Since its publication last Sunday, The New York Times Magazine article “Have We Been Thinking About ADHD All Wrong?” has been called provocative and controversial. We would like to add a few adjectives: misrepresentative, biased, and dangerous.

In his 8,800-word article, writer Paul Tough used cherry-picked bits of decades-old data, very small studies, and interviews with three patients (all men) to exhume long-debunked ideas about ADHD and its treatment with prescription stimulant medication. Tough dismissed the lifelong work of esteemed ADHD researcher Russell Barkley, Ph.D., and suggested that the diagnosis of ADHD was unreliable or subjective because it relies not on a biomarkers or genetic tests, but on a trained clinician’s careful review of patients’ self-reported and observed symptoms in several settings.

To be clear, identifiable biomarkers do not yet exist for many psychiatric, neurodevelopmental, and neurodegenerative disorders. In the case of ADHD, medical experts use rating scales, neuroimaging studies, and/or criteria in the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) to assess whether patients meet the threshold for a diagnosis.

“There’s no genetic marker for most psychiatric illness, but there is very clear heritability, as Dr. Russell Barkley has pointed out for years,” says Wes Crenshaw, Ph.D., a licensed psychologist and author. “I wonder if the Times author doubts depression? Or autism? Or anxiety? Or bipolar disorder?”

Though he was also quoted in the Times article, Crenshaw says he was never interviewed by the reporter, who pulled quotes out of context from his ADDitude articles.

ADHD Biases Divorced from Fact

Tough cited findings from the Multimodal Treatment of Attention Deficit Hyperactivity Disorder (MTA) Study to suggest that the benefits of stimulant medication wear off after 36 months. In arguing that Ritalin’s “advantage had completely faded,” Tough failed to report that long-term medication adherence among the MTA subjects was inconsistent — an important fact that undermines the author’s contradictory argument that stimulant medication is somehow both ineffective and “powerfully addictive,” as he claims in the article. (If it were addictive, wouldn’t the MTA subjects have taken it every day without fail? We know that half of teens and adults with ADHD stop taking stimulant medication within one year of starting it, suggesting that it is not addictive and shining a light on how woefully irresponsible it is to claim the ineffectiveness of a medication that is not taken consistently.)

Tough was guilty of biased reporting, or a deep misunderstanding of the subject he was covering, when he suggested that the increase in ADHD diagnosis rates — from 3 percent nearly 40 years ago to up to 11.4 percent of American children today, according to the CDC — represents a medical crisis or evidence of overdiagnosis. In truth, this uptick is is due, in large part, to a revised set of diagnostic criteria for ADHD in the DSM-5, a dramatic improvement in both clinician and patient understanding of ADHD, and critical research on its manifestations, especially in girls, women, and people of color — populations that have been historically overlooked and underserved, with serious consequences.

Perhaps the Times reporter was unaware of the basic fact that, 40 years ago, the scientific community screened almost exclusively only boys for symptoms of ADHD. It did not acknowledge the inattentive subtype of ADHD that many girls and women exhibit. And it insisted that symptoms only caused impairment in school settings. We now know much better.

Sloppy Reporting, Inaccurate Conclusions

Tough did Times readers a disservice by choosing not to interview more esteemed physicians, researchers, and clinical psychologists at the forefront of ADHD care. Instead, he plucked their quotes from the pages of ADDitude, stripped them of context, and did not pursue conversations with authors, like Crenshaw, or patients they suggested. [Crenshaw told ADDitude that, prior to the article’s publication, he offered “the author (through fact checker) a chance to interview an almost infinite number of ADHD people whose lives have been radically changed by integrative treatment.” No interviews were granted.]

For example, Tough quoted a feature from the Fall 2021 issue of ADDitude magazine in which Crenshaw addressed parents’ top concerns regarding ADHD medication. In the article, Crenshaw used established, evidence-based research to suggest that, if your child has ADHD, then stimulant medication paired with behavioral parent training and/or cognitive behavior therapy is shown to produce the greatest results in symptom management. Tough took Crenshaw’s words out of context to make it seem that he was arguing that ADHD exists as a binary, on-off diagnosis without any heterogeneity or symptom fluctuation. This is contrary to Crenshaw’s views and contradicts ADDitude‘s own recent reporting.

In its Spring 2025 issue, ADDitude magazine published a cover story titled “ADHD’s Vanishing (and Reappearing) Act,” in which author Maggie Sibley, Ph.D., explained her recent research into the sometimes unpredictable ebbs and flows of ADHD symptoms over a lifetime. Rather than acknowledge ADDitude‘s work to cover the scientific community’s evolving understanding of ADHD, Tough’s reporting painted ADDitude and its contributors as outdated. This is an unfair depiction.

He manipulated ADDitude content again in quoting an article published in 2020 and written by Roberto Olivardia, Ph.D., a clinical psychologist and Harvard Medical School lecturer. Tough did not interview Olivardia. Instead, he pulled a quote from Olivardia regarding the ways in which stimulant medication may quell a child’s social impulsivity. Tough deliberately omitted this vital precursor to the quoted statement in the ADDitude article: “Clinicians should assure parents that any medication that appears to mute the child’s positive aspects and core personality is indicative of an unsuccessful medical trial. Another medication should be tried.”

Olivardia didn’t mince words in his response to the Times article. “The suggestion that I and other ADHD clinicians would uniformly placate parental concerns with a canned response is insulting,” he says. “This is not the first time this has happened within the ADHD community, and it’s so frustrating. Some things in the article are accurate, but they are mixed in with very inaccurate, overly simplistic information.”

Unraveling a Dangerous Narrative About Medication

Of perhaps greatest concern is Tough’s inaccurate and harmful portrayal of stimulant medication as an ineffective Band-Aid that fails to improve students’ academic test scores and, therefore, must be unnecessary. He cited limited research casting doubt on ADHD medication’s ability to make kids score higher on timed tests, sort specific puzzles more efficiently, or excel in summer school. “If these studies are accurate, stimulant medications don’t do much to improve cognitive ability or academic performance,” Tough wrote. “And yet millions of young Americans (and their parents) feel that the pills are essential to their success in school. Why?”

Inexplicably, Tough did not report that ADHD medication has been shown to reduce impulsivity and, by extension, the risks of car accidents, substance abuse, unplanned pregnancy, comorbid depression and anxiety, incarceration, self-harm, and suicide. In fact, research has found that stimulant medication use among individuals with ADHD reduces the risk of premature death by a staggering 19%.

In a study published in The British Journal of Psychiatry in 2025, the life expectancy for adults with ADHD was found to be 7.5 years shorter than it was for those without the condition. Women with ADHD live 8.6 years fewer years than women without ADHD, while the life expectancy of men with ADHD was 6.8 years shorter than that of their peers. ADHD is a serious condition, and to willfully misrepresent its proven treatments is dangerous at best.

Research has documented the positive impact of ADHD treatment on life expectancy. A Swedish study, published in JAMA Network Open, followed nearly 150,000 adults and adolescents for two years after they received their ADHD diagnoses. The researchers shared the following insights about the use of stimulant medication — amphetamine or methylphenidate — which is effective for roughly 70% of patients with ADHD:

• ADHD medication use reduced overall risk of death by 19%. Among people with ADHD who did not receive medication, there were 48 deaths for every 10,000 people, contrasted with 39 deaths per 10,000 people within the medicated cohort.
• ADHD medication use reduced the risk of overdose by 50%. Medication use also reduced the risk of death from other unnatural causes, including accidental injuries, accidental poisoning such as drug overdoses, and suicide.
• ADHD medication use reduced the risk of death from natural causes, such as medical conditions, for women.

People with childhood ADHD are nearly twice as likely to develop a substance use disorder as are individuals without childhood ADHD. However, research suggests that patients with ADHD treated with stimulant medications experience a 60% reduction in substance use disorders compared to those who are not treated with stimulant medication. Considerable evidence also suggests that children taking ADHD medication experience improvements in academic and social functioning, which translates to improved self-esteem, lower rates of self-medication with drugs or alcohol, and decreased risk of substance abuse.

What’s more, researchers at the University of Michigan and Massachussets General Hospital studied 40,000 high school seniors, more than 4,000 of whom had ADHD. The research team compared the risk for marijuana abuse — the most common drug misused by this age group—among teens with ADHD to the overall population. They found that the students with the lowest incidence of substance abuse started ADHD treatment with stimulants before 9 years of age. When treatment began between ages 10 and 14, it was helpful, but the students still had a significantly higher likelihood of smoking marijuana. The highest risk of marijuana use was found among students with ADHD who started medication after age 15.

The late Joseph Biederman, M.D., the former Chief of the Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD at Massachusetts General Hospital, along with researchers at the hospital and at Massachusetts Institute of Technology, conducted a study in which teens with ADHD were separated into two groups, then tasked with driving through a virtual roadway featuring surprise events, including oncoming traffic. The teens in the first group received stimulant medication (lisdexamfetamine: brand name Vyvanse) while the teens in the second group did not. Compared with the group of non-medicated ADHD teens, the medicated group was 67% less likely to have a collision during these events.

“For families that stop ADHD treatment on weekends and during ‘downtime,’ I emphasize the importance of driving only while medication is active,” Dr. Biederman had said. “A short-acting medication taken about half an hour before hitting the road may just be lifesaving.”

Why Ignore Patients’ Real-World Experiences?

Indeed, ADHD treatment with medication is lifesaving for many children, adolescents, and adults with ADHD for many reasons beyond the decreased risks for car accidents, illegal drug use, unprotected sex, and the other dangers outlined above.

ADDitude readers write to us daily about the social, emotional, professional, and psychological benefits they experience while using prescription stimulant medication to treat their ADHD symptoms. By excluding these patient perspectives, Tough’s reporting could place lives at risk by telling a story that may scare caregivers and adult patients away from the ADHD treatments that are shown to safely, effectively improve and protect lives.

On that note, let us leave you with a few quotes from ADDitude readers explaining, in their own words, the benefits of stimulant medication and the threats they feel in 2025.

“Adderall is literally the difference between crippling depression due to executive function disorder and not. If my access to my much-needed medication goes away, the impact will be exponential.”

“If they mess with my stimulants or access to stimulants, I could lose my job and even my marriage. I rely on it to maintain focus as a design engineer. It also helps communication with my wife when I have my stimulants.”

“ADHD medication has huge benefits. It’s frustrating that the discourse is being steered from the top by someone so willfully ignorant, bringing out everyone who has totally misinformed ‘reckons’ about ADHD.”

Rebuttal from Russell Barkley, Ph.D.

More NYTimes Rebuttals

• 4-Part Video Response from Russell Barkley, Ph.D.
• The Child Mind Institute
• The ADHD Evidence Project

ADHD Article Corrections: Next Steps

• Free Download: The Ultimate Guide to ADHD Medication
• Reader Reactions: MAHA Commission Means Fear, Stigma, Health Threats for Two-Thirds of ADDitude Readers
• Read: Is ADHD Real? Yes — and Still Heavily Stigmatized

Corrections

This article was updated on April 25, 2025, to reflect the following:

• Wes Crenshaw, Ph.D., reported to ADDitude that he invited the author to interview several ADHD patients, not himself, and that invitation was not accepted
• The CDC’s 2022 estimate for the prevalence of ADHD in American children aged 3-17 years, which is 11.4 percent, not 5 to 7 percent
• Author Paul Tough did not directly describe the ADHD diagnosis process as “arbitrary,” but rather his quoted source, Edmund Sonuga-Barke, did. This quotation was removed.
• The full quote from Tough’s text was included: “If these studies are accurate, stimulant medications don’t do much to improve cognitive ability or academic performance. And yet millions of young Americans (and their parents) feel that the pills are essential to their success in school. Why?”
• This phrase was removed, “…and then questioned why American parents and students would accept the ‘risks inherent in taking prescription stimulants.'” The original article stated: “Researchers acknowledge that there are other risks inherent in taking prescription stimulants.”

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ADHD symptoms can manifest and be diagnosed in young children. In fact, research indicates that the earliest signs of ADHD can emerge in infancy. In preschoolers, certain behaviors and challenges — especially if they interfere with functioning as the child progresses through expected developmental milestones — offer early clues that ADHD is present.

Is it ADHD or Typical Preschool Behavior?

The preschool years are an exciting time of cognitive, physical, social, and emotional growth that bridges the gap between toddlerhood and the school-aged years. Common behaviors that mark the preschool years include the following:

• eagerness to participate in group activities
• curiosity and affection
• a budding sense of humor
• easily encouraged and discouraged
• intense feelings
• high energy
• showing off or demanding attention
• difficulty following adult-led activities for long periods of time
• emerging executive function skills

A wide range of behaviors is considered developmentally appropriate in preschool-age children. The following milestones, which focus on inhibition, a developing sense of danger, and awareness of social expectations, are particularly important:

• By age 3: avoids touching hot objects, like a stove, when warned
• By age 4: avoids danger (e.g., not jumping from tall heights at the playground); changes behavior based on the situation
• By age 5: follows rules and takes turns when playing games with other children; pays attention for 5 to 10 minutes during a screen-free activity

[Get This Free Download: Get the Caregiver’s Guide to Diagnosing ADHD]

The milestones above reflect the expected achievements of at least 75% of children in each age range. Similarly, common behavioral red flags that may indicate ADHD include the following:

• difficulty attending to a non-screen task for 5 to 10 minutes by age 5
• excessive climbing and jumping (like over furniture) when the behavior might not be expected or appropriate
• moving quickly from toy to toy or having difficulty playing with toys at all
• difficulty waiting; impatience
• frequently interrupting adults (during phone calls, in-person conversations)
• acting or moving in unsafe ways (e.g., bolting across the street despite being told to hold an adult’s hand, unbuckling their seat belt when the car is in motion, reaching for a piping hot dish)
• difficulty following instructions and adhering to routines
• excessive talking and noise making while doing activities (like homework)
• constantly on the go and “bouncing off the walls”; difficulty calming the body
• high reactivity
• social difficulties

It’s true that many preschool-age children will experience ADHD-like symptoms. Of these children, a small percentage will go on to develop ADHD that may impair day-to-day functioning if left untreated.

[Read: Is Preschool Too Early to Diagnose ADHD?]

How to Help Your Preschooler

By age 5, upwards of 90% of the brain is developed. Because of this, early childhood is a critical period of intervention, where new neural pathways can be built before patterns of behavior become entrenched. Here are some of the things you can do to help a child with ADHD develop positive patterns of behavior:

Offer Vigorous Praise

• Catch your preschooler being good. Celebrate your child when they engage in a behavior you want to see more of. Say, “Wow, thanks for coming to the table the first time I called you over!” or, “I love how you picked out your shirt without me even asking you to do it. Awesome work.” Do not immediately react when your child engages in behaviors you wish to see less of, like interrupting, so your child does not equate with non-preferred behaviors with instant attention.
• Praise by the numbers. You’ll be coaching and correcting your child in many ways, which makes frequent positive reinforcement essential. For every one time that you correct your child’s behavior, make sure to offer roughly four positive comments.

Model Structure & Consistency

• Use routines and visual schedules. These layer predictability into a unpredictable world, reducing stress and fostering stability. Illustrate the steps of your child’s morning, after-school, and evening routines on fun visuals to help with information processing. Have your child check off each step as they complete it.
• Offer advanced warnings. Because all good things must come to an end, let kids know when transitions are on the horizon. Give 3- and 1-minute alerts when playtime is about to end, for example. When time’s up, say, “Three, two, one, this is all done. Let me help you clean it up and move on to the next thing.” Visual timers are immensely helpful here, as they help your child know how much time is left, allowing them to better regulate their expectations and behavior.

Give Clear, Specific Instructions

• Clearly explain rules, expectations, and consequences. Your child must understand, in no uncertain terms, what is required of them and the consequences of not following the rules. You don’t want to surprise your child with an unexpected consequence for an expectation they didn’t fully understand.
  • Instead of: “Be a good boy!”
  • Try: “Please listen to your babysitter on your way home from school today.”
  • Instead of: “Play nicely with your toys!”
  • Try: “Toys are to play with. They’re not to throw. If you throw the toy, I will take it.”
  • Instead of: “Behave when you play with your brother!”
  • Try: “You cannot hit your brother. If you hit your brother, I will remove you.”
• Chunk it up — one step at a time. Directions like “get ready to go to school” or “get ready for bed” are complex and often difficult to process. Spell out all the involved micro-tasks to help your child follow through.
  • Instead of: “It’s time to go. Finish your breakfast, put your shoes on, and grab your backpack.”
  • Try: “Please finish your breakfast.” (Pause and wait to give the next step once this step is completed.)
• Avoid framing directions as questions or options that your child can say “no” to.
  • Instead of: “Can you put on your shoes?”
  • Try: “Please put on your shoes.”
  • Instead of: “Can you get ready for dinner?”
  • Try: “Please wash your hands for dinner.”

Never Penalize Your Child for Their Feelings

• Empathize but maintain expectations. Your child is allowed to feel sad or upset when, say, playtime is up. Show that you understand how they feel as you guide them to the next activity. Say:
  • “I know this is hard for you.”
  • “I hear you.”
  • “It’s OK to have big feelings.”
• Bond without correction. For 5 to 15 minutes a day, give your child your undivided attention as you engage in an activity together. Do not correct or discipline your child’s behavior during this special, positive time. If 15 minutes is too long to go without a correction, start with a shorter period of time. No matter the length, never make this bonding period with your child contingent on their behavior.

Involve the School

• Loop in your child’s school or nursery to their diagnosis and treatment program. Children with attention and regulation difficulties do better when they’re supported across environments. Without school-wide awareness, your child’s behaviors may be misunderstood and/or misattributed. Helpful school interventions include the following:
  • daily behavior report cards
  • visual schedules
  • movement breaks
  • clear directions
  • preferential seating
  • peer modeling

The Question of ADHD Medication

While the American Academy of Pediatrics (AAP) recommends behavioral interventions as the frontline treatment for ADHD in children ages 4 to 6, ADHD medication may be indicated for preschool-age children if behavioral interventions do not provide significant improvement and if moderate to severe disturbance in a child’s functioning persist. Talk to your pediatrician about whether medication may be an appropriate part of your preschooler’s treatment plan.

Signs of ADHD in Preschoolers: Next Steps

• Free Download: The Ages & Stages of ADHD: Key Solutions from Childhood to Adulthood
• Self-Test: Could Your Preschooler Have ADHD?
• Read: Starting with Preschool, Strive for Kids Who Thrive

The content for this article was derived from the ADDitude ADHD Experts webinar titled, “ADHD in Preschool: Early Diagnosis & Intervention for Young Children” [Video Replay & Podcast #516] with Alexis Bancroft, Ph.D., and Cynthia Martin, Psy.D., which was broadcast on August 8, 2024.

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

Emotional dysregulation is an invisible string linking sensory processing, anxiety, and ADHD in children, according to new research that explores the relationship between sensory processing subtypes and self-regulation in children with neurodevelopmental disorders. Researchers found that, while some sensory subtypes were associated with elevated anxiety and others with elevated ADHD symptomatology, all sensory processing subtypes were associated with higher emotional dysregulation compared with sensory-typical children.

The study, published in Nature, enrolled 117 participants from a community-based specialty clinic; all participants were children aged 8 to 12 years old with various neurodevelopmental diagnoses, including autism and ADHD.¹ The researchers uncovered five distinct sensory processing profiles in this group:

• Typical Sensory Processing (30% of the sample)
• Sensory Under-Responsive (20%): Child often does not respond to verbal information or what is around them
• Sensory Over-Responsive (19%): Child is bothered by wearing certain garments or by loud sounds
• Sensory Seeking (19%): Child has a persistent desire for fast movement and often cannot stop touching things or people
• Mixed Sensory Processing (11%): A combination of the above, depending on context or the stimuli

The study highlights the “wide range of heterogeneity in sensory experiences among populations with neurodevelopmental concerns,” say the study’s authors.

Elevated Emotional Dysregulation, Anxiety, ADHD

The researchers investigated the prevalence of behavioral and emotional regulation challenges in the group as a whole and in different sensory subtypes. They also considered the following comorbidities:

• 62% of the group exhibited ADHD symptoms
• 39% exhibited emotion dysregulation
• 19% exhibited anxiety

They also studied patterns associated with specific sensory subtypes:

• Children in the sensory over-responsive subtype reported significantly elevated anxiety levels.
• Children in the sensory seeking and sensory under-responsive subtypes reported the highest levels of ADHD behaviors.
• All subtypes, apart from typical sensory processing, reported elevated levels of emotion dysregulation.

These findings offer insights into the complicated relationship between sensory processing and self-regulation challenges, which researchers hope will help clinicians better serve neurodivergent children through targeted interventions that address overlapping symptomology.

“Not many people realize that the sensory systems are foundational to development, functioning and wellbeing. Differences in sensory processing may undermine the acquisition of skills of a higher order – from behavior to learning,” explains Candace Peterson MS, OTRL, in her ADDitude article. “What Is Your Child’s Sensory Profile?” “This is why sensory challenges in kids often manifest in school, show up as behavior problems, and make daily living difficult.”

An ADDitude reader who struggles with sensory over-responsiveness explains: “Sounds seem to overstimulate me the most frequently and easily. It feels like the sounds are physically pushing me into a corner and squishing me.” Another reader with sensory over-responsiveness says clothing tags and seams are her “mortal enemies.” “On good days, they’re a slight annoyance,” she says. “On bad days, it feels like they’ve come alive with tiny needles for fingers, incessantly poking at me, causing repeated stings.”

Sources

¹Brandes-Aitken, A., Powers, R., Wren, J. et al. Sensory processing subtypes relate to distinct emotional and behavioral phenotypes in a mixed neurodevelopmental cohort. Sci Rep 14, 29326 (2024). https://doi.org/10.1038/s41598-024-78573-2

ADHD is not a static condition with fixed symptoms, but rather a dynamic disorder with symptoms that wax and wane over the lifespan, sometimes disappearing for years at a time. This was the finding of a new study published in the Journal of Clinical Psychiatry ¹ that made another unexpected discovery: periods of higher environmental demands were associated with times of remission or reduced ADHD symptoms.

Led by Margaret Sibley, Ph.D., professor of psychiatry and behavioral sciences at the University of Washington School of Medicine, the research used data from the longitudinal Multimodal Treatment of ADHD (MTA) study, which followed 483 participants, diagnosed with ADHD at 7-10 years of age, for 16 years.² Follow-up assessments, which were administered every two years, asked participants and parents about the severity and frequency of ADHD symptoms and impairments, as well as about environmental demands, including responsibilities in education, work, and finances.

The researchers found that longitudinal patterns revealed four groups:

• Fluctuating ADHD: 64%

Alternating periods of remission and recurrence

• Stable Partial Remission: 16%

A significant reduction in symptoms was experienced, typically beginning in late adolescence or early adulthood, that remained stable afterward

• Stable Persistence: 11%

High symptoms that met diagnostic thresholds with minimal or no improvement over time

• Recovery: 9%

Sustained full remission of symptoms

Among the group that experienced fluctuating ADHD, the following trends were uncovered:

• There were typically three to four transitions between remission and recurrence over the 16-year period.
• The first remission period often began in early adolescence, around age 12, with symptoms returning within a few years.
• Compared to other groups, symptom severity was moderate.

ADHD symptoms improved to a point of remission at some point over the 16 years for most study participants, Sibley explains in an article titled “ADHD’s Vanishing Act” that appears in ADDitude’s forthcoming spring 2025 issue. In most cases, faded symptoms returned three to four years later, Sibley says.

“In other words, most individuals with ADHD can expect to go through years when their symptoms do not cause meaningful problems,” Sibley writes. “The neurocognitive risks are always present, but the clinical problems may only emerge sometimes. This is comparable to a person who may struggle with weight gain biologically, but who may fluctuate in and out of the obesity range over the course of their lifetime.”

A Busy Schedule Linked to Reduced ADHD Symptoms

The MTA study gathered information about environmental demands, such as an increase in significant responsibilities at work, school, or home, in order to explore whether these demands impacted ADHD symptoms. It turns out they did — but not in the way researchers hypothesized.

“We speculated that increased stresses would be associated with higher levels of ADHD in participants,” Sibley explains. “We were surprised to find quite the opposite, [that] higher levels of demands were associated with remission of ADHD. In other words, people with ADHD were rising to the challenge when demands were high.”

Sibley notes that the nature of the relationship between higher demands and reduced symptoms remains unclear; the study revealed a link, but not how the link works.  “One explanation is that ADHD symptoms fade when consequences in the environment create an urgent need to stay on track,” she speculates. “It is also possible that, when people have lower ADHD symptom levels, they are able to take on greater responsibilities.” Likely, it’s a combination of the two, Sibley says.

Childhood Factors Predict Long-Term Outcomes

The study found that certain childhood factors served as predictors for long-term outcomes. Individuals in the stable persistent group tended to be at higher risk for mood disorders, substance use problems in adolescence, low medication utilization, and poorer response to treatment in childhood. Those in the partial remission group tended to have higher rates of comorbid anxiety. By contrast, individuals in the recovery group were less likely to have mood disorders and parents with psychopathology.

The study helps the scientific community more fully understand the complex landscape of ADHD, and Sibley sees great potential benefit if clinicians pass along this nuanced understanding to patients.

“For some people with ADHD, this may mean staying busy and keeping an active schedule,” Sibley ventures. “It may also mean working with practitioners to leverage a nuanced understanding of ADHD fluctuations when designing a treatment plan that boosts wellbeing.”

Sources

¹Sibley MH, Kennedy TM, Swanson JM, Arnold LE, Jensen PS, Hechtman LT, Molina BSG, Howard A, Greenhill L, Chronis-Tuscano A, Mitchell JT, Newcorn JH, Rohde LA, Hinshaw SP. Characteristics and Predictors of Fluctuating Attention-Deficit/Hyperactivity Disorder in the Multimodal Treatment of ADHD (MTA) Study. J Clin Psychiatry. 2024 Oct 16;85(4):24m15395. doi: 10.4088/JCP.24m15395. PMID: 39431909.

²The MTA Cooperative Group: A 14-Month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder (ADHD) . Arch Gen Psychiatry 1999;56:1073-1086.

What are the signs of ADHD in a preschooler? Can preschoolers be diagnosed with ADHD? Research suggests that symptoms of ADHD can emerge in young children. In fact, to qualify for an ADHD diagnosis under the Diagnostic and Statistical Manual (DSM-5), the symptoms must be present before the age of 12. But because preschool children are typically active and easily distractable, identifying early signs of ADHD can be a challenge.

In general, today’s parents have more research-based information available to them than did previous generations of caregivers. But so-called “expert” opinions often conflict about what constitutes typical toddler behavior. Some experts minimize extreme behavior and suggest that most children will simply “outgrow” hyperactive or impulsive tendencies. Others over-pathologize common variations in typical child development, such as when preschoolers struggle to stay engaged in adult-oriented activities that are challenging for most young children. The contradictory information can leave parents perplexed about how to address their child’s behavior and whether that behavior indicates early signs of ADHD.

As such, conversations between parents and providers on the early identification and treatment of ADHD are critical. Indeed, some children will exhibit emergence of ADHD in early development, and the accurate diagnosis of children with ADHD can, in turn, help parents learn strategies to mitigate challenging behavior and teach skills that lead to long-term success.

This webinar will provide an overview of the behavioral onset patterns of ADHD as well as the early signs, symptoms, and treatment for preschool children with suspected ADHD.

In this webinar, participants will also learn:

• How to differentiate between typical development and behaviors among preschoolers that may indicate ADHD
• About the different types of ADHD and their early signs and symptoms
• How a diagnosis of ADHD is made during the preschool years
• Evidenced-based treatment guidelines for managing ADHD in young children at home and in preschool
• How to advocate for your child’s needs

Watch the Video Replay

Enter your email address in the box above labeled “Video Replay + Slide Access” to watch the video replay (closed captions available) and download the slide presentation.

Download or Stream the Podcast Audio

Click the play button below to listen to this episode directly in your browser, click the  symbol to download to listen later, or open in your podcasts app: Apple Podcasts; Audacy; Spotify; Amazon Music; iHeartRADIO 

ADHD in Preschool: More Resources

• Self-Test: ADHD Symptoms in Children
• Read: Isn’t My 4-Year-Old Too Young to Be Diagnosed With ADHD?
• Read: “The Day My Hyperactive Toddler Aced His ADHD Test”
• eBook: A Parent’s Guide to Effective Routines

Obtain a Certificate of Attendance

If you attended the live webinar on August 8, 2024, watched the video replay, or listened to the podcast, you may purchase a certificate of attendance option (cost: $10). Note: ADDitude does not offer CEU credits. Click here to purchase the certificate of attendance option »

Meet the Expert Speakers

Alexis Bancroft, Ph.D., is a psychologist in the Autism Center at the Child Mind Institute. She is a nationally certified school psychologist and a leader in the field of early childhood development. Dr. Bancroft specializes in the psychological and neuropsychological evaluation of individuals with autism and co-occurring neurodevelopmental disorders. She received her Ph.D. in school psychology from Columbia University and completed an APA-accredited internship at Mount Sinai Hospital in New York City, NY. Dr. Bancroft also completed a two-year postdoctoral fellowship program in pediatric psychology, with an emphasis in neurodevelopmental disorders, at Boston Children’s Hospital/Harvard Medical School. Read more here.

Cynthia Martin, Psy.D., is the Senior Director and a senior psychologist in the Autism Center at the Child Mind Institute. She is a nationally recognized expert in autism, neurodevelopmental disorders and rare genetic conditions that affect development and behavior. Dr. Martin is an international trainer on gold standard assessments used in autism evaluations and she specializes in the comprehensive evaluation, early detection and evidenced-based treatment of autism and related disorders. Read more here.

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ADHD symptoms in children and adolescents are routinely overlooked by general practitioners (GPs), who see these patients more often than they do their neurotypical peers in the two years preceding a diagnosis, according to the journal Archives of Disease in Childhood. With better training in ADHD, GPs could recognize these frequent visits — for everything from asthma and eczema to behavioral disorders — as possible indicators of ADHD and opportunities for early evaluation, say the researchers behind the study. ¹

The study found that children ultimately diagnosed with ADHD seek medical care, consult healthcare providers, undergo surgery, and get admitted to hospitals at double the rate of their neurotypical peers in the years preceding diagnosis. They also show increased rates of physical conditions, such as asthma and eczema; behavioral and mental health issues; learning differences, such as dyspraxia and dyslexia; autism; tics; and insomnia before receiving an ADHD diagnosis.

The research team from the University of Nottingham and King’s College London reported that reasons for delays in ADHD diagnosis referrals stemmed from GPs’ difficulty recognizing ADHD symptoms in children and a lack of specific recommendations for earlier ADHD detection in current guidelines from organizations such as the National Institute for Health and Care Excellence and the American Academy of Pediatrics. ²,³,⁴

William W. Dodson, M.D., LF-APA, clinician, writer, speaker, and consultant on ADHD medicine, says the lack of training hinders pediatricians and nurse practitioners as well as psychiatrists. “Around 93% of adult psychiatrists, when asked, report that they’ve never had any ADHD training, either in their residency or in their continuing medical education, whether in children, adolescents, or adults,” he says.

Inadequate training in early signs of ADHD may cause GPs to miss opportunities to identify and evaluate ADHD symptoms in children. “The peak age for diagnosis of ADHD is at 7 to 9 years,” the study’s authors wrote. “Yet, it is likely to have been present from an earlier age, with persistent symptoms.”

Untreated ADHD is associated with poor relationships and social functioning, low self-esteem, academic under-attainment, and injuries. In addition, children with ADHD may incur greater healthcare costs before their diagnosis.⁵

“The study underscores the importance of conducting additional research to identify children with ADHD at an earlier stage, thereby enabling them to receive more timely and effective treatments, including therapeutic interventions and medications,” the study’s authors wrote.

The clinical practice guidelines for ADHD, developed by the American Academy of Child and Adolescent Psychiatry (AACAP), recommend medication as the first-line treatment for ADHD in school-age children, citing a formal review of 78 studies on the treatment of ADHD, which “consistently supported the superiority of stimulant over the non-drug treatment.” (Footnote 5) According to the American Academy of Pediatrics (AAP), 80% of the children who use stimulant medications, either alone or combined with behavior therapy, increase focus and decrease impulsivity.⁶,⁷

“Treatment with ADHD stimulant medication prior to age 9 may actually decrease your child’s likelihood of abusing drugs and alcohol later in life, according to research,” says Timothy Wilens, M.D., an associate professor of psychiatry at Harvard Medical School. “Considerable evidence also suggests that children taking ADHD medication commonly experience improvements to academic and social functioning, which translates to improved self-esteem, lower rates of self-medication with drugs or alcohol, and decreased risk of substance abuse.”⁸

The population-based matched case-control study analyzed the medical records from 1998-2015 of 8,127 children and adolescents aged 4 to 17 years who were diagnosed with ADHD and 40,136 without ADHD from the Clinical Practice Research Datalink, a primary care database of 60 million patients in the U.K.

Sources

¹Prasad, V., Rezel-Potts, E., White, P., et al. (2024). Use of Healthcare Services Before Diagnosis of Attention-Deficit/Hyperactivity Disorder: A Population-Based Matched Case-Control Study. Archives of Disease in Childhood. https://adc.bmj.com/content/109/1/46
²Sayal, K., Prasad, V., Daley, D., et al . (2018). ADHD in Children and Young People: Prevalence, Care Pathways, and Service Provision. Lancet Psychiatry. doi:10.1016/S2215-0366(17)3016
³Tatlow-Golden, M., Prihodova, L., Gavin, B., et al. (2016) What Do General Practitioners Know About ADHD? Attitudes and Knowledge Among First-Contact Gatekeepers: Systematic Narrative Review. BMC Fam Pract. doi:10.1186/s12875-016-0516-x
⁴Sayal, K., Taylor, E., Beecham, J., et al. (2002). Pathways to Care in Children at Risk of Attention-Deficit Hyperactivity Disorder. Br J Psychiatry. doi:10.1192/bjp.181.1.43
⁵Holden, S.E., Jenkins-Jones, S., Poole, C.D., et al. (2013). The Prevalence and Incidence, Resource Use and Financial Costs of Treating People with Attention Deficit/Hyperactivity Disorder (ADHD) in the United Kingdom (1998 to 2010). Child Adolesc Psychiatry Ment Health. doi:10.1186/1753-2000-7-
⁶Pliszka, Steven. (2007). “Practice Parameter for the Assessment and Treatment of Children and Adolescents With Attention-Deficit/Hyperactivity Disorder.” Journal of the American Academy of Child & Adolescent Psychiatry. doi:10.1097/chi.0b013e318054e724
⁷Clinical Practice Guideline: Treatment of the School-Aged Child With Attention-Deficit/Hyperactivity Disorder. American Academy of Pediatrics. (Oct. 2001). https://pediatrics.aappublications.org/content/108/4/1033
⁸McCabe SE, et al. (2016). Age of Onset, Duration, and Type of Medication Therapy for Attention-Deficit/Hyperactivity Disorder (ADHD) and Substance Use During Adolescence: A Multi-Cohort National Study. J Am Acad Child Adolesc Psychiatry. 2016; 55(6):479-486: doi: 10.1016/j.jaac.2016.03.011

Depression and anxiety disorders occur with attention deficit hyperactivity disorder (ADHD) at significant rates. While figures vary across studies, it’s estimated that 18% of adults with ADHD also have major depressive disorder, and about half of adults with ADHD have anxiety.¹ What explains these high comorbidity rates?

Many factors may explain the overlap, and one of them I can’t stress enough: ADHD does not happen in a vacuum, and its effects are far more impairing when the condition goes undiagnosed, untreated, or improperly treated.

Untreated ADHD Causes Feelings of Inadequacy

Undiagnosed and/or untreated ADHD makes children, teens, and adults who are otherwise bright and competent feel severely inadequate. It’s not difficult to see how; untreated symptoms of ADHD, from impulsivity and emotional instability to poor planning and execution skills compromise one’s ability to find success in school, work, relationships, and other parts of life. Ongoing challenges and failures, especially when the root cause is neither identified nor treated, makes these individuals feel like failures — like they aren’t trying hard enough. Self-esteem, as a result, plummets.

Other emotions — like anger, resentment, and feelings of worthlessness — often come up as a result of experiencing challenges related to undiagnosed and/or untreated ADHD. Emotional sensitivity and reactivity are not uncommon, especially strong emotional responses to failure. These emotions cause depression and anxiety to develop. Irritability and feelings of worthlessness, after all, are symptoms of depression.

Living with ADHD and depression, of course, creates its own set of challenges. Children with ADHD and depression, for example, experience more impairment in social and academic functioning than do children with just ADHD or children without ADHD.²

[Self-Test: Could You Be Showing Signs of Depression?]

In adolescents with ADHD, feelings of worthlessness are particularly important to recognize, as one study found that these feelings are directly related to suicidal thoughts and planning.³

Women with ADHD Are at Greater Risk for Depression

ADHD does not disappear with age for most people⁴, and the longer ADHD goes undiagnosed, the more problems it potentially creates as life’s demands and responsibilities evolve in complexity. This may explain why females with ADHD — who tend to be diagnosed later than males — are more than twice as likely to develop depression compared to females without ADHD.⁵ Hyperactivity and impulsivity — obvious signs of ADHD — are not so common in girls and women, which may explain why clinicians miss or misdiagnose their ADHD. What we often see now is women getting diagnosed while in college.

Depression also appears to take a greater toll on women with ADHD, as depression has an earlier age of onset, lasts longer, comes with more severe symptoms, a higher rate of suicidality, and a greater likelihood of requiring psychiatric hospitalization in this group compared to women without ADHD.⁵

The Importance of Recognizing ADHD, Depression, and Anxiety

Yes, there is significant comorbidity between ADHD, depression, and anxiety. But even together, these conditions are treatable. Complete, thorough evaluations are a must to identify and properly manage these conditions in patients as early as possible. Measurement-based tools can help clinicians in this respect. Clinicom® is a psychiatric assessment tool I have been developing and refining for many years to help clinicians identify more conditions that may be comorbid with a patient’s presenting complaint. The assessment tool, completed by patients, can identify 80 psychiatric conditions, and it also takes a patient’s environmental stressors into account. (As epigenetics research tells us, we cannot ignore our environment, and adverse life events do appear to be linked to a whole host of conditions, including ADHD.^{6 7})

[Get This Free Download: Signs of Depression That May Surprise You]

As an example, I recently saw an 18-year-old female patient — a college student — with depression as her chief complaint. She completed the Clinicom assessment before her visit, and after a thorough evaluation that accounted for personal and family history and stressors, we realized she exhibited symptoms of ADHD — undiagnosed until then — and generalized anxiety disorder, among other conditions.

I can tell you story after story of seeing patients who did not know they had ADHD, and who had succumbed to the belief that they were failures and would never accomplish anything. I remember another patient I first saw as she was finishing high school. After an extensive evaluation, we diagnosed her with ADHD and started her on treatment. Many years later, she came back to my clinic — when she was finishing her medical school residency — to thank us for treating her. And that meant the world to me.

Untreated ADHD in Adults: Next Steps

• Read: Depression — When It’s More Than a Symptom Of ADHD
• Read: What’s Behind the “Depression Gap” Impacting Women?
• Read: Late Diagnosis — Was ADHD to Blame All Along?

The content for this article was derived from the ADDitude ADHD Experts webinar titled, “New Insights Into and Treatments for Comorbid Depression” [Video Replay & Podcast #456]  with Nelson M. Handal, M.D., DFAPA, which was broadcast on May 24, 2023.

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Sources

¹ Kessler, R. C., Adler, L., Barkley, R., Biederman, J., Conners, C. K., Demler, O., Faraone, S. V., Greenhill, L. L., Howes, M. J., Secnik, K., Spencer, T., Ustun, T. B., Walters, E. E., & Zaslavsky, A. M. (2006). The prevalence and correlates of adult ADHD in the United States: results from the National Comorbidity Survey Replication. The American journal of psychiatry, 163(4), 716–723. https://doi.org/10.1176/ajp.2006.163.4.716

² Blackman, G. L., Ostrander, R., & Herman, K. C. (2005). Children with ADHD and depression: a multisource, multimethod assessment of clinical, social, and academic functioning. Journal of attention disorders, 8(4), 195–207. https://doi.org/10.1177/1087054705278777

³ Katzenmajer-Pump, L., Komáromy, D., & Balázs, J. (2022). The importance of recognizing worthlessness for suicide prevention in adolescents with Attention-deficit/hyperactivity disorder. Frontiers in psychiatry, 13, 969164. https://doi.org/10.3389/fpsyt.2022.969164

⁴ Michielsen, M., Semeijn, E., Comijs, H. C., van de Ven, P., Beekman, A. T., Deeg, D. J., & Kooij, J. J. (2012). Prevalence of attention-deficit hyperactivity disorder in older adults in The Netherlands. The British journal of psychiatry : the journal of mental science, 201(4), 298–305. https://doi.org/10.1192/bjp.bp.111.101196

⁵ Biederman, J., Ball, S. W., Monuteaux, M. C., Mick, E., Spencer, T. J., McCREARY, M., Cote, M., & Faraone, S. V. (2008). New insights into the comorbidity between ADHD and major depression in adolescent and young adult females. Journal of the American Academy of Child and Adolescent Psychiatry, 47(4), 426–434. https://doi.org/10.1097/CHI.0b013e31816429d3

The Caregiver’s Guide to ADHD Diagnosis is a joint effort from WebMD and ADDitude designed to guide individuals through the difficult, important decisions they face when pursuing an evaluation for ADHD and its comorbid conditions in their children. This guided email course will cover the following topics:

DECISION 1: How can I better understand ADHD, its causes, and its manifestations?
DECISION 2: How can I understand the aspects of ADHD that might be new to the doctor?
DECISION 3: How can I improve the odds of an accurate ADHD evaluation for my child?
DECISION 4: How can I find the most appropriate professional to diagnose and treat my child’s ADHD?
DECISION 5: What should a thorough evaluation for pediatric ADHD include and exclude?
DECISION 6: How can I be sure my child’s evaluation screens for psychiatric comorbidities?
DECISION 7: How can I be sure my child’s evaluation considers look-alike comorbidities?
DECISION 8: Should my child be screened for the sleep, eating, and other disorders?

NOTE: This resource is for personal use only.

SLEEP: What sleep disorders commonly co-occur with ADHD in children?

A: In one study, about half the parents said their child with ADHD had difficulty sleeping. They said their child felt tired when they woke up, had nightmares, or had… | Keep reading on ADDitude »

SPD: What distinguishes ADHD from sensory processing disorder?

A: Both disorders will make you restless and unable to concentrate. You could also find it hard to control your emotions. Children might have frequent meltdowns… | Keep reading on ADDitude »

EATING DISORDERS: What distinguishes eating disorders from ADHD?

A: For individuals with bulimia nervosa, food is self-medication for anxiety, stress, anger, and boredom. Eating is stimulating, and food fills the gap. People with ADHD who… | Keep reading on ADDitude »

PTSD:  Does trauma increase the likelihood for ADHD in children, and vice versa?

A: ADHD is a largely genetic condition that impacts specific areas of the brain. Because trauma affects those same areas of… | Keep reading on ADDitude »

BFRB: What body-focused repetitive behaviors common co-occur with ADHD in children?

A: Recent studies suggest that 20 to 38 percent of children with trichotillomania also meet the criteria for ADHD. Available prevalence rates are few, but they suggest that… | Keep reading on ADDitude »

TRAUMA: What should I know about the impact of trauma and stress on developing brains?

A: Under stress and exposure to trauma, the brain effectively enters survival mode. It funnels more fuel and resources into the limbic system and diverts them away from the prefrontal cortex… | Keep reading on ADDitude »

FIRST-PERSON: “Sometimes, Raising My Sensitive Child Was Hell”

“Baths, sounds, clothing textures, food textures, naptime, bedtime — almost every daily routine set off meltdowns that made our daily life hell. I called them tantrums, but looking back, they were much more than that. My thought every day was ‘just get through it.'” | Keep reading on ADDitude »

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SYMPTOM TEST: Sensory Processing Disorder in Children

SPD interferes with the body’s ability to interpret sensory messages from the brain, and may manifest as meltdowns or anxiety. | Take the self-test on ADDitude »

SYMPTOM TEST: Eating Disorders in Children and Teens

Does your child express concerns about their body size? Feel guilty after eating? | Take the self-test on ADDitude »

8-Part Guide to ADHD Diagnosis in Children:

Q 1: How can I better understand ADHD, its causes, and its manifestations?
Q 2: How can I understand the aspects of ADHD that might be new to the doctor?
Q 3: How can I improve the odds of an accurate ADHD evaluation for my child?
Q 4: How can I find a professional to diagnose and treat my child’s ADHD?
Q 5: What should a thorough evaluation for pediatric ADHD include and exclude?
Q 6: How can I be sure my child’s evaluation screens for psychiatric comorbidities?
Q 7: How can I be sure my child’s evaluation considers look-alike comorbidities?
> Q 8: Should my child be screened for the sleep, eating, and other disorders?

LDs: What distinguishes ADHD from learning differences?

A: Between 30–50% of those with ADHD also have a learning disability — and if an LD is not recognized early, a child might exhibit ADHD-like symptoms… | Keep reading on ADDitude »

ODD: What distinguishes ADHD from oppositional defiant disorder?

A: ADHD is a type of brain disorder that often lasts well into adulthood. ODD is a type of behavior disorder that’s mostly diagnosed in childhood. If your child has ODD, they tend to be… | Keep reading on ADDitude »

AUTISM: What distinguishes ADHD from autism in children?

A: Autism spectrum disorders are a series of related developmental disorders that can affect language skills, behavior, socializing, and… | Keep reading on ADDitude »

CD: What distinguishes ADHD from conduct disorder?

A: While kids with ADHD might be disruptive, they aren’t typically aggressive. When kids show a pattern of more aggressive, violent, or antisocial behaviors… | Keep reading on ADDitude »

TIC DISORDERS: What distinguishes ADHD from Tourette’s Syndrome?

A: The main symptom of Tourette’s syndrome is repeated movements or sounds, called tics, that a person can’t control. They can be simple, like constant eye blinking, sniffing… | Keep reading on ADDitude »

FIRST-PERSON: “How My Son’s ADHD Masked His Dyslexia”

“Some of the signs were obvious, in retrospect. He was a late reader. He had significant struggles with spelling. But here’s where I went off track: I wrongly assumed that these issues were due to his ADHD distractibility. So many other things had landed in that bucket, why not this?” | Keep reading on ADDitude »

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SYMPTOM TEST: ODD in Children

Is your child touchy, prickly, or easily offended? Test limits by ignoring rules or arguing? | Take the self-test on ADDitude »

SYMPTOM TEST: Learning Disabilities in Children

Could your child’s reading, math, spelling, or coordination challenges be signs of a learning difference? | Take the self-test on ADDitude »

8-Part Guide to ADHD Diagnosis in Children:

Q 1: How can I better understand ADHD, its causes, and its manifestations?
Q 2: How can I understand the aspects of ADHD that might be new to the doctor?
Q 3: How can I improve the odds of an accurate ADHD evaluation for my child?
Q 4: How can I find a professional to diagnose and treat my child’s ADHD?
Q 5: What should a thorough evaluation for pediatric ADHD include and exclude?
Q 6: How can I be sure my child’s evaluation screens for psychiatric comorbidities?
> Q 7: How can I be sure my child’s evaluation considers look-alike comorbidities?
Q 8: Should my child be screened for the sleep, eating, and other disorders?

COMORBIDITIES: What co-existing conditions should my child’s doctor consider when evaluating for ADHD?

A: ADHD rarely exists in isolation. Clinicians must properly screen for and address ADHD and its comorbidities… | Keep reading on ADDitude »

DEPRESSION: What distinguishes ADHD from depression in children?

A: Clinical depression is more than just the blues. It’s a serious illness, and it affects more young people than parents realize… | Keep reading on ADDitude »

ANXIETY: What distinguishes ADHD from anxiety in children?

A: Some anxiety disorders can be hard to spot in children because symptoms include internal thoughts and feelings that don’t always… | Keep reading on ADDitude »

OCD: What distinguishes ADHD from OCD in children?

A: Obsessive-compulsive disorder is marked by repetitive thoughts or fears (obsessions) that may turn into repetitive behaviors… | Keep reading on ADDitude »

BIPOLAR: What distinguishes ADHD from bipolar disorder in children?

A: Medical science is learning more about bipolar disorder in children and teens. But the condition is still difficult to diagnose. That’s especially true for teenagers in whom irritability and moodiness… | Keep reading on ADDitude »

DMDD: What are the symptoms of disruptive mood dysregulation disorder in children?

A: DMDD causes children to experience unstable emotions they cannot regulate, including extreme outbursts of anger, leading to temper tantrums. These outbursts often occur in response to… | Keep reading on ADDitude »

FIRST-PERSON: “How I Calmed My Daughter’s Anxiety Attack”

“It’s critical that you accept the attack as real. The dizziness, sweating, chest pain, racing heart — all of it is real. Don’t tell her that it’s just in her head or that she’s OK. So what can you do? Start by holding her close.” | Keep reading on ADDitude »

RELATED RESOURCES

SYMPTOM TEST: Generalized Anxiety Disorder in Children

Every child worries sometimes — about monsters or tests or new experiences. A child with anxiety feels anxious about nearly everything. | Take the self-test on ADDitude »

SYMPTOM TEST: Depression in Children

Does your child say they’re ‘too tired’ to do activities they used to love? Have trouble making even simple decisions? | Take the self-test on ADDitude »

8-Part Guide to ADHD Diagnosis in Children:

Q 1: How can I better understand ADHD, its causes, and its manifestations?
Q 2: How can I understand the aspects of ADHD that might be new to the doctor?
Q 3: How can I improve the odds of an accurate ADHD evaluation for my child?
Q 4: How can I find a professional to diagnose and treat my child’s ADHD?
Q 5: What should a thorough evaluation for pediatric ADHD include and exclude?
> Q 6: How can I be sure my child’s evaluation screens for psychiatric comorbidities?
Q 7: How can I be sure my child’s evaluation considers look-alike comorbidities?
Q 8: Should my child be screened for the sleep, eating, and other disorders?

EVALUATIONS: What is the step-by-step ADHD evaluation process for children?

A: Diagnosing ADHD is a process that takes several steps and involves gathering information from multiple sources. You, your child… | Keep reading on ADDitude »

EARLY DIAGNOSIS: Can my child be evaluated for ADHD as early as preschool?

A: Most children aren’t checked for ADHD until they’re school age, but kids as young as 4 can be diagnosed, according to guidelines… | Keep reading on ADDitude »

TESTS: What tests are used to diagnose ADHD in children?

A: There’s no single test to diagnose ADHD. Instead, doctors rely on several things, including interviews with the parents, relatives, teachers, or other adults, questionnaires or rating scales… | Keep reading on ADDitude »

ONLINE CARE: Can my child get diagnosed with ADHD via a telehealth appointment?

A: While much of the process can be done online, medication fulfillment, physical exams, and cognitive or educational testing may… | Keep reading on ADDitude »

DIFFERENTIAL DIAGNOSIS: How can I be sure my child’s symptoms don’t point to another condition?

A: Many other disorders have the same, or similar, symptoms as ADHD, so it’s important for your doctor to look for all possibilities before coming to a conclusion… | Keep reading on ADDitude »

TIMELINE: How long will it take to get my child evaluated for and diagnosed with ADHD?

A: An initial consultation with the patient (and parents) could range from 45 minutes to two hours or more. You should also expect to fill out questionnaires, checklists… | Keep reading on ADDitude »

FIRST-PERSON: “How a Diagnosis Unlocked My Son’s Best Self”

“Gone was my happy, carefree boy who would sing in his room and laugh at our cats. In his place was a struggling child who could not focus on schoolwork, who had trouble getting along with other kids, and whose mishaps were bleeding him dry.” | Keep reading on ADDitude »

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FREE DOWNLOAD: ADHD Diagnosis Guide

There is no definitive way to check for ADHD. No blood test or X-ray. There is, however, a logical set of steps that medical professionals should take. | Download now on ADDitude »

FREE DOWNLOAD: Common ADHD Diagnosis Mistakes

Doctors sometimes diagnose ADHD too quickly. Here’s what you need to know to avoid common mistakes. | Download now on ADDitude »

8-Part Guide to ADHD Diagnosis in Children:

Q 1: How can I better understand ADHD, its causes, and its manifestations?
Q 2: How can I understand the aspects of ADHD that might be new to the doctor?
Q 3: How can I improve the odds of an accurate ADHD evaluation for my child?
Q 4: How can I find a professional to diagnose and treat my child’s ADHD?
> Q 5: What should a thorough evaluation for pediatric ADHD include and exclude?
Q 6: How can I be sure my child’s evaluation screens for psychiatric comorbidities?
Q 7: How can I be sure my child’s evaluation considers look-alike comorbidities?
Q 8: Should my child be screened for the sleep, eating, and other disorders?

HEALTH CARE TEAM: What types of providers should be on my child’s ADHD health care team?

A: If your child has ADHD symptoms, contact their doctor or pediatrician as a first step. They should already have a strong relationship with your family… | Keep reading on ADDitude »

FINDING A DOC: How can I choose the best health care professional(s) to manage my child’s ADHD?

A: When you find out your child has ADHD, you can turn to a team of pros who can get them the right treatment. Each one plays a different role… | Keep reading on ADDitude »

ASSESSING PROFESSIONALS:  What questions should I ask in evaluating health care providers to diagnose my child’s ADHD?

A: How many of your pediatric patients have ADHD? How do you evaluate the symptoms of ADHD in children?… | Keep reading on ADDitude »

SPECIALISTS: What steps should I follow to find an ADHD specialist for my child?

A: If your pediatrician dismisses your worries, you should request a referral to a specialist in child behavior and development… | Keep reading on ADDitude »

THE RIGHT FIT: How can I tell if a doctor is a good fit for our family?

A: What qualities in a health care provider are important to you? The following is a list of traits that people most often mention when asked what they want from a health care professional… | Keep reading on ADDitude »

FIRST QUESTIONS: How can I best prepare for my child’s ADHD evaluation?

A: Strong, engaged advocacy will help ensure the best outcomes for your child. Knowing the right questions to ask yourself and other professionals before your child’s ADHD evaluation will… | Keep reading on ADDitude »

FIRST-PERSON: “7 Therapists — and Counting”

“And then there were seven. Later this week, we’ll be meeting Dr. P, a cognitive behavioral therapist recommended by ‘the team.’ And I’ll do my best to stop judging who we are, who we’ve become, and how we got here.” | Keep reading on ADDitude »

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Use this comparison chart to help you understand the benefits and drawbacks of each option. | Download now on ADDitude »

EXPERT WEBINAR: Forming a Cross-Functional Care Team

Expert webinar with Leslie F. Graham, MSW, Douglas Russell, M.D., and Sheryl Morelli, M.D. | Listen now on ADDitude »

8-Part Guide to ADHD Diagnosis in Children:

Q 1: How can I better understand ADHD, its causes, and its manifestations?
Q 2: How can I understand the aspects of ADHD that might be new to the doctor?
Q 3: How can I improve the odds of an accurate ADHD evaluation for my child?
> Q 4: How can I find a professional to diagnose and treat my child’s ADHD?
Q 5: What should a thorough evaluation for pediatric ADHD include and exclude?
Q 6: How can I be sure my child’s evaluation screens for psychiatric comorbidities?
Q 7: How can I be sure my child’s evaluation considers look-alike comorbidities?
Q 8: Should my child be screened for the sleep, eating, and other disorders?

GENDER: Why is ADHD so often missed or misdiagnosed in girls?

A: Hyperactivity and impulsivity are two of the most well-known symptoms of ADHD. But they aren’t as common with girls… | Keep reading on ADDitude »

DIAGNOSING GIRLS: How can parents and doctors better recognize signs of ADHD in girls?

A: Girls with inattention can compensate in the early school years, especially if they’re bright. But the strategies often fail when they get to middle school, which demands more planning… | Keep reading on ADDitude »

AGE-BY-AGE: How might my child’s ADHD symptoms change as they age?

A: In the teen years, hyperactivity tends to improve. But your child may feel restless and be uncomfortable sitting for long periods. And an impulsive teen with ADHD might do risky things… | Keep reading on ADDitude »

TEENS: What do I need to understand about ADHD in adolescence?

A: Teens with ADHD face an extra set of challenges: puberty aggravates their symptoms, academics tax their EFs, and… | Keep reading on ADDitude »

ADHD & RACE: How can I combat disparities in ADHD diagnosis and treatment for children of color?

A: After hundreds of years of racialized history, trust won’t come overnight, but it can be improved by diversifying educational and medical communities… | Keep reading on ADDitude »

BEYOND TANTRUMS: Can early signs of emotional dysregulation suggest ADHD in my child?

A: The babies who may be at risk for ADHD are the ones who cry constantly and have trouble self-soothing; who are angry, fussy, and difficult to control; who have… | Keep reading on ADDitude »

FIRST-PERSON: “The Model Minority Myth Left No Room for My ADHD”

“Neurological differences are not talked about in my culture. They are taboo. This meant I was to tell nobody about my diagnosis, because even with that validation, I would face judgement and isolation.” | Keep reading on ADDitude »

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SYMPTOM TEST: Symptoms in Teen Girls

Typical symptoms of ADHD in girls — daydreaming, non-stop talking, tardiness — are too often shrugged off. | Take the self-test on ADDitude »

EXPERT WEBINAR: The Teen Years with ADHD

Expert webinar with Thomas E. Brown, Ph.D. | Listen now on ADDitude »

8-Part Guide to ADHD Diagnosis in Children:

Q 1: How can I better understand ADHD, its causes, and its manifestations?
Q 2: How can I understand the aspects of ADHD that might be new to the doctor?
> Q 3: How can I improve the odds of an accurate ADHD evaluation for my child?
Q 4: How can I find a professional to diagnose and treat my child’s ADHD?
Q 5: What should a thorough evaluation for pediatric ADHD include and exclude?
Q 6: How can I be sure my child’s evaluation screens for psychiatric comorbidities?
Q 7: How can I be sure my child’s evaluation considers look-alike comorbidities?
Q 8: Should my child be screened for the sleep, eating, and other disorders?

RSD: Is rejection sensitive dysphoria a symptom of ADHD?

A: Rejection sensitive dysphoria (RSD) is not a medical diagnosis, but a way of describing certain symptoms associated with ADHD… | Keep reading on ADDitude »

EMOTIONS: Is emotional dysregulation a symptom of ADHD?

A: Emotional dysregulation is a term used to describe an emotional response that is poorly regulated and does not fall within… | Keep reading on ADDitude »

SUBTLE SYMPTOMS: What symptoms of ADHD are often missed by educators, professionals, and even parents?

A: It’s not easy to know if your child has ADHD. As a parent, it may be less about the symptoms shouting ADHD, and more about feeling something’s not right. Your kid is struggling, but you don’t know why… | Keep reading on ADDitude »

EARLY YEARS: How does ADHD manifest in toddlers?

A: Emotional dysregulation often looks like excess emotion. Neurotypical toddlers typically experience up to three tantrums a week. Toddlers with ADHD, on the other hand… | Keep reading on ADDitude »

SOCIAL SKILLS: What social executive function deficits may suggest ADHD in my child?

A: Children and teens with ADHD tend to have a hard time with skills that underlie social interactions, such as perspective-taking, situational awareness… | Keep reading on ADDitude »

MISDIAGNOSIS: What symptoms of ADHD are my child’s doctor most likely to miss or misread?

A: Some children resort to defiant behavior to cover up anxiety, and other children who appear “defiant” are actually just impulsive. This is another case where it’s important for doctors to tease out the root cause… | Keep reading on ADDitude »

FIRST-PERSON: “When the First Signs of My Child’s ADHD Were Revealed”

“I asked our son why he didn’t like to wash his hair. ‘It takes too long and it’s boring,’ he told me. ‘Yeah, it is kind of boring,’ I replied. That’s when we decided to have him evaluated for ADHD. (I have ADHD myself, and told him he might have inherited mommy’s ‘silly brain.’)” | Keep reading on ADDitude »

RELATED RESOURCES

SYMPTOM TEST: Working Memory Deficits

A working memory deficit could explain a child’s difficulty with reading retention or mental math. | Take the self-test on ADDitude »

SYMPTOM TEST: Executive Function Deficit

Does your child have trouble getting started or struggle with problem-solving? | Take the self-test on ADDitude »

8-Part Guide to ADHD Diagnosis in Children:

Q 1: How can I better understand ADHD, its causes, and its manifestations?
> Q 2: How can I understand the aspects of ADHD that might be new to the doctor?
Q 3: How can I improve the odds of an accurate ADHD evaluation for my child?
Q 4: How can I find a professional to diagnose and treat my child’s ADHD?
Q 5: What should a thorough evaluation for pediatric ADHD include and exclude?
Q 6: How can I be sure my child’s evaluation screens for psychiatric comorbidities?
Q 7: How can I be sure my child’s evaluation considers look-alike comorbidities?
Q 8: Should my child be screened for the sleep, eating, and other disorders?