By Dr Snehal Patel
Consultant Paediatrician & Neonatologist
Dec 27, 2025
Understanding ADHD: More than just hyperactivity attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders affecting children today. According to recent estimates, approximately 6-9% of children worldwide are diagnosed with ADHD, making it a condition that touches millions of families. Despite its prevalence, ADHD remains widely misunderstood, often dismissed as simply "bad behaviour" or lack of discipline. Understanding the true nature of ADHD, recognising its symptoms, and implementing effective management strategies can dramatically improve outcomes for children living with this condition.
ADHD is a chronic condition characterised by persistent patterns of inattention, hyperactivity, and impulsivity that interfere with daily functioning and development. It's important to understand that ADHD is a neurobiological disorder involving differences in brain structure and function, particularly in areas responsible for executive function, attention regulation, and impulse control.
Children with ADHD aren't choosing to be inattentive or hyperactive. Their brains are wired differently, affecting how they process information, regulate behaviour, and respond to their environment. This neurological basis is why ADHD requires comprehensive, evidence-based treatment rather than simple behavioural correction.
ADHD symptoms typically emerge during early childhood, usually before age 12, and manifest in three primary categories: inattention, hyperactivity, and impulsivity.
Children with predominantly inattentive ADHD may have difficulty sustaining attention during tasks or play activities, appear not to listen when spoken to directly, frequently lose essential items such as school supplies or homework, struggle to follow through on instructions and complete schoolwork, and become easily distracted by external stimuli. They often avoid tasks requiring sustained mental effort, make careless mistakes in schoolwork, have trouble organising tasks and activities, and seem forgetful in daily activities.
These children are sometimes described as "daydreamers" and may go undiagnosed longer than their hyperactive peers because their symptoms are less disruptive to classroom settings.
Hyperactive symptoms include fidgeting with hands or feet or squirming in a seat, difficulty remaining seated when expected, running or climbing excessively in inappropriate situations, inability to play quietly, appearing to be "on the go" or acting as if "driven by a motor," and talking excessively.
While hyperactivity is often the most noticeable symptom, it's important to remember that not all children with ADHD display hyperactive behaviours. The intensity of hyperactivity also tends to decrease with age, though other symptoms may persist.
Impulsive behaviours include blurting out answers before questions are completed, difficulty waiting their turn in conversations or activities, frequently interrupting or intruding on others, making hasty decisions without considering consequences, and acting without thinking in potentially dangerous situations.
Impulsivity can significantly impact social relationships, as children may struggle to respect personal boundaries or accurately interpret social cues.
Diagnosing ADHD requires a comprehensive evaluation by qualified healthcare professionals, typically including paediatricians, child psychologists, psychiatrists, or developmental behavioural specialists. There is no single test for ADHD; instead, diagnosis involves gathering information from multiple sources and settings.
The evaluation begins with a detailed developmental and medical history, including pregnancy and birth complications, developmental milestones, previous medical conditions, family history of ADHD or other mental health conditions, and current medications and supplements.
Healthcare providers will also explore when symptoms first appeared, how they affect different areas of the child's life, and what interventions have been tried previously.
Standardised rating scales and questionnaires are completed by parents, teachers, and sometimes the children themselves. Common assessment tools include the vanderbilt ADHD diagnostic rating scales, conners rating scales, and ADHD rating scale-5. These instruments help quantify symptom severity and compare the child's behaviour to age-appropriate norms.
A thorough evaluation must exclude other conditions that can mimic ADHD symptoms, including learning disabilities, anxiety disorders, depression, sleep disorders, hearing or vision problems, and thyroid disorders. Sometimes these conditions coexist with ADHD, requiring a comprehensive treatment approach addressing all concerns.
For an ADHD diagnosis, children must meet specific criteria outlined in the diagnostic and statistical manual of mental disorders (DSM-5).
Symptoms must be present in two or more settings, persist for at least six months, be inappropriate for the child's developmental level, and cause significant impairment in social, academic, or occupational functioning.
Effective ADHD management typically involves a multimodal approach combining various interventions tailored to each child's specific needs and circumstances.
Behavioural therapy teaches children skills to manage their symptoms while helping parents develop effective strategies for supporting their child. Parent training programs equip parents with techniques for managing challenging behaviours, implementing consistent routines, and providing positive reinforcement.
Cognitive-behavioural therapy helps older children and adolescents develop coping strategies, organisational skills, and emotional regulation techniques. Social skills training addresses difficulties in peer interactions and helps children learn appropriate social behaviours.
Children with ADHD often benefit from educational accommodations through 504 plans or individualised education programs (IEPs). Common accommodations include preferential seating near the teacher, extended time for tests and assignments, breaking large tasks into smaller steps, providing written instructions alongside verbal ones, allowing movement breaks, and using organisational aids and checklists.
Teachers can implement classroom strategies such as establishing clear routines and expectations, providing immediate feedback, incorporating movement into lessons, and minimising distractions in the learning environment.
Several lifestyle factors can significantly impact ADHD symptoms. Regular physical exercise has been shown to improve focus, reduce hyperactivity, and enhance mood. Adequate sleep is crucial, as sleep deprivation exacerbates ADHD symptoms. Nutrition matters too, with some children benefiting from reducing sugar intake, ensuring enough protein, and identifying potential food sensitivities.
Limiting screen time, particularly before bedtime, and establishing consistent daily routines can help children with ADHD feel more organised and in control.
While medication and behavioural therapy form the foundation of ADHD treatment, some families explore complementary approaches, including mindfulness and meditation practices, neurofeedback training, omega-3 fatty acid supplementation, and yoga or martial arts for developing focus and self-control.
It's essential to discuss any complementary approaches with your child's healthcare provider to ensure they don't interfere with proven treatments.
Parents play a crucial role in managing ADHD. Create a structured environment with consistent routines for morning, after school, homework, and bedtime. Use visual schedules, timers, and checklists to help your child stay organised and on track.
Provide clear, specific instructions one at a time, and ensure you have your child's attention before giving directions. Break large tasks into manageable steps and offer frequent positive reinforcement for effort and progress, not just results.
Establish a quiet, organised homework space free from distractions, and consider using tools like fidget toys or standing desks if they help your child focus. Most importantly, maintain open communication with teachers and healthcare providers to ensure consistency across all environments.
Early identification and intervention significantly improve long-term outcomes for children with ADHD. When left untreated, ADHD can lead to academic underachievement, social difficulties, low self-esteem, increased risk of accidents and injuries, and higher rates of depression and anxiety in adolescence and adulthood.
With appropriate support and treatment, children with ADHD can thrive academically, socially, and emotionally. Many successful adults credit their ADHD with contributing to their creativity, energy, and ability to think outside the box.
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Living with ADHD presents challenges, but with proper understanding, support, and treatment, children with ADHD can lead fulfilling and successful lives. As research continues to advance, treatment approaches will evolve and new interventions will continue to emerge, offering greater support to children and their families.
Connecting with support groups—locally or online—can be immensely helpful, allowing families to share experiences and learn from others facing similar challenges. Organisations such as CHADD (Children and Adults with Attention-Deficit/Hyperactivity Disorder), the ADDitude community, and at KD Blossom also provide valuable resources, educational materials, and strong support networks for children with ADHD and their caregivers.
Remember that every child with ADHD is unique, with individual strengths, challenges, and needs. What works for one child may not work for another, so patience, flexibility, and ongoing collaboration with your healthcare team are essential. With an appropriate support system in place, your child can develop the skills and confidence necessary for success in school, relationships, and life.
