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Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by difficulty with inattention, hyperactivity, and/or impulsive behavior. It is estimated that around 5% of children and 2.5% of adults have ADHD. One of the primary difficulties associated with ADHD is cognitive in nature, meaning that it affects a person’s thinking and reasoning. The cognitive difficulties associated with ADHD can be divided into two main areas: executive functioning and attention/working memory. Executive functioning involves the ability to plan and organize, set goals, and regulate emotions. People with ADHD often have difficulty in these areas, making it hard for them to manage their daily activities and get tasks completed. Attention and working memory (which is the ability to hold information in your mind for a brief period of time) is also affected in those with ADHD. This can lead to being easily distracted, difficulty following directives, and trouble completing tasks. Other cognitive issues that those with ADHD may experience include difficulty recognizing patterns, trouble with problem solving, and issues with understanding abstract concepts. These difficulties can make it difficult for those with ADHD to do well in school and maintain social relationships.

While medications are often prescribed to treat ADHD, cognitive-behavioral therapy (CBT), a form of psychotherapy that focuses on how thoughts and beliefs influence behavior, can help children and adolescents with ADHD. The goal of CBT may include strategies to organize their materials, plan their work and set reminders. Setting up the environment to support children and teens with ADHD is also helpful. Parents are usually recommended to develop and maintain consistent routines at home. They are also often encouraged to set up explicit organization strategies, such as a family planner or calendar.

ADHD can also cause a range of emotional issues, such as difficulty controlling anger and frustration, anxiety, and low mood. Therefore, it is important for individuals with ADHD to be aware of their emotional responses and to develop strategies to manage them. During therapy, the psychotherapist or psychologist works with the patient to identify and challenge negative or automatic thoughts that may be contributing to their symptoms. Through this process, the therapist helps the patient learn to reframe their thoughts in a more positive and helpful manner, identify triggers for their symptoms, as well as techniques for managing their emotions. Self-regulation skills can include deep breathing, mindfulness, physical activity, pleasurable activities, or sensory activities.

Does my child have ADHD?

Signs of inattention:

  • Does not follow rules or instructions
  • Loses materials/belongings
  • Difficulty starting and completing tasks
  • Avoid tasks that require sustained effort
  • Gets easily distracted by self or others
  • Appears to have trouble with memory (forgetful)
  • Seems to not listen when spoken to
  • Makes careless mistakes

Talk to your child’s teacher if you notice 6 or more of these signs. If they have noticed them too, it is recommended to get your child assessed for ADHD. Remember that some children with ADHD present without impulsivity or hyperactivity, particularly girls.

Signs of hyperactivity:

  • Very active, high energy, ‘driven by motor’
  • Interrupting others, talking too much
  • Can’t wait in line or their turn when playing
  • Prone to being clumsy and have accidents
  • Squirm, fidget, pace
  • Difficulty staying silent or calm
  • Wanders and gets up constantly

Signs of hyperactivity are more noticeable than signs of inattention. Teachers are the ones who typically see it firsthand due to the demands of classroom environments. However, kids vary in their level of activity and level of maturity. When assessing hyperactivity, I always urge parents and teachers to determine if the activity/impulsivity is indeed above and beyond what a typical child would display at that age. If you and your child’ teacher notice these signs, it is recommended to get your child assessed for ADHD.

What about medication?

Research suggests that a combination of psychotherapy and medication is the best approach to ADHD. It appears that starting psychotherapy first can be most beneficial.

ADHD is a neurodevelopmental disorder that, by definition, presents with cognitive and behavioural symptoms from early childhood. Although symptoms often decrease in severity in adulthood, they tend to remain throughout life. Nevertheless, with proper diagnosis, treatment, and support, children (and eventually adults) with ADHD can learn to recognize their strengths and gain self-understanding that can help them lead productive and meaningful lives. In fact, many successful individuals have ADHD.

Dr. Stephanie Leon

Dr. Leon is a clinical psychologist and neuropsychologist practicing in the province of Ontario and Quebec. She works with children, teens, and their parents to address emotional, behavioural, and cognitive difficulties.

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