Understanding ADHD

What is ADHD?

ADHD is not simply about being distracted or having lots of energy.

People with ADHD can experience differences in the brain processes involved in directing attention, controlling impulses, regulating activity and organising behaviour.

Someone may struggle to concentrate on a routine task while being able to focus intensely on something they find interesting or stimulating. This can sometimes be confusing to the individual and to those around them.

ADHD is not caused by laziness, poor parenting or lack of intelligence.

Common signs and experiences

• Difficulty maintaining attention, particularly during repetitive or less stimulating activities
• Frequently becoming distracted
• Forgetfulness or regularly losing belongings
• Difficulty organising tasks and managing time
• Procrastination or difficulty getting started
• Restlessness or feeling internally “on the go”
• Talking excessively or interrupting conversations
• Acting or making decisions impulsively
• Difficulty waiting
• Becoming intensely absorbed in particularly interesting activities
• Feeling overwhelmed when several demands need to be managed at once

The different presentations of ADHD

ADHD is generally described using three presentations.

Predominantly inattentive presentation Difficulties are mainly associated with attention, organisation, forgetfulness and completing tasks. Hyperactivity may be less obvious.

Predominantly hyperactive-impulsive presentation Hyperactivity and impulsivity are more prominent. This can include physical or internal restlessness, difficulty waiting and acting before considering consequences.

Combined presentation The person experiences significant features of both inattention and hyperactivity/impulsivity. A person’s presentation can also change over time.

ADHD in children

In children, ADHD may become particularly noticeable when expectations around concentration, organisation and independence increase.

A child may struggle to remain focused in lessons, forget instructions, lose belongings, interrupt frequently, find waiting difficult or require significant support with routines.

However, ADHD is not determined by behaviour at school alone. A comprehensive assessment considers development and functioning across different areas of the child’s life.

ADHD in adults

Some adults reach adulthood without ADHD having been recognised.

They may have developed strategies to compensate for their difficulties but continue to experience problems with organisation, deadlines, relationships, finances, household responsibilities or managing competing demands.

For some people, the possibility of ADHD only becomes apparent when increasing responsibilities make existing coping strategies less effective.

ADHD and other conditions

ADHD can occur alongside other neurodevelopmental, mental-health and physical-health conditions.

These may include autism, anxiety, depression, sleep difficulties, learning differences and other conditions affecting everyday functioning.

This is one reason a thorough clinical assessment is important. An assessment should consider whether difficulties are best explained by ADHD, another condition, or a combination of factors.

What does an ADHD assessment consider?

An ADHD assessment looks at much more than a checklist of symptoms. It usually considers:

• Current ADHD symptoms
• Childhood and developmental history
• Education and/or employment
• Relationships and everyday functioning
• Physical and mental health
• Relevant family history
• Information from someone who knows the person well, where appropriate
• Whether symptoms are present across more than one setting
• Alternative explanations for the difficulties being experienced

Why can diagnosis be helpful?

For some people, receiving an ADHD diagnosis provides an explanation for difficulties they may have experienced for many years.

It can help identify individual strengths and needs and inform appropriate strategies, reasonable adjustments, psychological support and, where clinically appropriate, consideration of treatment options.

A diagnosis does not define a person. It is one part of understanding how they experience and navigate the world.

Considering an ADHD assessment?

Reading about ADHD can help you recognise experiences that feel familiar, but online information and screening questionnaires cannot diagnose ADHD.

If you are considering an assessment for yourself or your child, a comprehensive clinical assessment can help determine whether ADHD—or another explanation—best accounts for the difficulties being experienced.