using reminder apps ( 24 , 32 , 37 , 40 , 42 , 46 ) were frequently-reported strategies. Some participants reported thriving without formal structure while working from home since they were able to maintain daily routines and were free from distractions ( 34 ).

Participants reported being able to adjust their environment to best suit their needs, whether that be decreasing distracting stimulation ( 32 , 46 ) or cultivating a highly stressful and stimulating environment ( 39 ). Creating space for physical activity was reported as a helpful outlet for hyperactivity ( 24 , 33 , 39 , 43 , 46 ). Having awareness of their diagnosis allowed newly-diagnosed participants to attribute their symptoms to their disorder, thereby decreasing self-blame ( 24 , 26 , 32 ). In one study, participants engage in self-talk to modify their behavior ( 32 ). Participants reported implementing social skills to prevent interrupting others and adjusting their social circles to accommodate their symptoms ( 24 , 35 , 46 ).

Substance use was also described as a coping strategy, although there were also drawbacks associated with using substances. Such findings are discussed under “substance use.”

Stimulant medications were commonly used to help manage ADHD symptoms; participants reported that stimulants facilitated task prioritization, goal achievement, and productivity often to “life-changing” extents ( 22 , 24 – 27 , 29 , 32 , 35 , 40 , 46 – 48 ). Stimulants were sometimes reported as assisting with social and emotional functioning by promoting calmness ( 22 , 24 , 30 , 40 ). Some participants took their medications on an as-needed basis, choosing to take them only when they had much work ( 20 , 27 , 32 , 33 , 47 ). In one study, participants reported feeling pressured to sell their medication, and in another, participants reported increasing their dosages to stay up all night in order to better complete school work ( 27 , 47 ).

Participant ambivalence or hesitation to take stimulants was reported due to therapeutic and adverse effects. Reported adverse effects included “not feeling like oneself,” resulting in difficulties with socializing and creativity ( 22 , 27 , 35 , 40 , 47 ), somatic effects such as appetite suppression and insomnia ( 22 , 27 , 35 , 40 , 47 ), unpleasant emotions including irritability and numbness ( 35 , 40 , 47 ), and rebound symptoms and withdrawal side effects when the medications wore off ( 29 , 47 ).

Outside support

Studies noted participants adapting to living with their symptoms by receiving formal accommodations at work and school. Reported workplace accommodations included reduction of auditory distractions and bosses who would provide organizational advice or extra reminders about due dates ( 24 , 25 , 40 ). Reported accommodations in college consisted of separate testing environments and extra time on examinations. However, inaccessibility of disability offices, limited willingness of professors to comply with accommodations, and lack of participant engagement with accommodations due to not wanting to seem different resulted in many participants not utilizing such resources ( 27 , 32 ).

Individual therapy was reported as helpful for managing symptoms and acquiring self-knowledge, especially therapeutic interventions designed for ADHD and CBT ( 22 , 23 , 27 , 41 ). However, some participants reported minimal benefits from seeing therapists who did not specialize in ADHD, and CBT was reported to need improvement to be specially tailored to adults with ADHD such as being more engaging or being reframed as ADHD coaching ( 22 , 27 , 33 ). Community care workers added structure to some participants’ lives and aided with motivation in one study ( 42 ).

In some studies, participants expressed desires to be involved with support groups for adults with ADHD in order to learn new coping skills and find community, but not knowing where to access such services ( 28 , 40 ). Those who had participated in ADHD support or focus groups reported feeling validated and less isolated, as well leaving with improved strategies for symptom management ( 24 , 31 , 41 , 49 ). Support was also reported in personal relationships. Having a supportive partner often helped participants tremendously with organization and life tasks, especially for men married to women ( 24 , 43 ). A close friend or family member encouraging accountability and creating a sense of togetherness was viewed as advantageous ( 32 , 42 ).

Substance use and addiction

Reasons for substance use.

The SUDs were commonly reported among adults with ADHD and often seen as a form of self-medication. In every study that discussed self-medication, participants reported using substances to feel calm and relaxed; substances included nicotine/tobacco, alcohol, marijuana, cocaine, and methamphetamine ( 20 , 24 , 32 , 46 , 50 – 52 ). Nicotine/tobacco, marijuana, ecstasy (MDMA), and methamphetamine were used to help improve focus, particularly before diagnosis and subsequent to stimulant treatment ( 20 , 24 , 32 , 51 , 52 ). Participants also reported using substances to help feel “normal” as they facilitated social interactions and helped complete activities of daily life ( 20 , 50 , 52 ). One study described college males’ experiences with video game addictions which resulted in neglecting schoolwork ( 32 ).

The tendencies of people with ADHD to make impulsive decisions were suggested as linking ADHD and substance use ( 20 , 52 ). Substance use worsened ADHD symptoms, most notably impulsivity ( 44 , 52 ). One study attributed high rates of substance use to participants with ADHD being less fearful and more rebellious than individuals without ADHD ( 50 ).

Although discontinuing substance use was regarded as a difficult process with frequent relapses, participants considered their quality of life to improve after quitting ( 30 , 44 , 53 ). Nicotine withdrawal was reported to worsen ADHD symptoms, and participants desired smoking-cessation programs specifically tailored for those with ADHD ( 53 ). Even after discontinuation of substance use, participants reported difficulties accessing stimulant medication due to their substance-use histories ( 52 ).

Stimulants and use of other substances

Findings relating stimulant use and use of other substances were mixed. Prescription stimulant usage was reported as a protective factor against use of other substances. Participants who had previously been self-medicating reported that when they had been on stimulants, they did not need other substances to help them feel calm and focused ( 46 , 47 , 50 , 52 ). Stimulants were reported to decrease cigarette cravings ( 50 ). In one study, a participant commented that her stimulant prescription generated a hatred of taking pills, which she reported subsequently prevented her from using drugs ( 54 ).

Some participants reported stimulant prescriptions as increasing risk of substance use. Some reported that stimulants directly increased nicotine cravings ( 50 ). Indirect connections were reported, such as feelings of social exclusion due to being labeled as medicated or due to participants feeling used to taking drugs since childhood ( 54 ). Other participants reported no connection between stimulant medication and use of other substances ( 50 , 54 ).

Perceptions of self and diagnosis

Self-esteem.

Participants often reported experiencing low self-esteem which they attributed to feeling unable to keep up with work or school, being told they were not good enough by others, and frequently failing at life goals ( 24 , 27 – 29 , 33 , 36 , 37 , 41 , 43 ). Low self-image was typically worse in childhood and improved over time, especially after receiving a diagnosis ( 28 , 36 , 43 ). In one study, some participants did not see themselves as having any flaws despite repeatedly being told otherwise, possibly due to being distracted from the emotional impact of these remarks ( 29 ).

Views of attention-deficit/hyperactivity disorder

Some participants viewed ADHD as a personality trait or difference as opposed to a disorder or disability ( 31 , 32 , 39 , 41 , 45 ). Some participants reported finding the ADHD diagnosis limiting and not wanting the disorder to define who they were ( 27 , 28 ). When asked if they would want their ADHD “cured” in one study, participants’ responses ranged from “definitively yes” to “definitely no.” Many reported feeling ambivalent as they described both positive and negative aspects of ADHD ( 20 ).

Interactions with society

Relationships with others.

Difficulties building and maintaining relationships with others were regularly reported. Participants reported that impulsivity hindered their social interactions due to their tendencies to make inappropriate remarks, engage in reckless behaviors, and agree to engagements without thinking through consequences, resulting in being associated with people to whom they did not want to be linked ( 20 , 22 , 32 , 33 , 36 , 43 ). Reported organizational struggles contributed to participants frequently being late and having cluttered living spaces ( 24 , 38 ). Participants reported misunderstanding social norms and hierarchies and being hesitant about starting conversations ( 28 , 30 , 40 , 43 ). They reported feeling overwhelmed by others’ emotions and unsure how to respond to them ( 44 ). Some participants reported choosing to hide their ADHD diagnoses, and the resultant barrier made socializing feel exhausting ( 24 ). Participants reported that these factors made sustaining long-term relationships especially difficult ( 22 , 31 , 38 , 43 ).

Feeling different from others was widely reported, most notably in childhood ( 20 , 24 , 27 , 29 , 31 , 32 ). This experience was described as feeling misunderstood, like a misfit, abnormal, and/or like there was something wrong with them ( 20 , 24 , 27 , 29 , 33 , 43 , 45 , 50 ). Participants reported consciously pretending to be normal as an attempt to fit in ( 28 , 41 ). Some participants reported seeing themselves as more brave or rebellious than their peers, which sometimes resulted in positive self-images ( 24 , 36 , 50 ). A strong desire to advocate for “the underdog” in interpersonal relationships was described by some women ( 31 ). In one study, most participants did not describe feeling different from others, but reported having felt misunderstood as children ( 36 ).

Participants with ADHD who also had children diagnosed with ADHD reported that their approaches to their children’s diagnoses were shaped by their own ADHD experiences. Parents reported uniform support of diagnostic testing, although the best time for testing was not agreed-upon ( 26 , 48 ). Opinions on starting their children on stimulants varied, ranging from enthusiastic support to viewing medication as a last resort, even among participants who had responded positively to stimulants themselves ( 48 ). Most participants reported supporting shared decision-making with the child.

Outside perceptions of attention-deficit/hyperactivity disorder

Participants reported their social networks often expressed preconceived notions about the diagnosis, such as ADHD being “fake” or restricted to children ( 27 – 29 , 37 , 41 ). Stigma about ADHD was reported as having prevented many from disclosing their diagnosis both personally and professionally ( 24 , 26 , 28 , 29 , 32 ). Increased awareness and education about ADHD were desired by participants to help them function better in society ( 28 , 41 ).

Societal expectations

Some studies discussed participants’ difficulties with meeting societal expectations. Participants reported struggling to keep up with daily tasks such as maintaining their living spaces, paying bills and remembering to eat ( 28 , 33 , 35 , 41 ). These difficulties were reported to result in exasperation, low self-esteem, and exhaustion ( 29 , 33 ).

Education and occupation

Academic underachievement was widely reported; most studies focused on postsecondary education. Some participants reported having to try harder than their peers for the same results ( 28 , 35 ), while others reported that they fell behind due to not putting in much effort ( 24 , 27 ). Reports of low motivation to complete assignments until the last minute, as it then became easier to focus, led to missed deadlines ( 32 , 35 , 38 ). Participants reported difficulties paying attention in class ( 24 , 27 , 32 , 35 ), struggling with reading comprehension ( 27 , 32 ), and needing extra tutoring ( 24 , 28 ). Participants reported these difficulties prevented them from “reaching their potential” as they were unable to complete advanced courses or degrees necessary for their careers of choice ( 20 , 22 , 31 , 37 , 39 ). A third of participants in one study noted that they did not struggle academically ( 31 ). Reported coping mechanisms for mitigating academic impairment included medications ( 35 , 47 ), active engagement with materials facilitated by small class sizes or study groups ( 23 , 35 ), and studying from home with fewer distractions ( 34 ). Formal academic accommodations are discussed under the outside support subheading of adapting to symptoms.

Occupational struggles were commonly reported, with many studies detailing participant underemployment or unemployment and high job-turnover rates ( 22 , 31 , 33 , 37 , 41 , 43 ). Difficulties with punctuality and keeping up with tasks and deadlines were reported to generate tensions in the workplace ( 20 , 22 , 24 , 33 , 35 , 39 ), and participants reported frequently being bored and unable to stay focused on their responsibilities, with noisy workplaces promoting distractibility ( 20 , 24 , 33 , 35 , 39 , 40 ). Some studies noted difficulties understanding and navigating social hierarchies in the workplace ( 20 , 40 ). In one study, participants reported feeling unable to maintain work-life balance, overworking until they felt burnt out ( 36 ). Working in fields of intrinsic interest, multitasking, and self-employment were reported strategies used to achieve occupational success ( 24 , 31 , 40 ). Having an understanding employer who could assist with task delegation and understand their needs was described as promoting positive workplace dynamics ( 25 , 33 , 40 ). Clearly defied roles and working with others helped some participants remain engaged in work ( 42 ). College students often reported part-time jobs as rewarding, with responsibilities helping them manage their academic pursuits ( 35 ).

Accessing services

Adults described difficulties accessing healthcare for ADHD. Most reported having to fight to receive a diagnosis and medication due to perceptions of stigma from physicians about adult ADHD ( 22 ). After diagnosis, participants often felt they did not receive adequate counseling or follow-up, especially when seeing general practitioners ( 22 , 26 ). Many participants reported not seeing physicians regularly for medication management due to bureaucratic difficulties ( 21 ); college students reported often having their former pediatricians refill prescriptions without regular appointments ( 47 ). Many participants in one study had little knowledge of ADHD services available to them despite regular appointments ( 32 ).

This review characterizes the current literature on the lived experiences of adults with ADHD. This includes experiences of having been diagnosed as an adult, symptomatology of adult ADHD, skills used to adapt to ADHD symptoms, relationships between ADHD and substance use, individual perceptions of self and of having received ADHD diagnoses, and social experiences interacting in society.

Similar themes were noted in a previous review on lived experiences of adults with ADHD consisting of ten studies, three of which were included here ( 17 ). Such themes included participants feeling different from others, perceiving themselves as creative, and implementing coping skills. There were also other similar findings from a review of eleven studies on the experiences of adolescents with ADHD ( 55 ). Overlapping themes included participants feeling that ADHD symptomatology has some benefits, experiencing difficulties with societal expectations, emotions and interpersonal conflicts, struggling with identity and stigma, and having varying experiences with stimulants. The overlaps in findings from these two reviews suggest there are shared experiences between adolescents and adults with ADHD. Unique from previous reviews on lived experiences of people with ADHD are the present qualitative findings of experiences of having received diagnoses in adulthood, reflections on ADHD and substance use, occupational struggles, attention dysregulation, and emotional symptoms of ADHD.

The relationship between ADHD effects and poor occupational performance has been previously described. People with ADHD often struggle with unemployment and underemployment and functional impairment at work ( 56 – 58 ). The findings of this review suggest that adults with ADHD may benefit from workplace accommodations and from decreased stigma around adult ADHD.

Findings suggest that people with ADHD often experience attention dysregulation as opposed to attention deficits, per se . This notion builds on previous clinical observations ( 59 ) and quantitative literature ( 60 , 61 ) documenting that adults with ADHD may hyperfocus on tasks of interest. These findings suggest that inattention does not fully capture the attentional symptoms of the condition and suggest a possible need for updated diagnostic criteria.

Emotional dysregulation was described by many studies in this review, and there were no studies in which participants denied struggling with emotions. These findings provide support for a conceptual model of ADHD that presents emotional dysregulation as a core feature of ADHD, as opposed to models stating that emotional dysregulation is a subtype of ADHD or simply that the domains are correlated ( 62 ). Debates exist regarding whether or not specific clinical aspects of disorders constitute core or diagnostic features ( 63 ). The DSM-5 and ICD-11 have viewed differently the criteria for specific disorders, including with respect to engagement for emotional regulation or stress-reduction purposes [e.g., behavioral addictions like gambling and gaming disorders, and other behaviors relating to compulsive sexual engagement ( 3 , 64 , 65 )]. Because emotional dysregulation is often overlooked as being associated with ADHD, patients experiencing such symptoms may be mistaken for having other conditions such as mood or personality disorders. Appreciating the emotional symptoms of ADHD may help psychiatrists, psychologists, and social workers more accurately diagnose ADHD in adults and decrease misdiagnosis.

The recurrent themes of difficulty naming and recognizing emotions found here suggest that ADHD may be associated with alexithymia. One study found that 22% of adults with ADHD were highly alexithymic but their mean scores on the rating scale for alexithymia were not significantly different from controls ( 66 ). Parenting style, attachment features, and ADHD symptoms have been found to predict emotional processing and alexithymia measures among adults with ADHD ( 67 ). More research is needed into the relationship between ADHD symptoms and alexithymia.

There was considerable heterogeneity in wishes regarding cures for ADHD (suggesting both perceived benefits and detriments) and stimulant use being association with SUDs. From a clinical perspective, both points will be important to understand better. With regard to the latter, ADHD and SUDs frequently co-occur; one meta-analysis found that 23% of people with SUDs met criteria for ADHD ( 68 ). Furthermore, youth with ADHD are seven-fold more likely than those without to experience/develop SUDs; however, early treatment with stimulants appeared to decrease this risk ( 69 ). Understanding better motivations for substance use in adults with ADHD as may be gleaned through considering lived experiences may help decrease ADHD/SUD co-occurrence and improve quality of life.

This review highlights gaps in the qualitative literature on adult ADHD. Nearly all included studies took place in Europe, North America or Asia; there is a dearth of qualitative research on ADHD in the Global South. Although most studies did not report race, those that did often had a majority of White participants. Racial/ethnic disparities in ADHD diagnosis may contribute to the relatively low diversity of study participants ( 9 ), and such disparities are further reason to expand research focused on non-White individuals with ADHD. Most studies focused on young or middle-aged adults and most participants were male; more research is needed on how ADHD may impact older adults and other gender identities. Although long considered to disproportionately affect male children at approximately 3:1 ( 70 ), ADHD in adults has been reported to have gender ratios of 1.5:1 ( 71 ). Among the adult psychiatric population, some studies have found no gender difference in prevalence or up to a 2.5:1 female predominance ( 72 ). This finding suggests that women often may not receive diagnoses until adulthood and there may be strong links with other psychopathologies in women. The lived experience of women with ADHD should be further examined; this insight may help to understand why women often go undiagnosed and experience other psychiatric concerns.

Future qualitative studies should explore how ADHD symptoms change over the lifespan as this was not addressed in any of the included studies. There were very few findings relating to how adults with ADHD conceptualize the condition and how their diagnosis interacts with their identities. Some studies reported on difficulties adults with ADHD have with accessing services; further exploration is needed into how the medical community can better meet the needs of this population. Findings from this review may be used to inform future ADHD screening tools. The Adult ADHD Self-Report Scale (ASRS) is a widely used screening tool that covers symptoms of inattention, impulsivity, and hyperactivity ( 73 ). This review suggests that symptoms may be more expansive than what is included in the ASRS and that questions on attentional dysregulation and hyperfocusing, emotional dysregulation, internal chaos, low self-esteem, and strained interpersonal relationships could be tested for validity for inclusion. The Conners’ Adult ADHD Rating Scales (CAARS) includes questions on emotional lability and low self-esteem in addition to symptoms covered by the ASRS ( 74 ), although the scale has been found to have high false-positive and false-negative rates ( 75 ). Further studies are needed to develop screening tools that capture the lived experience of adults with ADHD while maintaining appropriate sensitivity and specificity. This review may also inform tailoring CBT and other therapeutic interventions for ADHD. For example, CBT may help develop skills for volitional hyperfocusing on productive tasks instead of feeling pulled away from daily activities.

This study has limitations. Being a rapid review, it was not an exhaustive search of the available literature and may have missed some relevant studies that would have been identified by a systematic search. The search strategy consisted of ADHD and qualitative research methods; studies that did not include “qualitative” in their titles or abstracts may not have been identified. This may explain why the previous review on the lived experiences of adults with ADHD ( 17 ) included studies not identified by this search. Although a formal quality appraisal was completed, all studies were included regardless of the quality assessment as to not further narrow the review. For example, studies were not excluded based on how they verified ADHD diagnosis as many studies did not specify if or how this was completed. Although restricting studies based on quality metrics may have made the present findings more robust, the amount of data that would have been excluded would have been considerable and may have resulted in omitting important findings. These variable quality metrics not only limit the findings of the present review, but also speak to limitations in the methodological rigor of qualitative research on adult ADHD.

Attention-deficit/hyperactivity disorder is a relatively common diagnosis among adults. Exploration of the lived experiences of adults with ADHD may illuminate the breadth of symptomatology of the condition and should be considered in the diagnostic criteria for adults. Understanding symptomatology of adults with ADHD and identifying areas of unmet need may help guide intervention development to improve the quality of life of adults with ADHD.

Author contributions

CG and MP contributed to the conception of the review. CG and GM-G performed the abstract and full text screening. CG performed the data synthesis and wrote the first draft of the manuscript. GM-G, GA, KB, and MP contributed to the revising and editing the manuscript. All authors read and approved the submitted version.

Acknowledgments

We would like to express gratitude to clinical librarian Courtney Brombosz for her assistance in developing the search strategy.

This work was supported by the Yale School of Medicine Office of Student Research One-Year Fellowship and the K12 DA000167 grant.

Conflict of interest

MP has consulted for and advised Opiant Pharmaceuticals, Idorsia Pharmaceuticals, BariaTek, AXA, Game Day Data, and the Addiction Policy Forum; has been involved in a patent application with Yale University and Novartis; has received research support from the Mohegan Sun Casino and Connecticut Council on Problem Gambling; has participated in surveys, mailings or telephone consultations related to drug addiction, impulse control disorders or other health topics; and has consulted for law offices and gambling entities on issues related to impulse control or addictive disorders. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fpsyt.2022.949321/full#supplementary-material

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• Volume 90, Issue suppl 1
• The effect of ADHD on the life of an individual, their family, and community from preschool to adult life
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• Correspondence to: Dr V A Harpin Ryegate Children’s Centre, Sheffield Children’s NHS Trust, Tapton Crescent Road, Sheffield S10 5DD, UK; Val.Harpinsheffch-tr.trent.nhs.uk

Attention deficit/hyperactivity disorder (ADHD) may affect all aspects of a child’s life. Indeed, it impacts not only on the child, but also on parents and siblings, causing disturbances to family and marital functioning. The adverse effects of ADHD upon children and their families changes from the preschool years to primary school and adolescence, with varying aspects of the disorder being more prominent at different stages. ADHD may persist into adulthood causing disruptions to both professional and personal life. In addition, ADHD has been associated with increased healthcare costs for patients and their family members.

• CHQ, Child Health Questionnaire
• ODD, oppositional defiant disorder

https://doi.org/10.1136/adc.2004.059006

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Attention deficit/hyperactivity disorder (ADHD) is a chronic, debilitating disorder which may impact upon many aspects of an individual’s life, including academic difficulties, 1 social skills problems, 2 and strained parent-child relationships. 3 Whereas it was previously thought that children eventually outgrow ADHD, recent studies suggest that 30–60% of affected individuals continue to show significant symptoms of the disorder into adulthood. 4 Children with the disorder are at greater risk for longer term negative outcomes, such as lower educational and employment attainment. 5 A vital consideration in the effective treatment of ADHD is how the disorder affects the daily lives of children, young people, and their families. Indeed, it is not sufficient to merely consider ADHD symptoms during school hours—a thorough examination of the disorder should take into account the functioning and wellbeing of the entire family.

As children with ADHD get older, the way the disorder impacts upon them and their families changes (fig 1 ⇓ ). The core difficulties in executive function seen in ADHD 7 result in a different picture in later life, depending upon the demands made on the individual by their environment. This varies with family and school resources, as well as with age, cognitive ability, and insight of the child or young person. An environment that is sensitive to the needs of an individual with ADHD and aware of the implications of the disorder is vital. Optimal medical and behavioural management is aimed at supporting the individual with ADHD and allowing them to achieve their full potential while minimising adverse effects on themselves and society as a whole.

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 Stages of ADHD. Adapted from Kewley G (1999). 6

The aim of this paper is to follow the natural history of this complex disorder through preschool years, school life, and adulthood and to consider its effect on the family, the community, and society as a whole. In addition, comorbidities and healthcare costs are examined.

THE PRESCHOOL CHILD

Poor concentration, high levels of activity, and impulsiveness are frequent characteristics of normal preschool children. Consequently, a high level of supervision is the norm. Even so, children with ADHD may still stand out. In this age group there is often unusually poor intensity of play and excessive motor restlessness. 8, 9 Associated difficulties, such as delayed development, oppositional behaviour, and poor social skills, may also be present. If ADHD is a possibility, it is vital to offer targeted parenting advice and support. Even at this early stage parental stress may be huge when a child does not respond to ordinary parental requests and behavioural advice. 9 Targeted work with preschool children and their carers has been shown to be effective in improving parent child interaction and reducing parental stress. 10, 11 A useful review of the available evidence and methods is provided by Barkley. 12

PRIMARY SCHOOL YEARS

The primary school child with ADHD frequently begins to be seen as being different as classmates start to develop the skills and maturity that enable them to learn successfully in school. Although a sensitive teacher may be able to adapt the classroom to allow an able child with ADHD to succeed, more frequently the child experiences academic failure, rejection by peers, and low self esteem (fig 2 ⇓ ). Comorbid problems, such as specific learning difficulties, may also start to impact on the child, further complicating diagnosis and management. Assessment by an educational psychologist may help to unravel learning strengths and difficulties, and advise on necessary support in the classroom.

 Emotional and family functioning in children with ADHD compared with controls. 13 *Higher scores indicative of greater functioning. CHQ, Child Health Questionnaire. 13

Frequently, difficulties at home or on outings with carers (for example, when shopping, out in the park, or visiting other family members) also become more apparent at this age. Parents may find that family members refuse to care for the child, and that other children do not invite them to parties or out to play. Many children with ADHD have very poor sleep patterns, and although they appear not to need much sleep, daytime behaviour is often worse when sleep is badly affected. As a result, parents have little time to themselves; whenever the child is awake they have to be watching them. Not surprisingly, family relationships may be severely strained, and in some cases break down, bringing additional social and financial difficulties. 14 This may cause children to feel sad or even show oppositional or aggressive behaviour.

Assessing the quality of life of the child suffering from ADHD is difficult. Behavioural assessments are usually carried out by parents, teachers, or healthcare professionals, and it can usually only be inferred how the child must feel. However, data from self evaluations indicate that children with ADHD view their most problematic behaviour as less within their control and more prevalent than children without ADHD. 15 Participation in a school based, nurse led support group was associated with an increase in self worth in pre-adolescents with ADHD. 16

Johnston and Mash reviewed the evidence of the effect of having a child with ADHD on family functioning. 14 They concluded that the presence of a child with ADHD results in increased likelihood of disturbances to family and marital functioning, disrupted parent-child relationships, reduced parenting efficacy, and increased levels of parent stress, particularly when ADHD is comorbid with conduct problems.

In a survey of the mothers and fathers of 66 children, parents of children with ADHD combined and inattentive subtypes expressed more role dissatisfaction than parents of control children. 17 Furthermore, ADHD in children was reported to predict depression in mothers. 18 Pelham et al reported that the deviant child behaviours that represent major chronic interpersonal stressors for parents of ADHD children are associated with increased parental alcohol consumption. 19

Limited attention has been given to sibling relationships in families with ADHD children. While it has been reported that siblings of children with ADHD are at increased risk for conduct and emotional disorders, 20 a more recent study presenting sibling accounts of ADHD identified disruption caused by symptoms and behavioural manifestations of ADHD as the most significant problem. 21 This disruption was experienced by siblings in three primary ways: victimisation, caretaking, and sorrow and loss. Siblings reported feeling victimised by aggressive acts from their ADHD brothers through overt acts of physical violence, verbal aggression, and manipulation and control. In addition, siblings reported that parents expected them to care for and protect their ADHD brothers because of the social and emotional immaturity associated with ADHD. Furthermore, as a result of the ADHD symptoms and consequent disruption, many siblings described feeling anxious, worried, and sad. 21

Broader social and family functioning has been assessed using the Child Health Questionnaire (CHQ), a parent rated health outcome scale that measures physical and psychosocial wellbeing. 22– , 24 The studies demonstrated that treatment of ADHD with atomoxetine, a new non-stimulant medication for ADHD, resulted in improved perception of quality of life, with improvements being apparent in social and family functioning, and self esteem. Further research assessing the ongoing quality of life for the child and their family following multimodal input is urgently needed.

ADHD IN YOUNG PEOPLE

Adolescence may bring about a reduction in the overactivity that is often so striking in younger children, but inattention, impulsiveness, and inner restlessness remain major difficulties. A distorted sense of self and a disruption of the normal development of self has been reported by adolescents with ADHD. 25 Furthermore, excessively aggressive and antisocial behaviour may develop, adding further problems (fig 3 ⇓ ). A study by Edwards et al 27 examined teenagers with ADHD and oppositional defiant disorder (ODD), which is defined by the presence of markedly defiant, disobedient, provocative behaviour and by the absence of more severe dissocial or aggressive acts that violate the law or the rights of others. These teenagers rated themselves as having more parent-teen conflict than did community controls. Increased parent-teen conflict was also reported when parents of teenagers with ADHD carried out the rating exercise. In addition, a survey of 11–15 year olds showed that those with hyperkinesis were twice as likely as the overall population to have “a severe lack of friendship”. 28

 Antisocial behaviour in adolescents with ADHD. 26 Data primarily represents outcomes in those with conduct disorder as teenagers.

Young people with ADHD are at increased risk of academic failure, dropping out of school or college, teenage pregnancy, and criminal behaviour (fig 4A ⇓ and B). Driving poses an additional risk. Individuals with ADHD are easily distracted from concentrating on driving when going slowly, but while driving fast may also be dangerous. It has been shown that, compared with age matched controls, drivers with ADHD are at increased risk of traffic violations, especially speeding, and are considered to be at fault in more traffic accidents, including fatal ones (fig 5 ⇓ ). 30 The risk of such events was increased further by the presence of concomitant ODD. 29 However, it has been suggested that treatment may have a positive effect on driving skills. 31

 Impact of ADHD in adolescence. Data from Barkley RA; 26 (A) Impact at school; (B) impact on health, social, and psychiatric wellbeing.

 Driving-related offences in young adults with ADHD and controls. NS, not significant. Data from Barkley RA et al . 29

As many as 60% of individuals with ADHD symptoms in childhood continue to have difficulties in adult life. 32, 33 Adults with ADHD are more likely to be dismissed from employment and have often tried a number of jobs before being able to find one at which they can succeed. 5 They may need to choose specific types of work and are frequently self employed. In the workplace, adults with ADHD experience more interpersonal difficulties with employers and colleagues. Further problems are caused by lateness, absenteeism, excessive errors, and an inability to accomplish expected workloads. At home, relationship difficulties and break-ups are more common. The risk of drug and substance abuse is significantly increased in adults with persisting ADHD symptoms who have not been receiving medication. 34 The genetic aspects of ADHD mean that adults with ADHD are more likely to have children with ADHD. This in turn causes further problems, especially as the success of parenting programmes for parents of children with ADHD is highly influenced by the presence of parental ADHD. 35 Thus, ADHD in parents and children can lead to a cycle of difficulties.

COMORBIDITIES

Comorbid disorders may impact on individuals with ADHD throughout their lives. It is estimated that at least 65% of children with ADHD have one or more comorbid conditions. 36 The reported incidence of some of the most frequent comorbidities is shown in figure 6 ⇓ , with neurodevelopmental problems, such as dyslexia and developmental coordination disorder, being particularly common. Many children with ADHD also suffer from tic disorders (not related to stimulant medication). In addition, around 60% of children with Tourette’s Syndrome fulfil criteria for ADHD, 38, 39 and autistic spectrum disorder is increasingly recognised with comorbid ADHD. 39 Initially, excessive hyperactivity may mask the features of autistic spectrum disorder until the child receives medication. Conduct disorder and ODD coexist with ADHD in at least 30%, and in some reports up to 90%, of cases. 36 These most frequently occurring comorbidities can, however, be considered more as complications of ADHD, with adversity in their psychological environment possibly determining whether children at risk make the transition to antisocial conduct. 40

 ADHD and comorbidity in Swedish school age children. 37 MR, mental retardation; RWD, reading/writing disorder; DC, developmental coordination; ODD, oppositional defiant disorder.

PROBLEMS ASSOCIATED WITH TREATMENT

Growth deficits in children receiving stimulant treatment for ADHD have long been the subject of scientific discussion. Conflicting results have been reported with some authors indicating that stimulants do indeed affect growth in children, 41– , 43 but that this only occurs during active treatment phase and does not compromise final height. 44 Other studies, however, have not found any evidence to suggest that stimulants influence growth. 45, 46 Taken together, the results suggest that clinicians should monitor the growth of hyperactive children receiving stimulants, and consider dose reduction in individual cases should evidence of growth suppression occur.

Another frequently quoted concern about treatment of ADHD with stimulant medications is that it could lead to drug addiction in later life. Young people with ADHD are by nature impulsive risk takers, and there is clear evidence that untreated ADHD—especially with concomitant conduct disorder—is associated with a three- to fourfold increase in the risk of substance misuse. 47, 48 In contrast, patients medicated with stimulants have a similar risk of substance misuse to controls. 49 These data therefore provide strong evidence in favour of careful treatment and support for young people with ADHD.

HEALTHCARE COSTS

Healthcare costs for individuals with ADHD in the UK have not been fully estimated, but evidence from the USA suggests that they are increased compared with age matched controls. A population based, historical cohort study followed 4880 individuals from 1987 to 1995 and compared the nine year median medical cost per person: ADHD medical costs were US$4306, whereas non-ADHD medical costs were US$1944 (p<0.01). 50 These findings are likely to reflect increased injury following accidents and a rise in use of substance abuse services and other outpatient facilities, although poor ability to comply with advice on medication (for example, asthma management) may also be implicated. A study of the injuries to children with ADHD established that children with ADHD were more likely to be injured as pedestrians or bicyclists than children not suffering from ADHD. They were more likely to sustain injuries to multiple body regions, head injuries, and to be severely injured. 51 ADHD has been found to represent a risk factor for substance abuse, 47, 52 and an investigation of prevalence of ADHD among substance abusers has established that ADHD was significantly overrepresented among inpatients with psychoactive substance use disorder. 53 Increased use of health services is also seen in the relatives of individuals with ADHD. A study has shown that direct and indirect medical costs were twice as high as those of family members of a control group. 54 The difference in these costs was primarily due to a higher incidence of mental health problems in the family members of ADHD patients, which reflects the increased stresses and demands of living with an adult or child with ADHD. Indeed, ADHD related family stress has been linked to increased risk of parental depression and alcohol related disorders. 55– , 57

It is vital to consider the role of treatment of ADHD in decreasing the individual’s risk of adverse outcomes. A number of studies on the effect of treatment of ADHD on the risk of substance abuse encouragingly demonstrate a fall in risk to that of the normal population. 58– , 60

Mannuzza’s review of the long term prognosis in ADHD concludes that childhood ADHD does not preclude high educational and vocational achievements (for example, Master’s degree or medical qualification). 61 However, ADHD is a disorder that may affect all aspects of a child’s life. Careful assessment is paramount, and if this demonstrates significant impairment as a result of ADHD, there is clear evidence that treatment of ADHD should be instituted. 62, 63 Current treatment focuses mainly on the short term relief of core symptoms, mainly during the school day. This means that important times of the day, such as early mornings before school and evening to bedtime, are frequently unaffected by current treatment regimes. This can negatively impact on child and family functioning and fail to optimise self esteem and long term mental health development.

In 2003, the American Academy of Pediatrics recommended that clinicians should work with children and their families to monitor the success (or failure) of treatment, using certain criteria to assess specific areas of difficulty and quality of life as a whole. 64 There has been a reluctance in the UK to treat ADHD with medication, fuelled by concerns about possible over-prescription in the USA. In addition, newspaper and media coverage of ADHD is often negative and stigmatising. The evidence of potentially severe difficulties for the child, the family, and, in some cases, for society as a whole, means that coordinated multi-agency effort to support the child and family is essential. Moreover, healthcare professionals have an important role in providing balanced and supportive information about ADHD and meeting the needs of affected individuals and their families.

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Linked Articles

• Editorial Introduction P Hill Archives of Disease in Childhood 2005; 90 i1-i1 Published Online First: 21 Jan 2005. doi: 10.1136/adc.2004.058842

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The Impact of ADHD on Academic Performance

The importance of advocating for your child with their educators..

Posted February 17, 2023 | Reviewed by Tyler Woods

• What Is ADHD?
• Find a therapist to help with ADHD
• ADHD symptoms contribute to poor academic performance.
• The symptoms of inattentive-type ADHD make it difficult diagnose in school-age children.
• Advocating for your child with educators can improve their academic performance.
• Working with your child’s ADHD is key to their academic success.

A major concern for parents of ADHD children is their performance in school, and parents often worry over criticizing their children for behaviors like difficulty finishing homework . Poor academic performance can result in failing grades, skipping school, dropping out of high school, or not attending college.

Inattentive-type ADHD is difficult to identify

Children with the inattentive subtype of ADHD can fly under the radar at school and at home with symptoms of inattention, forgetfulness, and disorganization. Michael Jellineck, professor of psychiatry and pediatrics at Harvard Medical School, has estimated children with ADHD could receive as many as 20,000 corrections for their behavior in school by the time they are 10 years old. The symptom of inattentive-type ADHD, including behaviors like disappearing to the bathroom or nurse’s office during class to avoid a disliked task, are difficult to identify correctly as the inattentive subtype and can often be confused with other behavioral problems.

According to the Centers for Disease Control 2017 report, nine out of ten children with ADHD received classroom accommodations in school. However, most children with ADHD are not in special education programs and their teachers may know little about ADHD behaviors. Knowledge of ADHD, including symptoms, behaviors, prognosis, and treatment, varies among teachers (Mohr-Jennsen et al., 2019), and educators are most knowledgeable about the “hallmark” symptoms of ADHD, like students fidgeting or squirming in their seat and being easily distracted by extraneous stimuli (Scuitto et al., 2016).

Advocating for your child

Since my son’s inattentive ADHD is not outwardly apparent (i.e., he isn’t hyperactive or disruptive in the classroom), advocating for him, and teaching him to advocate for himself, is one of my most important jobs as a parent. I was inspired by the story of a father who would send letters to his son’s teachers explaining the boy’s learning disability. Knowing my son’s performance did not always reflect his capabilities, I emailed my son’s middle and high school teachers at the beginning of each semester detailing his ADHD, his weaknesses, and, most importantly, his strengths. I was pleasantly surprised that the reaction from many of my son’s teachers over the years was positive; they were grateful for parental communication and support. Teachers with a greater understanding of ADHD recognize the benefit of behavioral and educational treatments and are more likely to help their students (Ohan et al., 2008). In my son’s case, educators who either had ADHD themselves, or sought to learn about it, had the biggest impact in terms of my son’s academic success.

Practical strategies for common academic struggles

Due to the executive function deficits that accompany ADHD, our kids cannot just “try harder” to get good grades. They are already working harder than their peers to stay afloat in school. According to Mayes and Calhoun (2000) more than half of ADHD children struggle with written expression, my son included. Executive function deficits in ADHD make organizing ideas, planning, and editing difficult. I helped my son by having him talk it out when he had to write an essay for school (this was also an accommodation in his 504 plan to help him answer essay questions on tests and other assignments). I would start by asking him to tell me one fact about his essay’s topic. I found that he knew what he wanted to say, but organizing his thoughts on the page was an overwhelming and difficult task for him. I would furiously type while he talked, then gave him the notes, making it much easier for him to compose his essay. Another strategy was to have him incorporate something about a topic he was interested in, if possible. Anytime my son could write something about outer space or rockets he struggled less, even being selected as a national finalist in a NASA-sponsored essay contest about traveling to Mars.

Approximately 25-40% of patients with ADHD have major reading and writing difficulties, and ADHD frequently co-occurs with other learning disabilities like dyslexia, which makes reading difficult. In addition, the inattention symptoms of ADHD likely interfere with reading ability, resulting in reading the same paragraph over and over without retaining the information. As parents, we have to accept that our ADHD kids learn differently and not be concerned with the traditional, or 'right' way of doing something. My son retained information from required reading in school much better when he listened to an audiobook, rather than trying to painstakingly read the book. What did it matter if my son read the book or listened to it being read? Let’s take a cue from our ADHD kids and think outside the box.

Learning to work with my son’s ADHD gave me a better understanding of his strengths and weaknesses when it came to his academic performance. As a result, I was a better advocate for him and was able to work with his teachers to ensure his academic success.

Albert, M., Rui, P., & Ashman, J.J. (2017). Physician office visits for attention-deficit/hyperactivity disorder in children and adolescents Aged 4–17 Years: United States, 2012–2013 . National Center for Health Statistics. https://www.cdc.gov/nchs/products/ databriefs/db269.htm.

Mayes, S.D. & Calhoun, S. (2000, April). Prevalence and degree of attention and learning problems in ADHD and LD. ADHD Reports , 8 (2).

Mohr-Jensen, C., Steen-Jensen, T., Bang Schnack, M., &Thingvad, H. (2019). What do primary and secondary school teachers kno about ADHD in children? Findings from a systematic review and a representative, nationwide sample of Danish teachers. Journal of Attention Disorders 23(3): 206-219.

Ohan, J. L., Cormier, N., Hepp, S. L., Visser, T. A. W., & Strain, M. C. (2008). Does knowledge about attention-deficit/hyperactivity disorder impact teachers' reported behaviors and perceptions? School Psychology Quarterly, 23 (3), 436–449.

Sciutto, M.J., Terjesen, M.D., Kučerová, A., Michalová, Z., Schmiedeler, S., Antonopoulou, K., Shaker, N.Z., Lee, J., Lee, K., Drake, B., & Rossouw, J. (2016). Cross-national comparisons of teachers’ knowledge and misconceptions of ADHD. International Perspectives in Psychology 5(1): 34-50.

Kristin Wilcox, Ph.D. , has spent over 20 years in academia as a behavioral pharmacologist studying drug abuse behavior and ADHD medications at Emory University and Johns Hopkins University School of Medicine.

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Understanding and Supporting Attention Deficit Hyperactivity Disorder (ADHD) in the Primary School Classroom: Perspectives of Children with ADHD and their Teachers

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• Published: 01 July 2022
• Volume 53 , pages 3406–3421, ( 2023 )

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• Emily McDougal   ORCID: orcid.org/0000-0001-7684-7417 1 , 3 ,
• Claire Tai 1 ,
• Tracy M. Stewart   ORCID: orcid.org/0000-0002-8807-1174 2 ,
• Josephine N. Booth   ORCID: orcid.org/0000-0002-2867-9719 2 &
• Sinéad M. Rhodes   ORCID: orcid.org/0000-0002-8662-1742 1  

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Children with Attention Deficit Hyperactivity Disorder (ADHD) are more at risk for academic underachievement compared to their typically developing peers. Understanding their greatest strengths and challenges at school, and how these can be supported, is vital in order to develop focused classroom interventions. Ten primary school pupils with ADHD (aged 6–11 years) and their teachers (N = 6) took part in semi-structured interviews that focused on (1) ADHD knowledge, (2) the child’s strengths and challenges at school, and (3) strategies in place to support challenges. Thematic analysis was used to analyse the interview transcripts and three key themes were identified; classroom-general versus individual-specific strategies, heterogeneity of strategies, and the role of peers. Implications relating to educational practice and future research are discussed.

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Characterised by persistent inattention, hyperactivity and impulsivity (APA, 2013), ADHD is a neurodevelopmental disorder thought to affect around 5% of children (Russell et al., 2014 ) although prevalence estimates vary (Sayal et al., 2018 ). Although these core symptoms are central to the ADHD diagnosis, those with ADHD also tend to differ from typically developing children with regards to cognition and social functioning (Coghill et al., 2014 ; Rhodes et al., 2012 ), which can negatively impact a range of life outcomes such as educational attainment and employment (Classi et al., 2012 ; Kuriyan et al., 2013 ). Indeed, academic outcomes for children with ADHD are often poor, particularly when compared with their typically developing peers (Arnold et al., 2020 ) but also compared to children with other neurodevelopmental disorders, such as autism (Mayes et al., 2020 ). Furthermore, children with ADHD can be viewed negatively by their peers. For example, Law et al. ( 2007 ) asked 11–12-year-olds to read vignettes describing the behaviour of a child with ADHD symptoms, and then use an adjective checklist to endorse those adjectives that they felt best described the target child. The four most frequently ascribed adjectives were all negative (i.e. ‘careless’, ‘lonely’, ‘crazy’, and ‘stupid’). These negative perceptions can have a significant impact on the wellbeing of individuals with ADHD, including self-stigmatisation (Mueller et al., 2012 ). There is evidence that teachers with increased knowledge of ADHD report more positive attitudes towards children with ADHD compared to those with poor knowledge (Ohan et al., 2008 ) and thus research that identifies the characteristics of gaps in knowledge is likely to be important in addressing stigma.

Previous research of teachers' ADHD knowledge is mixed, with the findings of some studies indicating that teachers have good knowledge of ADHD (Mohr-Jensen et al., 2019 ; Ohan et al., 2008 ) and others suggesting that their knowledge is limited (Latouche & Gascoigne, 2019 ; Perold et al., 2010 ). Ohan et al. ( 2008 ) surveyed 140 primary school teachers in Australia who reported having experience of teaching at least one child with ADHD. Teachers completed the ADHD Knowledge Scale which consisted of 20 statements requiring a response of either true or false (e.g. “A girl/boy can be appropriately labelled as ADHD and not necessarily be over-active ”). They found that, on average, teachers answered 76.34% of items correctly, although depth of knowledge varied across the sample. Almost a third of the sample (29%) had low knowledge of ADHD (scoring less than 69%), with just under half of teachers (47%) scoring in the average range (scores of 70–80%). Only a quarter (23%) had “high knowledge” (scores above 80%) suggesting that knowledge varied considerably. Furthermore, Perold et al. ( 2010 ) asked 552 teachers in South Africa to complete the Knowledge of Attention Deficit Disorders Scale (KADDS) and found that on average, teachers answered only 42.6% questions about ADHD correctly. Responses of “don’t know” (35.4%) and incorrect responses (22%) were also recorded, indicating gaps in knowledge as well as a high proportion of misconceptions. Similar ADHD knowledge scores were reported in Latouche and Gascoigne’s ( 2019 ) study, who found that teachers enrolled into their ADHD training workshop in Australia had baseline KADDS scores of below 50% accuracy (increased to above 80% accuracy after training).

The differences in ADHD knowledge reported between Ohan et al. ( 2008 ) and the more recent studies could be due to the measures used. Importantly, when completing the KADDS, respondents can select a “don’t know” option (which receives a score of 0), whereas the ADHD Knowledge Scale requires participants to choose either true or false for each statement. The KADDS is longer, with a total of 39 items, compared to the 20-item ADHD Knowledge Scale, offering a more in-depth knowledge assessment. The heterogeneity of measures used within the described body of research is also highlighted within Mohr-Jensen et al. ( 2019 ) systematic review; the most frequently used measure (the KADDS) was only used by 4 out of the 33 reviewed studies, showing little consensus on the best way to measure ADHD knowledge. Despite these differences in measurement, the findings from most studies indicate that teacher ADHD knowledge is lacking.

Qualitative methods can provide rich data, facilitating a deeper understanding of phenomena that quantitative methods alone cannot reveal. Despite this, there are very few examples in the literature of qualitative methods being used to understand teacher knowledge of ADHD. In one example, Lawrence et al. ( 2017 ) interviewed fourteen teachers in the United States about their experiences of working with pupils with ADHD, beginning with their knowledge of ADHD. They found that teachers tended to focus on the external symptoms of ADHD, expressing knowledge of both inattentive and hyperactive symptoms. Although this provided key initial insights into the nature of teachers’ ADHD knowledge, only a small section of the interview schedule (one out of eight questions/topics) directly focused on ADHD knowledge. Furthermore, none of the questions asked directly about strengths, with answers focusing on difficulties. It is therefore difficult to determine from this study whether teachers are aware of strengths and difficulties outside of the triad of symptoms. A deeper investigation is necessary to fully understand what teachers know, and to identify areas for targeted psychoeducation.

Importantly, improved ADHD knowledge may impact positively on the implementation of appropriate support for children with ADHD in school. For example, Ohan et al. ( 2008 ) found that teachers with high or average ADHD knowledge were more likely to perceive a benefit of educational support services than those with low knowledge, and teachers with high ADHD knowledge were also more likely to endorse a need for, and seek out, those services compared to those with low knowledge. Furthermore, improving knowledge through psychoeducation may be important for improving fidelity to interventions in ADHD (Dahl et al., 2020 ; Nussey et al., 2013 ). Indeed, clinical guidelines recommend inclusion of psychoeducation in the treatment plan for children with ADHD and their families (NICE, 2018 ). Furthermore, Jones and Chronis-Tuscano ( 2008 ) found that educational ADHD training increased special education teachers’ use of behaviour management strategies in the classroom. Together, these findings suggest that understanding of ADHD may improve teachers’ selection and utilisation of appropriate strategies.

Child and teacher insight into strategy use in the classroom on a practical, day-to-day level may provide an opportunity to better understand how different strategies might benefit children, as well as the potential barriers or facilitators to implementing these in the classroom. Previous research with teachers has shown that aspects of the physical classroom can facilitate the implementation of effective strategies for autistic children, for example to support planning with the use of visual timetables (McDougal et al., 2020 ). Despite this, little research has considered the strategies that children with ADHD and their teachers are using in the classroom to support their difficulties and improve learning outcomes. Moore et al. ( 2017 ) conducted focus groups with UK-based educators (N = 39) at both primary and secondary education levels, to explore their experiences of responding to ADHD in the classroom, as well as the barriers and facilitators to supporting children. They found that educators mostly reflected on general inclusive strategies in the classroom that rarely targeted ADHD symptoms or difficulties specifically, despite the large number of strategies designed to support ADHD that are reported elsewhere in the literature (DuPaul et al., 2012 ; Richardson et al., 2015 ). Further to this, when interviewing teachers about their experiences of teaching pupils with ADHD, Lawrence et al. ( 2017 ) specifically asked about interventions or strategies used in the classroom with children with ADHD. The reported strategies were almost exclusively behaviourally based, for example, allowing children to fidget or move around the classroom, utilising rewards, using redirection techniques, or reducing distraction. This lack of focus on cognitive strategies is surprising, given the breadth of literature focusing on the cognitive difficulties in ADHD (e.g. Coghill, et al., 2014 ; Gathercole et al., 2018 ; Rhodes et al., 2012 ). Furthermore, to our knowledge research examining strategy use from the perspective of children with ADHD themselves, or strengths associated with ADHD, is yet to be conducted.

Knowledge and understanding of ADHD in children with ADHD has attracted less investigation than that of teachers. In a Canadian sample of 8- to 12-year-olds with ADHD (N = 29), Climie and Henley ( 2018 ) found that ADHD knowledge was highly varied between children; scores on the Children ADHD Knowledge and Opinions Scale ranged from 5 to 92% correct (M = 66.53%, SD = 18.96). The authors highlighted some possible knowledge gaps, such as hyperactivity not being a symptom for all people with ADHD, or the potential impact upon social relationships, however the authors did not measure participant’s ADHD symptoms, which could influence how children perceive ADHD. Indeed, Wiener et al ( 2012 ) has shown that children with ADHD may underestimate their symptoms. If this is the case, it would also be beneficial to investigate their understanding of their own strengths and difficulties, as well as of ADHD more broadly. Furthermore, if children do have a poor understanding of ADHD, they may benefit from psychoeducational interventions. Indeed, in their systematic review Dahl et al. ( 2020 ) found two studies in which the impact of psychoeducation upon children’s ADHD knowledge was examined, both of which reported an increase in knowledge as a consequence of the intervention. Understanding the strengths and difficulties of the child, from the perspective of the child and their teacher, will also allow the design of interventions that are individualised, an important feature for school-based programmes (Richardson et al., 2015 ). Given the above, understanding whether children have knowledge of their ADHD and are aware of strategies to support them would be invaluable.

Teacher and child knowledge of ADHD and strategies to support these children is important for positive developmental outcomes, however there is limited research evidence beyond quantitative data. Insights from children and teachers themselves is particularly lacking and the insights which are available do not always extend to understanding strengths which is an important consideration, particularly with regards to implications for pupil self-esteem and motivation. The current study therefore provides a vital examination of the perspectives of both strengths and weaknesses from a heterogeneous group of children with ADHD and their teachers. Our sample reflects the diversity encountered in typical mainstream classrooms in the UK and the matched pupil-teacher perspectives enriches current understandings in the literature. Specifically, we aimed to explore (1) child and teacher knowledge of ADHD, and (2) strategy use within the primary school classroom to support children with ADHD. This novel approach, from the dual perspective of children and teachers, will enable us to identify potential knowledge gaps, areas of strength, and insights on the use of strategies to support their difficulties.

Participants

Ten primary school children (3 female) aged 7 to 11 years (M = 8.7, SD = 1.34) referred to Child and Adolescent Mental Health Services (CAMHS) within the NHS for an ADHD diagnosis were recruited to the study. All participant characteristics are presented in Table 1 . All children were part of the Edinburgh Attainment and Cognition Cohort and had consented to be contacted for future research. Children who were under assessment for ADHD or who had received an ADHD diagnosis were eligible to take part. Contact was established with the parent of 13 potential participants. Two had undergone the ADHD assessment process with an outcome of no ADHD diagnosis and were therefore not eligible to take part, and one could not take part within the timeframe of the study. The study was approved by an NHS Research Ethics Committee and parents provided informed consent prior to their child taking part. Co-occurrences data for all participants was collected as part of a previous study and are reported here for added context. All of the children scored above the cut-off (T-score > 70) for ADHD on the Conners 3 rd Edition Parent diagnostic questionnaire (Conners, 2008 ). The maximum possible score for this measure is 90. At the point of interview, seven children had received a diagnosis of ADHD, two children were still under assessment, and one child had been referred for an ASD diagnosis (Table 1 ). The ADHD subtype of each participant was not recorded, however all children scored above the cut-off for both inattention (M = 87.3, SD = 5.03) and hyperactivity (M = 78.6, SD = 5.8) which is indicative of ADHD combined type. Use of stimulant medication was not recorded at the time of interview.

Following the child interview and receipt of parental consent, each child’s school was contacted to request their teacher’s participation in the study. Three teachers could not take part within the timeframe of the study, and one refused to take part. Six teachers (all female) were successfully contacted and gave informed consent to participate.

Due to the increased likelihood of co-occurring diagnoses in the target population, we also report Autism Spectrum Disorder (ASD) symptoms and Developmental Co-ordination Disorder (DCD) symptoms using the Autism Quotient 10-item questionnaire (AQ-10; Allison et al., 2012 ) and Movement ABC-2 Checklist (M-ABC2; Henderson et al., 2007 ) respectively, both completed by the child’s parent.

Scores of 6 and above on the AQ-10 indicates referral for diagnostic assessment for autism is advisable. All but one of the participants scored below the cut-off on this measure (M = 3.6, SD = 1.84).

The M-ABC2 checklist categorises children as scoring green, amber or red based on their scores. A green rating (up to the 85th percentile) indicates no movement difficulty, amber ratings (between 85 and 95th percentile) indicate risk of movement difficulty, and red ratings (95th percentile and above) indicate high likelihood of movement difficulty. Seven of the participants received a red rating, one an amber rating, and two green ratings.

Socioeconomic status (SES) is also known to impact educational outcomes, therefore the SES of each child was calculated using the Scottish Index of Multiple Deprivation (SIMD), which is an area-based measure of relative deprivation. The child’s home postcode was entered into the tool which provided a score of deprivation on a scale of 1 to 5. A score of 1 is given to the 20% most deprived data zones in Scotland, and a score of 5 indicates the area was within the 20% least deprived areas.

Semi-Structured Interview

The first author, who is a psychologist, conducted interviews with each participant individually, and then a separate interview with their teacher. This was guided by a semi-structured interview schedule (see Appendix A, Appendix B) developed in line with our research questions, existing literature, and using authors (T.S. and J.B.) expertise in educational practice. The questions were adapted to be relevant for the participant group. For example, children were asked “If a friend asked you to tell them what ADHD is, what would you tell them?” and teachers were asked, “What is your understanding of ADHD or can you describe a typical child with ADHD?”. The schedule comprised two key sections for both teachers and children. The first section focused on probing the participant’s understanding and knowledge of ADHD broadly. The second section focused on the participating child’s academic and cognitive strengths and weaknesses, and the strategies used to support them. Interviews with children took place in the child’s home and lasted between 19 and 51 min (M = 26.3, SD = 10.9). Interviews with teachers took place at their school and were between 28 and 50 min long (M = 36.5, SD = 7.61). Variation in interview length was mostly due to availability of the participant and/or age of the child (i.e. interviews with younger children tended to be shorter). All interviews were recorded on an encrypted voice recorder and transcribed by the first author prior to data analysis. Pseudonyms were randomly generated for each child to protect anonymity.

Reflexive thematic analysis was used to analyse the data (Braun & Clarke, 2019 ). This flexible approach allows the data to drive the analysis, putting the participant at the centre of the research and placing high value on the experiences and perspectives of individual participants (Braun & Clarke, 2006 ). The six phases of reflexive thematic analysis as outlined by Braun and Clarke were followed: (1) familiarisation, (2) generating codes, (3) constructing themes, (4) revising themes, (5) defining themes, (6) producing the report. Due to the exploratory nature of this study, bottom-up inductive coding was used. Two of the authors (E.M. and C.T.) worked collaboratively to construct and subsequently define the themes using the process described above. More specifically, one author (E.M.) generated codes, with support from another author (C.T.). Collated codes and data were then abstracted into potential themes, which were reviewed and refined using relevant literature, as well as within the wider context of the data. This process continued until all themes were agreed upon.

In the first part of the analysis, focus was placed on summarising the participants’ understanding of ADHD, as well as what they thought their biggest strengths and challenges were at school. Following this, an in-depth analysis of the strategies used in the classroom was conducted, taking into account the perspective of both teachers and children, aiming to generate themes from the data.

Knowledge of ADHD

Children and teachers were asked about their knowledge of ADHD. When asked if they had ever heard of ADHD, the majority of children said yes. Some of the children could not explain to the interviewer what ADHD was or responded in a way that suggested a lack of understanding ( “it helps you with skills” – Niall, 7 years; “ Well it’s when you can’t handle yourself and you’re always crazy and you can just like do things very fast”— Nathan, 8 years). Very few of the children were able to elaborate accurately on their understanding of ADHD, which exclusively focused on inattention. For example, Paige (8 years) said “ its’ kinda like this thing that makes it hard to concentrate ” and Finn (10 years) said “ they get distracted more just in different ways that other people would ”. This suggests that children with ADHD may lack or have a limited awareness or understanding of their diagnosis.

When asked about their knowledge of ADHD, teachers tended to focus on the core symptoms of ADHD. All teachers directly mentioned difficulties with attention, focus or concentration, and most directly or indirectly referred to hyperactivity (e.g. moving around, being in “ overdrive ”). Most teachers also referred to social difficulties as a feature of ADHD, including not following social rules, reacting inappropriately to other children and appearing to lack empathy, which they suggested could be linked to impulsivity. For example, “ reacting in social situations where perhaps other children might not react in a similar way” (Paige’s teacher) and “ They can react really really quickly to things and sometimes aggressively” (Eric’s teacher). Although no teachers directly mentioned cognitive difficulties, some referred to behaviours indicative of cognitive difficulties, for example, “ they can’t store a lot of information at one time” (Eric’s teacher) and, “ it’s not just the concentration it’s the amount they can take in at a time as well” (Nathan’s teacher), which may reflect processing or memory differences. Heterogeneity was mentioned, in that ADHD can mean different things for different children (e.g., “ I think ADHD differs from child to child and I think that’s really important” —Nathan’s teacher). Finally, academic difficulties as a feature of ADHD were also mentioned (e.g., “ a child… who finds some aspects of school life, some aspects of the curriculum challenging ”—Jay’s teacher).

After being asked to give a general description of ADHD, each child was asked about their own strengths at school and teachers were also asked to reflect on this topic for the child taking part.

When asked what they like most about school, children often mentioned art or P.E. as their preferred subjects. A small number of children said they enjoyed maths or reading, but this was not common and the majority described these subjects as a challenge or something they disliked. There was also clear link between the aspects of school children enjoyed, and what they perceived to be a strength for them. For example, when asked what he liked about school, Eric (10 years) said, “ Math, I’m pretty good at that”, or when later asked what they were good at, most children responded with the same answers they gave when asked what they liked about school. It is interesting to note that subjects such as art or P.E. generally have a different format to more traditionally academic subjects such as maths or literacy. Indeed, Felicity (11 years) said, “ I quite like art and drama because there’s not much reading…and not really too much writing in any of those” . Children also tended to mention the non-academic aspects of school, such as seeing their friends, or lunch and break times.

Teachers’ descriptions of the children’s strengths were much more variable compared to strengths mentioned by children. Like the children, teachers tended to consider P.E and artistic activities to be a strength for the child with ADHD. Multiple teachers referred to the child having a good imagination and creative skills. For example, “ she’s a very imaginative little girl, she has a great ability to tell stories and certainly with support write imaginative stories” (Paige’s teacher) . Teachers referred to other qualities or characteristics of the child as strengths, although these varied across teachers. These included openness, both socially but also in the context of willingness to learn or being open to new challenges, being a hard worker, or an enjoyable person to be around (e.g., “ he is the loveliest little boy, I’ve got a lot of time for [Nathan]. He makes me smile every day, you know, he just comes out with stuff he’s hilarious”— Nathan’s teacher). The most noticeable theme that emerged from this data was that when some teachers began describing one of the child’s strengths, it was suffixed with a negative. For example, Henry’s teacher said, “ He’s got a very good imagination, his writing- well not so much the writing of the stories, he finds writing quite a challenge, but his verbalising of ideas he’s very imaginative”. This may reflect that while these children have their own strengths, these can be limited by difficulties. Indeed, Paige’s teacher said, “ I think she’s a very able little girl without a doubt, but there is a definite barrier to her learning in terms of her organisation, in terms of her focus” , which reinforces this notion.

Children were asked directly about what they disliked about school, and what they found difficult. Children tended to focus more on specific subjects, with maths and aspects of literacy being the most frequently mentioned of these. Children referred to difficulties with or a dislike for reading, writing and/or spelling activities, for example, Rory (9 years) said “ Well I suppose spelling because … sometimes we have to do some boring tasks like we have to write it out three times then come up with the sentence for each one which takes forever and it’s hard for me to think of the sentences if I’m not ready” . Linking this with known cognitive difficulties in ADHD, it is interesting to note that both memory and planning are implicated in this quote from Rory about finding spelling challenging. In terms of writing, children referred to both the physical act of writing (e.g., “ probably writing cause sometimes I forget my finger spaces ”—Paige, 8 years; “ [writing the alphabet is] too hard… like the letters joined together … [and] I make mistakes” —Jay, 7 years) as well as the planning associated with writing a longer piece of work (e.g. “ when I run out of ideas for it, it’s really hard to think of some more so I don’t usually get that much writing done ”—Rory (9 years) .

Aside from academic subjects, several children referred to difficulties with focus or attention (e.g. “ when I find it hard to do something I normally kind of just zone out ”—Felicity, 11 years, “ probably concentrating sometimes ”—Rory, 9 years), but boredom was also a common and potentially related theme (e.g. “ Reading is a bit hard though … it just sometimes gets a bit boring” —Finn, 10 years, “ I absolutely hate maths … ‘cause it’s boring ”—Paige, 8 years). It could be that children with ADHD find it more difficult to concentrate during activities they find boring. Indeed, when Jay (7 years) was asked how it made him feel when he found something boring, he said “ it made me not do my work ”. Some children also alluded to the social difficulties faced at school, which included bullying and difficulties making friends (e.g. “ just making all kind of friends [is difficult] ‘cause the only friend that I’ve got is [name redacted] ”—Nathan, 8 years; “ sometimes finding a friend to play with at break time [is difficult] ” – Paige, 8 years; “ there’s a lot of people in my school that they bully me” —Eric, 10 years).

When asked what they thought were the child’s biggest challenges at school, teachers' responses were relatively variable, although some common themes were identified. As was the case for children, teachers reflected on difficulties with attention, which also included being able to sit at the table for long periods of time (e.g. “ I would say he struggles the most with sitting at his table and focusing on one piece of work ”—Henry’s teacher). Teachers did also mention difficulties with subjects such as maths and literacy, although this varied from child to child, and often they discussed these in the context of their ADHD symptom-related difficulties. For example, Eric’s teacher said, “ we’ve struggled to get a long piece of writing out of him because he just can’t really sit for very long ”. This quote also alludes to difficulties with evaluating the child’s academic abilities, due to their ADHD-related difficulties, which was supported by other teachers (e.g. “ He doesn’t particularly enjoy writing and he’s slow, very slow. And I don’t know if that’s down to attention or if that’s something he actually does find difficult to do ” —Henry’s teacher). Furthermore, some teachers reflected on the child’s confidence as opposed to a direct academic difficulty. For example, Luna’s teacher said, “ I think it’s she lacks the confidence in maths and reading like the most ” and later, elaborated with “ she’ll be like “I can’t do it” but she actually can. Sometimes she’s … even just anxious at doing a task where she thinks … she might not get it. But she does, she’s just not got that confidence”.

Teachers also commonly mentioned social difficulties, and referred to these difficulties as a barrier to collaborative learning activities (e.g. “ he doesn’t always work well with other people and other people can get frustrated” —Henry’s teacher; “ [during] collaborative group work [Paige] perhaps goes off task and does things she shouldn’t necessarily be doing and that can cause friction within the group” —Paige’s teacher). Teachers also mentioned emotion regulation, mostly in relation to the child’s social difficulties. For example, Eric’s teacher said “ I think as well he does still struggle with his emotions like getting angry very very quickly, and being very defensive when actually he’s taken the situation the wrong way” , which suggests that the child’s difficulty with regulating emotions may impact on their social relationships.

Strategy Use in the Classroom

Strategies to support learning fell into one of four categories: concrete or visual resources, information processing, seating and movement, and support from or influence of others. Examples of codes included in each of these strategy categories are presented in Table 2 .

Concrete or visual resources were the most commonly mentioned type of strategy by teachers and children, referring to the importance of having physical representations to support learning. Teachers spoke about the benefit of using visual aids (e.g. “ I think [Henry] is quite visual so making sure that there is visual prompts and clues and things like that to help him ”—Henry’s teacher), and teachers and children alluded to these resources supporting difficulties with holding information in mind. For example, when talking about the times table squares he uses, Rory said “ sometimes I forget which one I’m on…and it’s easier for me to have my finger next to it than just doing it in my head because sometimes I would need to start doing it all over again ”.

Seating and movement were also commonly mentioned, which seemed to be specific to children with ADHD in that it was linked to inattention and hyperactivity symptoms. For example, teachers referred to supporting attention or avoiding distraction by the positioning of a child’s location in the classroom (e.g. “ he’s so easily distracted, so he has an individual desk in the room and he’s away from everyone else because he wasn’t coping at a table [and] he’s been so much more settled since we got him an individual desk” —Eric’s teacher). Some teachers also mentioned the importance of allowing children to move around the room where feasible, as well as giving them errands to perform as a movement break (e.g. “ if I need something from the printer, [Nathan] is gonna go for it for me…because that’s down the stairs and then back up the stairs so if I think he’s getting a bit chatty or he’s not focused I’ll ask him to go and just give him that break as well” —Nathan’s teacher). Children also spoke about these strategies but didn’t necessarily describe why or how these strategies help them.

Information processing and cognitive strategies included methods that supported children to process learning content or instructions. For example, teachers frequently mentioned breaking down tasks or instructions into more manageable chunks (e.g. “ with my instructions to [Eric] I break them down … I’ll be like “we’re doing this and then we’re doing this” whereas the whole class wouldn’t need that ”—Eric’s teacher). Teachers and children also mentioned using memory strategies such as songs, rhymes or prompts. For example, Jay’s teacher said, “ if I was one of the other children I could see why it would be very distracting but he’s like he’s singing to himself little times table songs that we’ve been learning in class” , and Paige (8 years) referred to using mnemonics to help with words she struggles to spell, “ I keep forgetting [the word] because. But luckily we got the story big elephants can always understand little elephants [which helps because] the first letter of every word spells because” .

Both groups of participants mentioned support from and influence of others, and referred to working with peers, the teacher–child relationship, and one-to-one teaching. Peer support was a common theme across the data and is discussed in more detail in the thematic analysis findings, where teachers and children referred to the importance of the role of peers during learning activities. Understanding the child well and adapting to them was also seen as important, for example, Luna’s teacher said, “ with everything curricular [I] try and have an art element for her, just so I know it’ll engage her [because] if it’s like a boring old written worksheet she’s not gonna do it unless you’re sitting beside her and you’re basically telling her the answers” . As indicated in this quote, teachers also referred to the effectiveness of one-to-one or small group work with the child (e.g. “ when somebody sits beside her and explains it, and goes “come on [Paige] you know how to do this, let’s just work through a couple of examples”… her focus is generally better ” – Paige’s teacher), however this resource is not always available (e.g. “ I’d love for someone to be one-to-one with [Luna] but it’s just not available, she doesn’t meet that criteria apparently ” – Luna’s teacher). Children also referred to seeking direct support from their teacher (e.g. “if I can’t get an idea of what I’m doing then I ask the teacher for help” – Paige, 8 years), but were more likely to mention seeking support from their peers than the teacher.

Thematic Analysis

In addition to summarising the types of strategies that teachers and children reported using in the classroom, the data were also analysed using thematic analysis to generate themes. These are now presented. The theme names, definitions, and example quotes for each theme are presented in Table 3 .

Theme 1: Classroom-General Versus Individual-Specific Strategies

During the interviews, teachers spoke about strategies that they use as part of their teaching practice for the whole class but that are particularly helpful for the child/children with ADHD. These tended to be concrete or visual resources that are available in the classroom for anyone, for example, a visual timetable or routine checklist (e.g. “ there’s also a morning routine and listing down what’s to be done and where it’s to go … it’s very general for the class but again it’s located near her” —Paige’s teacher).

Teachers also mentioned using strategies that have been implemented specifically for that child, and these strategies tended to focus on supporting attention. For example, Nathan’s teacher spoke about the importance of using his name to attract his attention, “ maybe explaining to the class but then making sure that I’m saying “[Nathan], you’re doing this”, you know using his name quite a lot so that he knows it’s his task not just the everybody task ”, and this was a strategy that multiple teachers referred to using with the individual child and not necessarily for other children. Other strategies to support attention with a specific child also tended to be seating and movement related, such as having an individual desk or allowing them to fidget. For example, Luna’s teacher said, “ she’s a fidgeter so she’ll have stuff to fidget with … [and] even if she’s wandering around the classroom or she’s sitting on a table, I don’t let other kids do that, but as long as she’s listening, it’s fine [with me]” .

Similar to teachers, children spoke about strategies or resources that were in place for them specifically as well as about general things in the classroom that they find helpful. That said, it was less common for children to talk about why particular strategies were in place for them and how they helped them directly.

In addition to recognising strategies that teachers had put in place for them, children also referred to using their own strategies in the classroom. The most frequently mentioned strategy was fidgeting, and although some of the younger children spoke about having resources available in the classroom for fidgeting, some of the older children referred to using their own toy or an object that was readily available to them but not intended for fidgeting. For example, Finn (10 years) and Rory (9 years) both spoke about using items from their pencil case to fiddle with, and explained that this would help them to focus. (“ Sometimes I fidget with something I normally just have like a pencil holder under the table moving about … [and] it just keeps my mind clear and not from something else ”—Rory; “ Sometimes I fiddle with my fingers and that sometimes helps, but if not I get one of my coloured pencils and have a little gnaw on it because that actually takes my mind off some things and it’s easier for me to concentrate when I have something to do ”—Finn). Henry (9 years) spoke about being secretive with his fidgeting as it was not permitted in class, “ if you just bring [a fidget toy] in without permission [the teacher will] just take it off of you, so it has to be something that’s not too big. I bring in a little Lego ray which is just small enough that she won’t notice ”. Although some teachers did mention having fidget toys available, not all teachers seemed to recognise the importance of this for the child, and some children viewed fidgeting as a behaviour they should hide from the teacher.

Another strategy mentioned uniquely by children was seeing their peers as a resource for ideas or information. This is discussed in more detail in Theme 3—The role of peers , but reinforces the notion that children also develop their own strategies, independently from their teacher, rather than relying only on what is made available to them.

Theme 2: Heterogeneity of Strategies

Teachers spoke about the need for a variety of strategies in the classroom, for two reasons: (1) that different strategies work for different children (e.g. “ some [strategies] will work for the majority of the children and some just don’t seem to work for any of them ”—Jay’s teacher), and (2) what works for a child on one occasion may not work consistently for the same child (e.g. “ I think it’s a bit of a journey with him, and some things have worked and then stopped working, so I think we’re constantly adapting and changing what we’re doing ”—Eric’s teacher). One example of both of these challenges of strategy use came from Luna’s teacher, who spoke about using a reward chart with Luna and another child with ADHD, “ [Luna] and another boy in my class [with ADHD] both had [a reward chart]… but I think whereas the boy loved his and still loves his, she was getting a bit “oh I’m too cool for this” or that sort of age… so I stopped doing that for her and she’s not missing that at all” . These quotes demonstrate that strategies can work differently for different children, highlighting the need for a variety of strategies for teachers to access and trial with children.

Some children also referred to the variability of whether a strategy was helpful or not; for example, Henry (9 years) said that he finds it helpful to fidget with a toy but that sometimes it can distract him and prevent him from listening to the teacher. He said, “ Well, [the fidget toy] helps but it also gets me into trouble when the teacher spots me building it when I’m listening…but then sometimes I might not listen in maths and [use the fidget toy] which might make it worse”. This highlights that both children and teachers might benefit from support in understanding the contexts in which to use particular strategies, as well as why they are helpful from a psychological perspective.

For teachers, building a relationship with and understanding the child was also highly important in identifying strategies that would work. Luna’s teacher reflected upon the difference in Luna’s behaviour at the start of the academic year, compared to the second academic term, “ at the start of the year, we would just clash the whole time. I didn’t know her, she didn’t know me … and then when we got that bond she was absolutely fine so her behaviour has got way better ”. Eric’s teacher also reflected on how her relationship with Eric had changed, particularly after he received his diagnosis of ADHD, “ I think my approach to him has completely changed. I don’t raise my voice, I speak very calmly, I give him time to calm down before I even broach things with him. I think our relationship’s just got so much better ‘cause I kind of understand … where he’s coming from ”. She also said, “ it just takes a long time to get to know the child and get to know what works for them and trialling different things out ”, which demonstrates that building a relationship with and understanding the child can help to identify the successful strategies that work with different children.

Theme 3: The Role of Peers

Teachers and children spoke about the role of the child’s peers in their learning. Teachers talked about the benefit of partnering the child with good role models (e.g. “ I will put him with a couple of good role models and a couple of children who are patient and who will actually maybe get on with the task, and if [Jay] is not on task or not on board with what they’re doing at least he’s hearing and seeing good behaviour ”—Jay’s teacher), whereas children spoke more about their peers as a source of information, idea generation, or guidance on what to do next. For example, when asked what he does to help him with his writing, Henry (9 years) said, “ [I] listen to what my partner’s saying… my half of the table discuss what they’re going to do so I can literally hear everything they’re doing and steal some of their ideas ”. Henry wasn’t the only child to use their peers as a source of information, for example, Niall (7 years) said, “ I prefer working with the children because some things I might not know and the children might help me give ideas ”, and with a more specific example, Rory (9 years) said, “ somebody chose a very good character for their bit of writing, and I was like “I think I might choose that character”, and somebody else said “my setting was going to be the sea”, and I chose that and put that in a tiny bit of my story ”.

Some children also spoke about getting help from their peers in other ways, particularly when completing a difficult task. Paige (8 years) said, “ if the question isn’t clear I try and figure it out, and if I can’t figure it out then… don’t tell my teacher this but I sometimes get help from my classmates ”, which suggests some guilt associated with asking for help from her peers. This could be related to confidence and self-esteem, which teachers mentioned as a difficulty for some children with ADHD. In some instances, children felt it necessary to directly copy their peers’ work; for example, Nathan (8 years) spoke about needing a physical resource (i.e. “ fuzzies ”) to complete maths problems, but that when none were available he would “ just end up copying other people ”. This could also be related to a lack of confidence, as he may feel as though he may not be able to complete the task on his own. Indeed, Nathan’s teacher mentioned that when he is given the option to choose a task from different difficulty levels, Nathan would typically choose something easier, and that it was important to encourage him to choose something more difficult to build his confidence, “ I quite often say to him “come on I think you can challenge yourself” and [will] use that language”.

Peers clearly play an important role for the children with ADHD, and this is recognised both by the children themselves, and by their teachers. Teachers also mentioned that children with ADHD respond well to one-to-one learning with staff, indicating that it is important for these children to have opportunities to learn in different contexts: whole classroom learning, small group work and one-to-one.

In this study, a number of important topics surrounding ADHD in the primary school setting were explored, including ADHD knowledge, strengths and challenges, and strategy use in the classroom, each of which will now be discussed in turn before drawing together the findings and outlining the implications.

ADHD Knowledge

Knowledge of ADHD varied between children and their teachers. Whilst most of the children claimed to have heard of ADHD, very few could accurately describe the core symptoms. Previous research into this area is limited, however this finding supports Climie and Henley’s ( 2018 ) finding that children’s knowledge of ADHD can be limited. By comparison, all of the interviewed teachers had good knowledge about the core ADHD phenotype (i.e. in relation to diagnostic criteria) and some elaborated further by mentioning social difficulties or description of behaviours that could reflect cognitive difficulties. This supports and builds further upon existing research into teachers’ ADHD knowledge, demonstrating that although teachers understanding may be grounded in a focus upon inattention and hyperactivity, this is not necessarily representative of the range of their knowledge. By interviewing participants about their ADHD knowledge, as opposed to asking them to complete a questionnaire as previous studies have done (Climie & Henley, 2018 ; Latouche & Gascoigne, 2019 ; Ohan et al., 2008 ; Perold et al., 2010 ), the present study has demonstrated the specific areas of knowledge that should be targeted when designing psychoeducation interventions for children and teachers, such as broader aspects of cognitive difficulties in executive functions and memory. Improving knowledge of ADHD in this way could lead to increased positive attitudes and reduction of stigma towards individuals with ADHD (Mueller et al., 2012 ; Ohan et al., 2008 ), and in turn improving adherence to more specified interventions (Bai et al., 2015 ).

Strengths and Challenges

A range of strengths and challenges were discussed, some of which were mentioned by both children and teachers, whilst others were unique to a particular group. The main consensus in the current study was that art and P.E. tended to be the lessons in which children with ADHD thrive the most. Teachers elaborated on this notion, speaking about creative skills, such as a good imagination, and that these skills were sometimes applied in other subjects such as creative writing in literacy. Little to no research has so far focused on the strengths of children with ADHD, therefore these findings identify important areas for future investigation. For example, it is possible that these strengths could be harnessed in educational practice or intervention.

Although a strength for some, literacy was commonly mentioned as a challenge by both groups, specifically in relation to planning, spelling or the physical act of writing. Previous research has repeatedly demonstrated that literacy outcomes are poorer for children with ADHD compared to their typically developing peers (DuPaul et al., 2016; Mayes et al., 2020 ), however in these studies literacy tended to be measured using a composite achievement score, where the nuance of these difficulties can be lost. Furthermore, in line with a recent systematic review and meta-analysis (McDougal et al., 2022 ) the present study’s findings suggest that cognitive difficulties may contribute to poor literacy performance in ADHD. This issue was not unique to literacy, however, as teachers also spoke about academic challenges in the context of ADHD symptoms being a barrier to learning, such as finding it difficult to remain seated long enough to complete a piece of work. Children also raised this issue of engagement, who referred to the most challenging subjects being ‘boring’ for them. This link between attention difficulties and boredom in ADHD has been well documented (Golubchik et al., 2020 ). The findings here demonstrate the need for further research into the underlying cognitive difficulties leading to academic underachievement.

Both children and teachers also mentioned social and emotional difficulties. Research has shown that many different factors may contribute to social difficulties in ADHD (for a review see Gardner & Gerdes, 2015 ), making it a complex issue to disentangle. That said, in the current study teachers tended to attribute the children’s relationship difficulties to behaviour, such as reacting impulsively in social situations, or going off task during group work, both of which could be linked to ADHD symptoms. Despite these difficulties, peers were also considered a positive support. This finding adds to the complexity of understanding social difficulties for children with ADHD, demonstrating the necessity and value of further research into this key area.

The three key themes of classroom-general versus individual-specific strategies , heterogeneity of strategies and the role of peers were identified from the interview transcripts with children and their teachers. Within the first theme, classroom-general versus individual-specific strategies, it was clear that teachers utilise strategies that are specific to the child with ADHD, as well as strategies that are general to the classroom but that are also beneficial to the child with ADHD. Previously, Moore et al. ( 2017 ) found that teachers mostly reflected on using general inclusive strategies, rather than those targeted for ADHD specifically, however the methods differ from the current study in two key ways. Firstly, Moore et al.’s sample included secondary and primary school teachers, for whom the learning environment is very different. Secondly, focus groups were used as opposed to interviews where the voices of some participants can be lost. The merit of the current study is that children were also interviewed using the same questions as teachers; we found that children also referred to these differing types of strategies, and reported finding them useful, suggesting that the reports of teachers were accurate. Interestingly, children also mentioned their own strategies that teachers did not discuss and may not have been aware of. This finding highlights the importance of communication between the child and the teacher, particularly when the child is using a strategy considered to be forbidden or discouraged, for example copying a peer’s work or fidgeting with a toy. This communication would provide an understanding of what the child might find helpful, but more importantly identify areas of difficulty that may need more attention. Further to this, most strategies specific to the child mentioned by teachers aimed to support attention, and few strategies targeted other difficulties, particularly other aspects of cognition such as memory or executive function, which supports previous findings (Lawrence et al., 2017 ). The use of a wide range of individualised strategies would be beneficial to support children with ADHD.

Similarly, the second theme, heterogeneity of strategies , highlighted that some strategies work with some children and not others, and some strategies may not work for the same child consistently. Given the benefit of a wide range of strategy use, for both children with ADHD and their teachers, the development of an accessible tool-kit of strategies would be useful. Importantly, and as recognised in this second theme, knowing the individual child is key to identifying appropriate strategies, highlighting the essential role of the child’s teacher in supporting ADHD. Teachers mostly spoke about this in relation to the child’s interests and building rapport, however this could also be applied to the child’s cognitive profile. A tool-kit of available strategies and knowledge of which difficulties they support, as well as how to identify these difficulties, would facilitate teachers to continue their invaluable support for children and young people with ADHD. This links to the importance of psychoeducation; as previously discussed, the teachers in our study had a good knowledge of the core ADHD phenotype, but few spoke about the cognitive strengths and difficulties of ADHD. Children and their teachers could benefit from psychoeducation, that is, understanding ADHD in more depth (i.e., broader cognitive and behavioural profiles beyond diagnostic criteria), what ADHD and any co-occurrences might mean for the individual child, and why certain strategies are helpful. Improving knowledge using psychoeducation is known to improve fidelity to interventions (Dahl et al., 2020 ; Nussey et al., 2013 ), suggesting that this would facilitate children and their teachers to identify effective strategies and maintain these in the long-term.

The third theme, the role of peers , called attention to the importance of classmates for children with ADHD, and this was recognised by both children and their teachers. As peers play a role in the learning experience for children with ADHD, it is important to ensure that children have opportunities to learn in small group contexts with their peers. This finding is supported by Vygotsky’s ( 1978 ) Zone of Proximal Development; it is well established in the literature that children can benefit from completing learning activities with a partner, especially a more able peer (Vygotsky, 1978 ).

Relevance of Co-Occurrences

Co-occurring conditions are common in ADHD (Jensen & Steinhausen, 2015 ), and there are many instances within the data presented here that may reflect these co-occurrences, in particular, the overlap with DCD and ASD. For ADHD and DCD, the overlap is considered to be approximately 50% (Goulardins et al., 2015 ), whilst ADHD and autism also frequently co-occur with rates ranging from 40 to 70% (Antshel & Russo, 2019 ). It was not an aim of the current study to directly examine co-occurrences, however it is important to recognise their relevance when interpreting the findings. Indeed, in the current sample, scores for seven children (70%) indicated a high likelihood of movement difficulty. One child scored above the cut-off for autism diagnosis referral on the AQ-10, indicating heightened autism symptoms. Further to this, some of the discussions with children and teachers seemed to be related to DCD or autism, for example, the way that they can react in social situations, or difficulties with the physical act of handwriting. This finding feeds into the ongoing narrative surrounding heterogeneity within ADHD and individualisation of strategies to support learning. Recognising the potential role of co-occurrences should therefore be a vital part of any psychoeducation programme for children with ADHD and their teachers.

Limitations

Whilst a strong sample size was achieved for the current study allowing for rich data to be generated, it is important to acknowledge the issue of representativeness. The heterogeneity of ADHD is recognised throughout the current study, however the current study represents only a small cohort of children and young people with ADHD and their teachers which should be considered when interpreting the findings, particularly in relation to generalisation. Future research should investigate the issues raised using quantitative methods. Also on this point of heterogeneity, although we report some co-occurring symptoms for participants, the number of co-occurrences considered here were limited to autism and DCD. Learning disabilities and other disorders may play a role, however due to the qualitative nature of this study it was not feasible to collect data on every potential co-occurrence. Future quantitative work should aim to understand the complex interplay of diagnosed and undiagnosed co-occurrences.

Furthermore, only some of the teachers of participating children took part in the study; we were not able to recruit all 10. It may be, for example, that the six teachers who did take part were motivated to do so based on their existing knowledge or commitment to understanding ADHD, and the fact that not all child-teacher dyads are represented in the current study should be recognised. Another possibility is the impact of time pressures upon participation for teachers, particularly given the increasing number of children with complex needs within classes. Outcomes leading from the current study could support teachers in this respect.

It is also important to recognise the potential role of stimulant medication. Although it was not an aim of the current study to investigate knowledge or the role of stimulant medication in the classroom setting, it would have been beneficial to record whether the interviewed children were taking medication for their ADHD at school, particularly given the evidence to suggest that stimulant medication can improve cognitive and behavioural symptoms of ADHD (Rhodes et al., 2004 ). Examining strategy use in isolation (i.e. with children who are drug naïve or pausing medication) will be a vital aim of future intervention work.

Implications/Future Research

Taking the findings of the whole study together, one clear implication is that children and their teachers could benefit from psychoeducation, that is, understanding ADHD in more depth (i.e., broader cognitive and behavioural profiles beyond diagnostic criteria), what ADHD might mean for the individual child, and why certain strategies are helpful. Improving knowledge using psychoeducation is known to improve fidelity to interventions (Dahl et al., 2020 ; Nussey et al., 2013 ), suggesting that this would facilitate children and their teachers to identify effective strategies and maintain these in the long-term.

To improve knowledge and understanding of both strengths and difficulties in ADHD, future research should aim to develop interventions grounded in psychoeducation, in order to support children and their teachers to better understand why and in what contexts certain strategies are helpful in relation to ADHD. Furthermore, future research should focus on the development of a tool-kit of strategies to account for the heterogeneity in ADHD populations; we know from the current study’s findings that it is not appropriate to offer a one-size-fits-all approach to supporting children with ADHD given that not all strategies work all of the time, nor do they always work consistently. In terms of implications for educational practice, it is clear that understanding the individual child in the context of their ADHD and any co-occurrences is important for any teacher working with them. This will facilitate teachers to identify and apply appropriate strategies to support learning which may well result in different strategies depending on the scenario, and different strategies for different children. Furthermore, by understanding that ADHD is just one aspect of the child, strategies can be used flexibly rather than assigning strategies based on a child’s diagnosis.

This study has provided invaluable novel insight into understanding and supporting children with ADHD in the classroom. Importantly, these insights have come directly from children with ADHD and their teachers, demonstrating the importance of conducting qualitative research with these groups. The findings provide clear scope for future research, as well as guidelines for successful intervention design and educational practice, at the heart of which we must acknowledge and embrace the heterogeneity and associated strengths and challenges within ADHD.

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The funding was provided by Waterloo Foundation Grant Nos. (707-3732, 707-4340, 707-4614).

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Emily McDougal, Claire Tai & Sinéad M. Rhodes

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Tracy M. Stewart & Josephine N. Booth

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E.M. Conceptualization, Methodology, Investigation, Data Curation, Formal Analysis, Writing - original draft, C.T. Formal Analysis, Writing - review & editing, T.M.S., J.N.B. and S.M.R. Conceptualization, Methodology, Writing - review & editing.

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Interview Schedule—Teacher

Demographic/experience.

How many years have you been teaching?

Are you currently teaching pupils with ADHD and around how many?

If yes, do you feel competent/comfortable/equipped teaching pupils with ADHD?

If no, how competent/comfortable/equipped would you feel to teach pupils with ADHD?

Would you say your experience of teaching pupils with ADHD is small/moderate/significant?

Psychoeducation

What is your understanding of ADHD/Can you describe a typical child with ADHD?

Probe behaviour knowledge

Probe cognition knowledge

Probe impacts of behaviour/cognition difficulties

Probe knowledge that children with ADHD differ from each other

Probe knowledge that children with ADHD have co-occurring difficulties as the norm

(If they do have some knowledge) Where did you learn about ADHD?

e.g. specific training, professional experience, personal experience, personal interest/research

Cognitive skills and strategies

Can you tell me about the pupil’s strengths?

Can you tell me about the pupil’s biggest challenges/what they need most support with?

When you are supporting the pupil with their learning, are there any specific things you do to help them? (i.e. strategies)

Probe internal

Probe external

Probe whether they think those not mentioned might be useful/feasible/challenges

Probe if different for different subjects/times of the day

In your experience, which of these you have mentioned are the most useful for the pupil?

Probe for examples of how they apply it to their learning

Probe whether these strategies are pupil specific or broadly relevant

Probe if specific to particular subjects/times of the day

In your experience, which of these you have mentioned are the least useful for the pupil?

What would you like to be able to support the pupil with that you don’t already do?

Probe why they can’t access this currently e.g. lack of training, resources, knowledge, time

Is there anything you would like to understand better about ADHD?

Probe behaviour

Probe cognition

Interview Schedule—Child

Script: We’re going to have a chat about a few different things today, mostly about your time at school. This will include things like how you get on, how you think, things you’re good at and things you find more difficult. I’ve got some questions here to ask you but try to imagine that I’m just a friend that you’re talking to about these things. There are no right or wrong answers, I’m just interested in what you’ve got to say. Do you have any questions?

Script: First we’re going to talk about ADHD (Attention Deficit Hyperactivity Disorder).

Have you ever heard of/has anyone ever told you what ADHD is?

(If yes) If a friend asked you to tell them what ADHD is, what would you tell them?

Is there anything you would like to know more about ADHD?

Cognition/strategy use

Script: Now we’re going to talk about something a bit different. Everyone has things they are good at, and things they find more difficult. For example, I’m quite good at listening to what people have to say, but I’m not so good at remembering people’s names. I’d like you to think about when you’re in school, and things you’re good at and things you are not so good at. It doesn’t just have to be lessons, it can be anything.

Do you like school?

Probe why/why not?

Probe favourite lessons

What sort of things do you find you do well at in school?

Is there anything you think that you find more difficult in school?

Probe: If I asked your teacher/parent what you find difficult, what would they say?

Probe: Is there anything at school you need extra help with?

Probe: Is there anything you do to help yourself with that?

Script: Some people do things to try to help themselves do things well. For example, when someone tells me a number to remember, I repeat it in my head over and over again.

Can you try to describe to me what you do to help you do these things?

Solving a maths problem

Planning your writing

Doing spellings

Trying to remember something

Concentrating/ignoring distractions

Listening to the teacher

Remaining seated in class when doing work

Working with other children in the class

Probe: Do you use anything in lessons to help you with your work?

Probe: What kind of things do you think could help you with your work?

Probe: Is there anything you do at home, such as when you’re doing your homework, to help you finish what you are doing to do it well?

Probe: Does someone help you with your homework at home? If yes, what do they do that helps? If no, what do you think someone could do to help?

Script: In this last part we’re going to talk about your time at school.

How many teachers are in your class?

Is there anyone who helps you with your work?

Do you work mostly on your own or in groups?

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About this article

McDougal, E., Tai, C., Stewart, T.M. et al. Understanding and Supporting Attention Deficit Hyperactivity Disorder (ADHD) in the Primary School Classroom: Perspectives of Children with ADHD and their Teachers. J Autism Dev Disord 53 , 3406–3421 (2023). https://doi.org/10.1007/s10803-022-05639-3

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Published : 01 July 2022

Issue Date : September 2023

DOI : https://doi.org/10.1007/s10803-022-05639-3

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Attention-Deficit / Hyperactivity Disorder (ADHD) is a mental illness that is characterized by the lack of the ability of an individual to concentrate or stay still. This is a problematic disorder for all individuals that have been diagnosed with it, but it is particularly difficult for students with the disease to participate in school activities. The symptoms of ADHD are commonly mistaken for learning disabilities, as the individuals who exhibit them often demonstrate difficulty with learning. However, these symptoms are not related to learning impairment and result in an impaired ability to learn because these individuals are not able to concentrate in the same way as their peers.

Many individuals believe that ADHD is not a real disorder and is simply a term that is assigned to children who are not able to follow rules or behave properly (Schonwald 189). While many children would be classified as having some type of behavior problem according to current behavioral standards, ADHD is present in only those that demonstrate that their lack of focus and attention in addition to their large amounts of energy is impacting with their ability to learn normally (Ramsay 25). Many energetic children can be directed to focus on their studies, and after several tries, a teacher or a parent will be successful. However, children with ADHD often cannot gain this focus at any point in time, indicating that there is a clinical problem.

ADHD is typically diagnosed when a parent, friend, or teacher observes that the behavior patterns exhibited by an individual is not characteristic for his or her age. In order to confirm this diagnosis, the individual will typically travel to a psychologist to be evaluated. A series of tests will be conducted that attempt to assess whether the child is simply energetic and cannot always retain focus or whether there is a chronic problem. The psychologists will use a combination of these tests in addition to self-assessment from the patient and observations from friends and family to make the diagnosis. Many medical professionals believe that ADHD could be treated in part through therapy sessions that aim to adjust reactions to certain stimuli, while others believe that because the illness has a biological basis, medication is the only effective treatment method. Yet, other parties believe that a combination of therapy and medicine is the only proper way to treat ADHD.

The individuals that claim that ADHD is not a real disease do not understand the biological aspects of this illness. Studies have shown that the brains of children with ADHD are typically physically smaller than individuals without the disease (Cohen 5). In particular, the prefrontal cortex, basal ganglia and cerebellum are reduced in size and are therefore not able to achieve the expected connectivity with the other areas of the brain. Ultimately, this leads to chemical imbalances with regards to the neurotransmitters that are responsible for sending messages to the different parents of the brain. Individuals without ADHD use some of these signals to know when they should stop their behaviors, but children and adults with this disorder do not experience the same signaling process (Curatolo 79). Therefore they are unable to stop their behaviors in the same manner as normal children and adults, which is in part because they are simply unable to comprehend that the behaviors they are exhibiting are wrong.

Ultimately, psychological treatment and medical treatment would not be effective to treat individuals with ADHD if this were not a real disease. When people diagnose with this illness have gone under treatment, they have demonstrated clear progress in behavior. Therapy is meant to allow these individuals to recognize which behaviors they are exhibiting and how they differ from their peers. They are then given ways to recognize when they are acting inappropriately and educated about how these situations could be prevented or rectified. In many situations, therapy alone is only ideal for cases of ADHD in which patients exhibit only slight symptoms. The purpose of the medication is to in part, rectify the problems that are occurring with the brain’s chemistry in these patients. In patients that exhibit severe symptoms, it is often difficult for them to be able to benefit from therapy because they may continue to exhibit these behaviors during the learning process, which impairs these therapy goals. Therefore, they may be provided medication to lesson these symptoms to make therapy more effective. The particular treatment that is assigned to an individual suffering from ADHD depends on the professional opinions of psychologists and psychiatrists, who collaborate to determine the severity of the symptoms and the best way to allow the child or adult to function in a normal school or work environment (Sim 615).

Professionals attempt to diagnose individuals with ADHD using criteria from a book called the DSM-IV. Some professionals prefer to use this book for mental disorders, while others opt to use the newer addition of this publication called the DSM-V. As a whole, this document describes ADHD as “persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development” (CDC, n.d.). For ADHD to be diagnosed by a professional, they must observe that these symptoms have been occurring over a long period of time. Therefore, one of the primary criterion for this diagnosis is that individuals must exhibit six or more of the following symptoms: they must not be able to give complete attention to details or make unanticipated mistakes at their jobs, in school, or in other functions; they must often not appear to listen to verbal directions despite repeated attempts; they must not frequently follow directions which leads to them not completing projects that they have started and are expected to finish; they frequently have trouble organizing tasks and activities; they often ignore and do not enjoy work that requires a lot of thought; they frequently misplace objects that are necessary to complete their responsibilities; they are frequently and easily distracted; they are frequently generally forgetful with regards to daily activities (CDC, n.d.). While many of these situations are exhibited by children or adults at some point, individuals with ADHD repeat many of these behaviors over a long period of time, which interferes with their ability to function in school or at work. Therefore, children with ADHD are typically diagnosed by teachers or other members of school staff because they are most likely to pick up on these behaviors before the parents. It is often an educator or a school psychologists who arranges the appointment for the formal diagnosis with the parent.

An additional symptom of ADHD is hyperactivity and impulsivity. According to the psychologist’s diagnostic manual, the following symptoms must be met, demonstrating inappropriate behavior for the child’s age level: they are frequently not able to stay still and must play with objects or move in their seat; they frequently travel away from their seats when remaining seated is appropriate; they are not able to play quietly; they must frequently talk or move; they respond to questions in class before they have fully completed the question; they have difficulty taking turns; they frequently invade the space of others (CDC, n.d.). Again, many individuals believe that these symptoms do not signify ADHD because they understand that some children exhibit these behaviors normally. While this is true in some cases, children with ADHD exhibit a majority of these symptoms, which have been repeated over a long period of time. These individuals are generally those who are unable to remain seated and quiet in school, which may interfere with the learning process of both themselves and of their peers. Individuals with ADHD exhibit some symptoms that overlap with other disorders, so it is necessary for the health care professional to rule out these other options before confirming a diagnosis of the disease (Greathead).

Despite the attempts of many individuals to deny the existence of ADHD, it is clear that this cannot be done. There are many environmental and biological factors that contribute to the development of the illness, and these factors are evident upon medical and psychological examination. It is therefore necessary to avoid demonizing both individuals with this disorder in addition to their families for psychological impacts that are beyond their control. It is instead important to work towards building an understanding of how individuals with ADHD can be helped and to understand the challenges that they face on a daily basis.

One of the most beneficial solutions to addressing the ADHD problem is modifying educational practices to cater to individuals that need to exert their energy, rather than sitting quietly in the classroom and listening. Many activities can be made for the whole class that will enable this type of engagement and promote learning. For example, activities that require standing and sitting to say “yes” or “no” to a question would be beneficial because it allows students with ADHD to move around. Since they are likely to do so without permission, it is necessary to take control of the situation by allowing this behavior, but assigning rules to it first. In addition, children with ADHD occasionally wish to stand as they write, which should be considered acceptable, provided that they are not disturbing their classmates. These solutions can only be reached once we understand that ADHD is not simply a behavior problem that children choose to enact, rather it is a consequence of complex environmental and biological factors that are beyond our control.

In conclusion, ADHD is a real disorder that must be taken very seriously. It is detrimental to the individuals with this illness to pretend that it does not exist. While many children do exhibit behavior problems from time to time and do not have ADHD, we must be aware that those with repetitive behavior problems have the disease and should be provided with help to alleviate some of these symptoms. These individuals can be helped by spreading an understanding that they are not misbehaving on purpose and that we should assist their learning by finding the methods that work best for them.

Works Cited

CDC. Symptoms and Diagnosis. N.D. Web. 24 April 2015.           <http://www.cdc.gov/ncbddd/adhd/diagnosis.html>

Cohen DJ. Cicchetti D, ed. Developmental Psychopathology, Developmental Neuroscience (2nd,illustrated ed.). John Wiley & Sons, 2006.

Curatolo P, D’Agati E, Moavero R. The neurobiological basis of ADHD. Ital J Pediatr 36(2010): 79.

Greathead, Philippa. Language Disorders and Attention Deficit Hyperactivity Disorder. 6 November 2013. Web. 24 April 2015. <http://www.addiss.co.uk/languagedisorders.htm>.

Ramsay JR. Cognitive behavioral therapy for adult ADHD. Routledge, 2007.

Schonwald A, Lechner E. Attention deficit/hyperactivity disorder: complexities and controversies. Curr. Opin. Pediatr . 18.2(2006):189–195.

Sim MG, Hulse G, Khong E. When the child with ADHD grows up. Aust Fam Physician  33.8 (2014): 615–618.

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Example Of ADHD - Causes Essay

Type of paper: Essay

Topic: Children , Disorders , Family , ADHD , Trauma , Brain , Study , Genetics

Words: 2500

Published: 03/05/2020

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Introduction

Most of us have faced moments when we were not able to concentrate on the work on hand. There were times when focusing on a task was a big challenge. However, for most of us this type of syndrome is not very common. However, for some people these types of behaviors are a day-to-day affair. For those people this type of syndrome is uncontrollable and persistent. If a person shows such signs then they may be a victim of attention deficit hypersensitivity syndrome. Attention Deficit Hypersensitivity Syndrome (ADHD) does not show any physical signs or cannot be detected using laboratory tests. The symptoms of ADHD are often same as other physical and psychological disorders. ADHD probably has been around lot longer than we actually realized. ADHD became a well-known disease in USA during 1970s. Since that time US has seem an increase in ADHD patients over the last few decades. Reasons of ADHD are still not well known to the doctors and researchers. This essay will discuss about ADHD in detail, the major causes of the disorder, controversial reasons, future research requirement and treatments options available for ADHD.

What is ADHD?

One of the most common brain disorders found in children is attention deficit hyperactivity disorder (ADHD) which depending on its degree of severity can continue through one's adolescence to even adulthood. Though there is no definite scientific explanation but boys are more likely to be affected by ADHD than girls (NIMH, 2012). Children with ADHD have difficulty staying focused and attentive to anything for long. They also tend to be hyperactive. Children suffering from ADHD are found to be having problem in getting along with other children in school or adults and finishing tasks on time. The overall performance of children gets hugely affected due to ADHD.

Signs and Symptoms

Though normally children are a bit hyperactive, inattentive and impulsive sometimes but with children with ADHD, these symptoms are more severe than others. Children with ADHD can get easily distracted, forget things, miss details and move from one activity to another frequently. They also have trouble focusing on one task for more than few minutes. They have problem finishing their tasks on time and often struggle to follow instructions. They have problem sitting still and are constantly in motion. They are very impatient and can talk nonstop. When children show these symptoms for 6 months or more in a severe manner, only then they are only diagnosed with ADHD (NIMH, 2012).

What Causes ADHD?

There is an array of factors attributed to the cause of ADHD. ADHD is not a medical disorder resulting out of low intelligence, poor motivation or upbringing and laziness. Rather a combination of genetic, environmental and other factors is considered to be the main causative factor for this disorder.

Genetic Reasons

Genetic reasons are an important factor for ADHD. Several studies have indicated that children who have a family history of ADHD are more likely to be affected by this order than general population. Dr. Joseph Biederman along with his colleagues conducted family studies at the Massachusetts General Hospital to find out whether or not ADHD runs in families and their finding showed that more than 25% children with ADHD have first degree family members suffering from the same disorder (Biederman, Faraone, Keenan & Knee, 1990). A family history of ADHD increases the likelihood of having ADHD five times more in children. Psychiatrist Dr. Dennis Cantwell conducted adoption studies on adopted children to find out if hyperactive adopted children resemble their biological parents more closely than their adoptive parents and the research result showed that hyperactive adopted children resembled their biological parents far more closely than their adoptive parents, thereby proving yet again that ADHD is a genetic disorder (MyADHD). Different researchers around the world in order to find out if ADHD has any genetic basis or not conducted twin studies by studying a group of non-identical and identical twins. Identical twins share the same genetic information whereas the genetic information shared by non-identical twins is different. That is why if ADHD is a hereditary or genetic disorder then identical twins are more likely than non-identical twins to be affected by this disorder. In Australia, Dr. Florence Levy and her colleagues conducted twin studies by studying about 1,938 families with twins and siblings and they came up with the finding that identical twins have 82% concordance rate for ADHD than 38% of the same in non-identical twins (MyADHD). Although family, adoption and twin studies have strongly reinforced the genetic basic for ADHD, these studies could not specify the genes related to this order. Therefore, different molecular genetic studies have been conducted by many researchers around the world and two dopamine genes have come to the forefront of being associated with ADHD - the dopamine transporter (DAT1) gene and the dopamine receptor D4 (DRD4) gene (Swansona, Kennedyb & Flodmana, 2000). Dopamine is a neurotransmitter that functions like a chemical messenger by passing signals and information in different vital areas of the brain. The specific genes DAT1 and DRD4 alter the dopamine transmission in the neural networks of the brain, resulting in ADHD (Swansona, Kennedyb & Flodmana, 2000).

Environmental Reasons

Scientists have found out that a lot of environmental factors also attribute to the cause of ADHD. Researchers have conducted several studies to find out the correlation between environment and ADHD and have come up with the finding that women who continued smoking tobacco products and consumed alcohol during pregnancy have their children affected by ADHD. Nicotine and alcohol leave sustained damaging effects on the brain tissue of children if they are exposed to these toxics at an early age. The toxic exposure of nicotine and alcohol lead damages the activity of vital nerve cells which produce neurotransmitters in the brain, attributing to the growth of ADHD (Reader's Digest, 2014). Despite the link between maternal smoking and ADHD, a genetic explanation cannot be removed because women suffering from ADHD are more likely to smoke than non-ADHD mothers (Martin, 2007). Similarly, when lead exposure takes place in the first three years of a child, then a child may develop ADHD as the toxic lead affects the developing brain tissue of the child. Children exposed to lead paint and rusted pipes may develop hyperactivity and short span of attention. Michigan State University conducted a study in 2007 and came up with the finding that children with ADHD had higher levels of lead in their blood (Reader's Digest, 2014). The presence of lead in great amount may damage the process of a developing brain, making it difficult for children to control themselves. If a healthy living environment with no lead and other toxic exposure can be ensured then children may be able to lead a life devoid of ADHD symptoms.

Brain Injury

Brain injury caused by a serious blow to the head, disease, stroke and tumor can also lead to the problems of inattention and poor regulation of motor activity. However, the National Institute of Mental Health (NIMH) disregards brain injury as a serious risk factor for ADHD because a very small portion of children experiences traumatic head injury (Koch, 2014). Professor Heather Keenan along with her team from the University of Utah performed a study by exploring the database of 62,088 children who were registered with the National Health Service in the UK. Of these children, only 2,782 (4.5%) children suffered a traumatic head injury before they completed two years of age and another 1.8% children were found to have sustained burn injury. Of all the children, only 1.5% children between the age range of 2 and 10 years were diagnosed with ADHD (Collingwood, 2009). Their analysis showed that the rate of ADHD is significantly higher among children with severe head injury than non-injured children.

Controversies

There are many reasons deemed to be the attributive factors of ADHD but these reasons have sparked controversy because contrary to the popular notions, none of these reasons has any scientific basis. There is a notion prevalent among many parents that sugar consumption leads to the growth of ADHD, but many research studies conducted over the years have completely discounted this theory. In one study, children were given foods containing either sugar or sugar substitute every alternate day. The children who consumed sugar showed no behavioral symptoms different from the ones who consumed sugar substitute. In another study, all the children were given sugar substitute aspartame aka Nutrasweet but half of those children's mothers were informed that their children received sugar while the remaining half of the mothers were informed that the children received aspartame. The mothers who believed that their children had received sugar were critical of their children rating them as hyperactive (NIMH, 2012). Dr. Wolraich, a practicing pediatrician, therefore concludes that "the overwhelming number of studies have not been able to demonstrate behavior changes due to sugar consumption in children" (Koch, 2014). Though no scientific evidence is there that food additives are a contributive factor to ADHD, several studies show that some food colorings and preservatives may prove harmful for children making them hyperactive. The food additives considered to trigger hyperactivity in children are sodium benzoate, FD&C Yellow No. 6, D&C Yellow No. 10, FD&C Yellow No. 5 and FD&C Red No.40 (Huxsahl, 2011). The British government has made it mandatory for many food manufacturers to remove artificial food colorings from their products. FDA in USA has made it mandatory for FD&C Yellow No. 5 to be labelled clearly on the package along with other ingredients (Huxsahl, 2011). Since till date there has been no correlation established between food colorings and ADHD, this is one area requiring further research whether or not limiting certain foods would help prevent this hyperactive disorder. For a long period of time some of the physicians argued that vestibular system in the brain is the main cause of ADHD. They believed that since vestibular system controls the motor functions of our body, it must be the root cause of the problem. However, subsequent research has shown no correlation between vestibular system in the brain and ADHD. For a long time and even today some believe that poor parenting is definitely a cause of ADHD in children. Children who are not treated properly by their parents have more chances of developing ADHD than children who are treated in a better way by their parents (MyADHD). However, there is not research evidence to support that claim also. The only thing known is that the condition of a child with ADHD may worsen if he faces poor parenting. Good parenting can reduce the effects of ADHD but it definitely is not the root cause of the disorder.

Requirement of Future Research

ADHD is a disease not fully understood. There are treatments which can help reduce the effects of ADHD but still the root causes of ADHD are unknown. One of the areas requiring future research is definitely how the brain functions are different for ADHD patients than a normal patient. Already research is underway to map brain responses for ADHD patients under different conditions. Brain imaging will help us better understand the disease. This will also help the doctors and researchers come up with medication which will be able to cure the problem from the root (Martin, 2007). Another area of future research is to understand various types of ADHD. Still it is not very clear if there are different types of ADHDs and if there are how they are different. This research may provide us insight into why some ADHD patients have anxiety issue and depression while others do not, why some children have behavioral disorders and violent sprees (Martin, 2007). Future research is also required in the field of medications for ADHD.

Attention deficit hyperactivity disorder (ADHD) is a problem found in many children and adults across the world. Children with ADHD show some common symptoms of hyperactivity, inattention and difficulty in getting along with others. Though there is no scientific explanation as yet but boys tend to be more affected by ADHD than girls. Over the years, researchers around the world through numerous studies have found out that the main reasons of ADHD are genetic, environmental and brain injury. It has been seen through twin, adoption and molecular genetic studies that the disorder is highly genetical. Other than genetic reasons, there are environmental reasons like early exposure to toxins like nicotine, alcohol and lead attributing to the growth of this disorder among children. Furthermore, serious head injury is also one of the major reasons for ADHD. There are, however, many controversies associated with some of the reasons considered to be the attributive factors of ADHD. Many parents believe that excessive sugar consumption causes ADHD in children but several studies have shown that there is no link between sugar consumption and hyperactivity. Many others believed that television and bad parenting cause ADHD which again have been discounted by the researchers as completely baseless. There are many who believe that food additives and colorings cause ADHD but no scientific basis has been established till date. There are many areas in ADHD requiring further research. Some of the areas in requirement of more research include how brain functions of an ADHD patient is different from that of a normal child, the various types of ADHD and the medications used for the treatment of this disorder. Since ADHD is a disorder discovered by physicians not many years ago, there are a lot of things still unknown about it and only more in-depth future studies and research will bring about an explanation for the questions still unanswered.

National Institute of Mental Health (NIMH). (2012). Attention Deficit Hyperactivity Disorder. Retrieved on 11th January 2014 from <http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder/index.shtml?utm_source=REFERENCES_R7#pub1> Biederman, J., Faraone, S. V., Keenan, K., Knee, E., et al. (1990). Family-genetic and psychosocial risk factors in DSM-III attention deficit disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 526-533. Retrieved on 11th January 2014 from <http://www.ncbi.nlm.nih.gov/pubmed/2387786> MyADHD. Causes of ADHD. Retrieved on 11th January 2014 from <http://www.myadhd.com/causesofadhd.html> Swansona, J.M., Kennedyb, J., Flodmana, P., et al. (2000). Dopamine Genes and ADHD. Science Direct. Retrieved on 11th January 2014 from <http://www.sciencedirect.com/science/article/pii/S0149763499000627> Reader's Digest. (2014). Can Environmental Factors Cause ADHD. Retrieved on 11th January 2014 from <http://www.rd.com/health/conditions/can-environmental-factors-cause-adhd/> Martin, B. (2007). Causes of Attention Deficit Disorder (ADHD). Psych Central. Retrieved on 11th January 2014 from <http://psychcentral.com/lib/causes-of-attention-deficit-disorder-adhd/0001202> Collingwood, J. (2009). ADHD and Head Injury Link Examined. Psych Central. Retrieved on 11th January 2014 from <http://psychcentral.com/lib/adhd-and-head-injury-link-examined/0001574> Koch, Kristin. (2014). What Causes ADHD? 12 Myths and Facts. Health Media Ventures Inc. Retrieved on 11th January 2014 from <http://www.health.com/health/gallery/0,,20441463,00.html> Huxsahl, J. E. (2011). What does the research say about the relationship between food additives and ADHD?. Mayo Clinic. Retrieved on 11th January 2014 from <http://www.mayoclinic.org/diseases-conditions/adhd/expert-answers/adhd/FAQ-20058203>

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