Children and youngsters with ADHD present with one or more of the following signs and symptoms:

• Lack of attention to details
• Average or below average memory, have trouble remembering most things 
• Easily distracted
• Careless behavior, frequently lose possessions, mix up things, etc.
• Not good at following instructions 
• Unable or not good at completing step by step projects 
• Unable to stay focused
• Unable to stay still, continuously fidget and move
• Constantly 'up to something'
• Talk excessively and energetically 
• May act without thinking 
• Impatience 
• Mood swings

• Problems at School

  Nearly everyone shows some of these behaviors at times, but ADHD lasts more than 6 months and causes problems in school, at home and in social situations. ADHD is more common in boys than girls. It affects 3-5 percent of all American children. [medlineplus.gov]

  Nearly everyone shows some of these behaviors at times, but adhd lasts more than 6 months and causes problems in school, at home and in social situations. Adhd is more common in boys than girls. [icd9data.com]

  This can cause problems at school, as they can find it hard to prioritize homework, school projects, and other assignments. Kids with ADHD may be forgetful in daily activities. They may forget to do chores or their homework. [healthline.com]

  It often causes problems at school and home. ADHD symptoms can be mild or severe. Certain places (like school) can make them worse, but they happen in at least two places. [merckmanuals.com]

• Toothache

  Tolerability of Stimulant and Atomoxetine Combination Therapy AEs, n Article n AEs Discontinuations Serious Other safety and tolerability findings Patients with ADHD – prospective studies Carlson, 2007 9 6 (cardiac SE, GI discomfort, initial insomnia, rash, toothache [ncbi.nlm.nih.gov]

• Periodontitis

  Conclusions: ADHD children that were medicated exhibited similar dental caries prevalence and periodontal health status. [ncbi.nlm.nih.gov]

• Diplopia

  A 17-year-old male was found to have a fourth cranial nerve palsy and chronic papilloedema following his presentation to our institution with a 6-week history of blurred vision in both eyes and vertical binocular diplopia. [ncbi.nlm.nih.gov]

• Motor Restlessness

  The most obvious evidence of lowered vigilance is motor restlessness (fidgeting and moving about, yawning and stretching, talkativeness, or a combination of these) to improve alertness when sitting or standing still or when involved in tasks requiring [ncbi.nlm.nih.gov]

  The most characteristic symptom of affected children was a marked motor restlessness (Kramer and Pollnow 1932, p. 1). [doi.org]

• Short Nose

  nose, broad nasal bridge and microretrognathia. [ncbi.nlm.nih.gov]

• Impulsivity

  […] hyperactivity A behavior disorder originating in childhood in which the essential features are signs of developmentally inappropriate inattention, impulsivity, and hyperactivity. [icd9data.com]

  Overview Attention-deficit/hyperactivity disorder (ADHD) is a brain disorder marked by an ongoing pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development. [nimh.nih.gov]

  However, the small number of impulsivity items in the DSM-IV symptom list may have constrained the ability to distinguish between impulsivity and hyperactivity, and additional research is needed to test whether impulsivity and hyperactivity symptoms may [ncbi.nlm.nih.gov]

  An impulsive person may be socially intrusive and excessively interrupt others or make important decisions without considering the long-term consequences. Signs and Symptoms Inattention and hyperactivity/impulsivity are the key behaviors of ADHD. [web.archive.org]

• Distractibility

  Others are highly distractible, forgetful, or inattentive. Some appear distracted by every little thing and don't seem to learn from their mistakes. Many of these children disregard rules, even when they are punished repeatedly. [citeseerx.ist.psu.edu]

  The most common type of ADHD, this is characterized by impulsive and hyperactive behaviors as well as inattention and distractibility. Inattentive and distractible type. [bswhealth.com]

  The “core,” or main, symptoms of ADHD include: Inattentiveness (trouble paying attention) Distractibility (easily distracted) Impulsivity (doing things on sudden urges) Hyperactivity (restlessness) Some children may have ADHD without hyperactivity. [my.clevelandclinic.org]

  This, the least common type of ADHD, is characterized by impulsive and hyperactive behaviors without inattention and distractibility. ADHD, inattentive and distractible type. [stanfordchildrens.org]

• Fidgeting

  Hyperactivity means a person seems to move about constantly, including in situations in which it is not appropriate; or excessively fidgets, taps, or talks. In adults, it may be extreme restlessness or wearing others out with constant activity. [nimh.nih.gov]

  Is Helpful for ADHD Patients, Study Shows Feb. 22, 2016 — Children often fidget or move when they are trying to solve a problem, and that movement may have a positive effect on children with ADHD, new research ... read more Link Between ADHD, Vision [sciencedaily.com]

  Not good at following instructions Unable or not good at completing step by step projects Unable to stay focused Unable to stay still, continuously fidget and move Constantly 'up to something' Talk excessively and energetically May act without thinking [symptoma.com]

  Daydreaming, fidgeting, and persistent interruptions are all common behaviors in children. [healthline.com]

• Low Self-Esteem

  ADHD can cause low self-esteem in the child and impair quality of life for the child and the family. It is known that ADHD is a chronic illness and that clinicians needed to use chronic illness principles in treating it. [intechopen.com]

  Continued In addition to symptoms of inattention and/or impulsiveness, adults with ADHD may have other problems, including: Chronic lateness and forgetfulness Anxiety Poor organizational skills Low self-esteem Employment problems Short temper Difficulty [webmd.com]

  Her marriage was troubled, and she had low self-esteem, says Clionsky, the cofounder of the ADD Center of Western Massachusetts in Springfield. [web.archive.org]

  They may also exhibit angry and resistant behavior toward their parents or have low self-esteem. This may be the result of the child's exasperation at failing to meet their parents' expectations or to manage day-to-day tasks due to ADHD symptoms. [healthychildren.org]

• Short Attention Span

  Inattentiveness The main signs of inattentiveness are: having a short attention span and being easily distracted making careless mistakes – for example, in schoolwork appearing forgetful or losing things being unable to stick to tasks that are tedious [nhs.uk]

  If the high activity level is combined with short attention span and impulsivity, it may be defined as hyperactivity and considered part of ADHD. [merckmanuals.com]

  Short attention span for age, difficulty listening to others, difficulty attending to details, easily distracted, forgetfulness, poor study and organizational skills for age. Impulsivity. [bswhealth.com]

  Attention-deficit/hyperactivity disorder (ADHD) describes individuals who have problems due to a short attention span, impulsivity, and/or hyperactivity. ADHD occurs in 5 to 8 percent of school-age children and about 2 to 4 percent of adults. [chop.edu]

• Hyperactivity

  Attention deficit hyperactivity disorder combined Attention deficit hyperactivity disorder combined type Attention deficit hyperactivity disorder, combined type Attention deficit hyperactivity disorder, hyperactive impulsive type Attention deficit hyperactivity [icd9data.com]

  Attention Deficit Hyperactivity Disorder in Prison Inmates [PhD thesis] [ Google Scholar ] 61. Hazell P. Review of attention-deficit/hyperactivity disorder comorbid with oppositional defiant disorder. [ncbi.nlm.nih.gov]

  Morrison JR (1980a) Adult psychiatric disorders in parents of hyperactive children. Am J Psychiatry 137:825–827 Google Scholar 84. Morrison JR (1980b) Childhood hyperactivity in an adult psychiatric population: social factors. [doi.org]

  Deficit Disorder with Hyperactivity--therapy schema:about http://id.worldcat.org/fast/820831 > ; # Attention-deficit hyperactivity disorder--Treatment schema:about http://id.loc.gov/authorities/subjects/sh92002171 > ; # Attention-deficit hyperactivity [worldcat.org]

• Forgetful

  Inattentiveness The main signs of inattentiveness are: having a short attention span and being easily distracted making careless mistakes – for example, in schoolwork appearing forgetful or losing things being unable to stick to tasks that are tedious [nhs.uk]

  Others are highly distractible, forgetful, or inattentive. Some appear distracted by every little thing and don't seem to learn from their mistakes. Many of these children disregard rules, even when they are punished repeatedly. [citeseerx.ist.psu.edu]

  They have brought you their own and his advisor's Vanderbilt's, which each endorse 7 of 9 inattentive symptoms including trouble organizing, poor attention to detail, and easily distracted and forgetful in daily activities. [ncbi.nlm.nih.gov]

  Kids with ADHD may be forgetful in daily activities. They may forget to do chores or their homework. They may also lose things often, such as toys. A child with ADHD will show symptoms of the condition in more than one setting. [healthline.com]

• Irritability

  An instrument to measure EI and DESR which demarcates them from irritability and other emotional symptoms could improve the accuracy of diagnostic criteria for ADHD. [ncbi.nlm.nih.gov]

  Those symptoms can include difficulty concentrating, problems with memory, restlessness, irritability, talkativeness, sleep problems, moodiness, and academic or work failures. [verywell.com]

• Excitement

  Emotional dysregulation (ED) is a dysfunction in modifying an emotional state in an adaptive and goal oriented way, with excitability, ease anger, and mood lability. [ncbi.nlm.nih.gov]

  To compensate, they are drawn to new and exciting experiences and get famously impatient and restless with the regimented structure that characterizes our modern world. [nytimes.com]

  “We’re pretty excited about the possibility that some brain measurement would tell us which child or adult is most likely to benefit from a treatment.” [mcgovern.mit.edu]

  Royal College of Psychiatrists ( 2004b ) The restless and excitable child. In Mental Health and Growing Up ( 3rd edn ) (eds Rose, G. & York, A. ), p. 1. London : Royal College of Psychiatrists ( http://www.rcpsych.ac.uk/info/mhgu/newmhgu1.htm ). [dx.doi.org]

  "We are excited to offer physicians and families a potential new option in the treatment of ADHD and are working closely with the FDA to obtain final approval." [phx.corporate-ir.net]

• Tantrums

  His parents have good command of typical behavior management strategies such as the use of rewards, time out, and behavioral contingencies to target noncompliance and temper tantrums. [ncbi.nlm.nih.gov]

  Younger children may have temper tantrums. Children with ADHD often can’t sit still. They may try to get up and run around, fidget, or squirm in their chair when forced to sit. [healthline.com]

  At home, he had mood swings and threw tantrums. "I was grumpy at night," the second-grader explained. The family doctor diagnosed mild to moderate attention deficit hyperactivity disorder and prescribed medication. [tampabay.com]

  Behavioral history can reveal low frustration tolerance, opposition, temper tantrums, aggressiveness, poor social skills and peer relationships, sleep disturbances, anxiety, dysphoria, depression, and mood swings. [msdmanuals.com]

Workup includes a detailed history from the child, his/her parents and sometimes even questioning from teachers and friends of the affected child, along with a physical examination. Laboratory tests are conducted to rule out any hidden abnormality or disorder which may be the cause behind the child's symptoms. Other examinations may include:

• Checking for otitis media and other ear disorders to rule out hearing problems. If the child is unable to hear properly, that will result in failure to follow orders and understanding instructions.
• Eye examination: If the child is unable to see or read clearly, he may have trouble coping up with studies. 
• Checking for any learning disabilities like dyslexia .
• Testing for any other disease or abnormality that may result in impaired thinking and task execution.
• CT scan of the brain may be conducted.

No single diagnostic test is available to confirm ADHD. The diagnosis is based on exclusion as well as on appropriate identification and judging of symptoms and signs.

• Sinus Arrhythmia

  Parasympathetic-based regulation was indexed via respiratory sinus arrhythmia (RSA), and sympathetic-based reactivity was indexed via cardiac pre-ejection period (PEP). [ncbi.nlm.nih.gov]

Where drug treatment is considered appropriate, methylphenidate, atomoxetine and dexamfetamine are recommended [8]. National Institute of Mental Health (NIMH)-funded research has shown that medication works best when treatment is regularly monitored by the prescribing doctor and the dose is adjusted based on the child's needs [9].

Cognitive behavioral therapy (CBT), behavior modification and intensive contingency treatment have been used. The latter two treatments are more effective than CBT in improving behavior and academic performance [10]. Psychotherapy may prove to be useful and support group sessions may also help in making the child understand his condition better and not feel alone in this.

A recent meta-analysis of follow-up studies of children found that [7]:

• About 15% continued to have ADHD.
• 65% had persistence of some symptoms and continuing functional impairment. 

There is no clear cure of ADHD yet, so prognosis varies from person to person. Sometimes, the child may grow out of this condition but this rarely happens.

 Complications

ADHD does not cause other disorders, but children suffering from this condition are more likely to have:

• Bipolar disorder
• Anxiety disorder
• Depression
• Tourette syndrome
• Borderline personality disorder
• Obsessive-compulsive disorder

The exact etiology of ADHD is unknown. Many factors have been implicated in the development of this disease, one of which is genetics. Recent studies of twins link genes with ADHD [3]. Many studies have shown that ADHD runs in families. Other factors include environmental triggers such as exposure to damaging radiation, toxins or undue stress. Maternal usage of alcohol, drugs or tobacco may also affect the child's developing brain. Lastly, idiopathic underdevelopment of the brain can cause ADHD to occur.

Incidence

ADHD is estimated to affect about 6-7% of people aged 18 and under when diagnosed via DSM-5 criteria [2].

Sex

Studies show that it is almost 3 times more common in boys than in girls.

Race

ADHD has no known predilection to any race and occurs worldwide with no known statistical difference.

Brain imaging studies have revealed that, in youth with ADHD, the brain matures at a normal pattern but is delayed, on average, by about 3 years [4]. This delay is most apparent in brain areas involved in generating thoughts and plans. More recent studies have found that the outermost layer of the brain, the cortex, shows delayed maturation overall [5].

Current models involve the mesocorticolimbic dopamine pathway and the locus ceruleus-nonadrenergic system [6]. So, the damage is clearly due to underdevelopment of the brain, be it just the prefrontal cortex, the posterior parietal cortex or the dopamine pathways. Due to this delayed or impaired development of the brain, the child appears to be slow, mentally impaired and 'abnormal'.

There is no exact preventive measure known but the following factors may contribute in the prevention of this condition:

• Maternal health care
• Proper diet
• Protection from exposure to any environmental toxin
• Providing a safe and secure social and home environment to the child

Attention deficit hyperactivity disorder (ADHD) is a chronic condition that includes a combination of problems, such as difficulty sustaining attention, hyperactivity and impulsive behaviour. ADHD is described as the most common neurobehavioural disorder of childhood [1], due to improper or delayed brain development. It occurs in children and may persist in adults as well.  

According to the Diagnostic and Statistical Manual, Fifth Edition (DSM-5) of the American Psychiatric Association there are three different types of ADHD, depending on the presentation of the affected individual:

• Predominantly inattentive presentation
• Predominantly hyperactive-impulsive presentation
• Combined presentation

Attention deficit hyperactivity disorder (ADHD) is a common disorder affecting children and often goes undiagnosed when parents simply label the child as 'simpleminded or dull' when in reality the child is suffering from ADHD. A child with ADHD needs to be given special care and support with which he/she may lead a normal health life. Contact should be made with a specialist if your child shows symptoms including:

• Lack of attention to details
• Memory problems, trouble remembering most things 
• Easily distracted
• Careless behavior, frequently lose possessions, mix up things, etc.
• Not good at following instructions 
• Difficulty focusing attention
• Problems organizing and completing a task  
• Unable to stay focused
• Unable to stay or sit still, continuously fidget and move
• Constantly 'up to something'
• Talk excessively and energetically 
• May act without thinking 
• Impatience 
• Mood swings

1. American Academy of Paediatrics, author Clinical Practise Guideline:Diagnosis and evaluation of the child with attention-deficit/hyperactivity disorder. Peadiatrics 2000;105:1158-1170
2. Willcutt EG. The prevalence of DSM-IV ADHD: a meta-analytic review. Neurotherapeutics 2012 9(3):430-9. 
3. The ADHD Molecular Genetics Network. Reports from the third international meeting of the ADHD molecular genetics network. American Journal of Medical Genetics 2002; 272-277
4. Shaw P, Eckstrand K, Sharp W, Blumenthal J, Lerch JP, et al. Attention Deficit/Hyperactivity Disorder is characterised by a delay in cortical maturation. Proc Natl acad Sci USA 2007 Dec 4;104(49):19649-54. 
5. Shaw P, Malek M, Watson B, Sharp W, Evans A, Greenstein D. Development of cortical surface area and gyrification in attention deficit/hyperactivity disorder. Biol Psychiatry. 2012 Aug 1;72(3):191-7. 
6. Malenka RC, Nestler EJ, Hyman SE. 2009. Chapters 10 and 13. In Sydor A, Brown RY. Molecular Neuropharmacology: A Foundation for Clinical Neuroscience. 2nd ed. New York: McGraw Hill Medical, pp 266, 318-323 
7. Faroane SV, Biederman J, Mick E;The age-dependent decline of ADHD:a Psychol Med.2006 Feb:36(2):159-65
8. Attention-deficit Hyperactivity Disorder-ADHD. 'Methylphenidate, atomoxetine and dexamfetamine'; NICE 2006
9. The MTA Cooperative Group. A 14-month randomised clinical trial of treatment strategies for attention deficit-hyperactivity disorder. Arch Gen. Psychiatry. 1999 Dec;56(12):1073-86. PMID 10591283
10. Management of attention deficit and hyperkinetic disorders in children and young people; Scottish Intercollegiate Guidelines Network- SIGN (Oct 2009)