Attention-Deficit/Hyperactivity Disorder (ADHD) is often diagnosed in childhood, but sometimes it’s not identified until the teen years. Although individuals regardless of gendercan have ADHD, boys are about 3 times more likely to be diagnosed due to increased attention to externalizing symptoms in boys. Externalizing symptoms, like hyperactivity, are more commonly observed in boys with ADHD than girls thus leading to a higher rate of ADHD diagnosis in boys. Research also suggests that girls who are diagnosed with ADHD may have increased difficulties in the domains of friendship, peer interaction, and social skills and functioning, relative to girls who have not been diagnosed with ADHD.However, children and adolescents regardless of gender may struggle with a combination of externalizing (e.g., hyperactivity, restlessness, impulsivity) and internalizing (e.g., inattentiveness, difficulty concentrating) symptoms. Children and adolescents with ADHD may also struggle with anxiety, depression, and emotional dysregulation.
Management of ADHD symptoms is likely to change in an individual’s teen years because of different academic and social demands. This guide is intended to help parents of children with ADHD understand and manage their children’s ADHD.
What is ADHD?
ADHD is a neurodevelopmental disorder which makes it difficult to focus or pay attention. The different categories of ADHD are: Inattentive Presentation, Hyperactive Presentation, and Combined Presentation. ADHD has multiple levels of severity, meaning that symptoms range from very mild to severe, and vary according to which presentation an individual has. Those with inattentive type may struggle the most with paying attention in school, daydream, or lose attention when in a conversation or doing a task. They may have trouble focusing on homework and get easily distracted. If they also have hyperactivity, they may become restless often and have trouble sitting still. In a young child, this may take the form of not being able to sit still in a classroom and engaging in impulsive behavior. For a teen, this may involve impulsive or risky behavior as well. Your child may also notice an inner feeling of restlessness.
What is executive functioning and how does it relate to ADHD?
Executive functioning is a term that refers to the way we organize our lives. People with executive functioning problems may have trouble prioritizing, planning, and organizing their time and space. All of these can be problems for children with ADHD.
Why does my child have ADHD?
ADHD may be caused by a number of different things. There is often a genetic component, so a child with ADHD may have a parent with similar behaviors and symptoms. It’s likely that parents of today’s teens were not diagnosed with ADHD when they were young, but they may recognize some of their child’s symptoms as things they struggle with. Other possible causes of ADHD include head injuries, pre-natal conditions, and maternal drug use. Overall, there is no singular cause of ADHD.
When does ADHD first show up?
It is generally thought that ADHD is present from birth. However, symptoms may not be recognized until much later. Hyperactivity is often recognized early in school and a teacher may be the first to wonder about ADHD presentations. Students with ADHD may be singled out for talking out of turn or being a “class clown.” Those without hyperactivity often go unnoticed in school because they don’t cause trouble. Young people are often mistaken for being unmotivated, not working up to their potential, or being messy and disorganized.
Teens with ADHD who have reached adolescence without being diagnosed will often recognize that they have poor attention and focus, and are too easily distracted. Sometimes teens may get to college or even graduate school without being identified or identifying for themselves that they are having more trouble than is normal. In fact, there are adults with ADHD who have never been diagnosed, but have learned ways to adapt and work around their attention problems. Symptoms of ADHD may persist into adulthood or may resolve with growth and maturing.
What are symptoms of ADHD in teens?
Your child may exhibit some or all of the following symptoms and behaviors:
- Doesn’t do or complete homework or takes a very long time doing homework
- Has to read things over and over because they lose focus and don’t absorb what they read
- Becomes easily distracted, either by external noise or by their own thoughts
- Forgets to take important things to school or bring home things from school
- Copies down assignments wrong
- Gets into trouble in school for goofing off
- Has trouble waiting their turn
- Interrupts others when they are talking
- Does impulsive and sometimes risky things such as driving too fast
- Is attracted to things that are new or action-oriented
- Has to be moving a lot of the time
- Has trouble holding on to thoughts because they think fast
- Has trouble transitioning from wake to sleep and vice versa
What are possible consequences of ADHD?
- Trouble in school: Teens with ADHD may do poorly in school, even when they understand the material. They may also get into trouble for talking out of turn, clowning around, or behaving in other impulsive ways.
- Low Self-Esteem: If a teen has trouble in school, they may feel like they’re not smart, and may suffer from low self-esteem.
- Harm/Injury: A teen with ADHD may also get injured in sports or other activities because they act impulsively and without caution or planning. They may also put themselves in harm’s way by engaging in risky behaviors including drug and alcohol use.
Is ADHD a Learning Disability?
ADHD is not considered a Learning Disability (LD) although approximately 20 to 30 percent of children with ADHD also have a specific learning disability. However, ADHD can be recognized as a disability under a special act called the Rehabilitation Act. The Rehabilitation Act allows your child to receive additional services at school, such as receiving a 504 plan.
How can I have my child evaluated?
There are many professionals who are considered qualified to diagnose ADHD. You can have your child evaluated by:
- Primary care provider (PCP): Many PCPs are knowledgeable about and comfortable with ADHD and can make an initial diagnosis or refer you for psychological testing.
- Neurologist: Neurologists may specialize in ADHD.
- Mental Health Provider: Mental health providers such as clinical psychologists and clinical social workers may be skilled at evaluating teens with ADHD
- School Psychologist: A school psychologist may perform learning disability evaluations which may include observation of a student’s ability to pay attention.
The most comprehensive evaluation for ADHD is performed by a psychologist who does a series of tests that measure attention, distractibility, and impulsiveness. They will also test for general intelligence, memory, learning disabilities, and emotional problems.
How is ADHD treated?
By far the most effective treatment for ADHD is a combination of medication and psychotherapy. Most medications prescribed for teens with ADHD are stimulants such as Ritalin, Concerta, or Adderall. These medications take effect shortly after ingestion and wear off several hours later. Although you may feel reluctant about having your child take medication, it’s important to become educated about their benefits and possible side effects.
Many teens with ADHD can benefit from behavior therapy or various behavioral interventions. These can be helpful whether or not the teen is taking medication. One intervention is to help the teen be more organized by making lists or using an app that helps organize tasks. Another is to break up tasks into manageable time frames, like 15-20 minute segments, so the teen is less likely to lose focus. There is training and/or coaching available for parents, teachers and teens with ADHD. Some strategies are especially helpful because they address organizational problems that are not necessarily helped by medication.
What are some helpful strategies?
Here are some strategies that may be helpful for those with ADHD:
- Write things down, make lists, use reminders or alarms in cell phones.
- Create some schedules or routines that are the same every day.
- Repeat instructions or have your child repeat back what they heard.
- Don’t try to do too much concentrating at once. Have your child take brief homework breaks every 20-30 minutes.
- Listen to a radio while doing homework, as it blocks out other external stimuli.
How can I help and support my child?
It’s important to remember that ADHD is nobody’s fault – not your child’s and not yours. It may be exasperating to have a child who doesn’t seem to pay attention when you’re talking to them, who forgets what you tell them, who can’t settle down, or does risky things without thought of the consequences. Remember that they’re not doing these things on purpose, but can learn to be more aware of what they’re doing and exert some self-control. It is useful to know that teens with ADHD may need more parental support than you may expect for people their age. They may need help getting places on time, completing tasks and remembering things and they need extra help in learning to do these things for themselves.
You can help and support your child by:
- Making sure they get the treatment they need.
- Encouraging them to talk to teachers and get extra help in school.
- Setting limits about how much time they spend on video games or online.
- Encourage and reward them when they do well and make progress.
- It’s also very important to recognize their strengths and talents. They may be a fantastic athlete or artist, they may be funny and smart and creative. Those qualities should not go unnoticed!
Our health guides are developed through a systematic, rigorous process to ensure accuracy, reliability, and trustworthiness. Written and reviewed by experienced healthcare clinicians from Boston Children's Hospital, a Harvard Medical School teaching hospital and consistently ranked as a top hospital by Newsweek and U.S. News & World Report, these guides combine clinical expertise, specialized knowledge, and evidence-based medicine. We also incorporate research and best practices from authoritative sources such as the CDC, NIH, PubMed, top medical journals, and UpToDate.com. Clinical specialists and subject matter experts review and edit each guide, reinforcing our commitment to high-quality, factual, scientifically accurate health information for young people.