10 Symptoms Never to Ignore With Childhood ADHD

Medically Reviewed By William C. Lloyd III, MD, FACS
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  • More than six million children in the United States have been diagnosed with attention deficit-hyperactivity disorder (ADHD). Of these, about 60% also have other conditions, such as conduct disorders, anxiety, autism spectrum disorder, or learning disabilities. Some of the symptoms of these overlapping disorders are the same as for ADHD, which can make diagnosis difficult. However, it's important to find out if your child has another disorder, because early treatment can often help. Learn more about the childhood ADHD symptoms that might be signs of co-occurring conditions.

  • 1
    Refusing to comply with rules
    mother confronting her daughter about stealing money from her wallet

    Behavior or conduct disorders affect about 52% of children with ADHD. Oppositional defiant disorder is one of the most common ADHD complications, usually starting by age 8. Children who develop this often lose their tempers easily, argue with adults, and refuse to follow orders or requests. Conduct disorder also is common. It has similar, but more extreme symptoms, such as running away, fighting, lying and stealing.

    Early identification and treatment of these behavioral disorders is key. Individual and family therapy may be necessary, and sometimes medication as well.

  • 2
    Problems reading or doing math
    confused girl at blackboard

    About half of children with ADHD have a learning disorder. The most common are dyslexia (difficulty reading) and dyscalculia (difficulty with math). About 12% of children with ADHD also have speech problems. Having a childhood ADHD learning disability can make school difficult. ADHD symptoms, such as inattention and difficulty concentrating can worsen the problem. If you notice your child is having learning difficulties, the first step is a professional evaluation.

    Once your child has a diagnosis, you work with your child’s learning coach or counselor to address the issue, which may include therapy, skills training, and medication (for ADHD).

  • 3
    Worrying excessively
    frustrated young girl with hands over her face trying to do school work in class

    About 30% of children with ADHD develop an anxiety disorder, such as separation anxiety, social anxiety, generalized anxiety, or phobias. Besides excess worrying, childhood ADHD anxiety symptoms may include feeling edgy, stressed out, tired, or tense. Children with anxiety and ADHD may develop perfectionistic tendencies; have trouble socializing with other children; and may have panic attacks.

    Other signs: difficulty sleeping and trouble concentrating. Bring persistent anxiety symptoms to your doctor's attention, because early intervention with therapy and possibly medication can help.

  • 4
    Near-constant sadness
    little girl sitting on sofa looks at a hand-drawn picture of a sad face shown to her by her mother or a therapist

    About 14 to 17% of children with ADHD develop depression. Besides feeling sad or hopeless almost all the time, other signs include near-constant irritability, no pleasure in most daily activities, appetite loss, and trouble sleeping. Your child may cry frequently, withdraw from others, be exceedingly self-critical, feel worthless or useless, and have difficulty concentrating—more so than with ADHD alone. A red flag is suicidal talk and self-injury, which require emergency attention. Early treatment with therapy for the child and possibly other family members can help.

  • 5
    Extreme mood swings
    teenage biting nails

    Some children with ADHD may develop bipolar disorder, a severe mood disorder. Childhood ADHD mood symptoms include extreme emotional instability, behavioral difficulties, and social problems. A bipolar child may have ADHD traits, such as hyperactivity and impulsivity, but also explosive outbursts, aggression, very high energy levels, reduced need for sleep, racing thoughts, and extreme talkativeness. Also possible: psychosis, delusions, depression, self-injury and suicidal impulses.

    During adolescence, children with ADHD and bipolar disorder are more likely to turn to drugs and alcohol than children with ADHD alone. Early treatment interventions, such as intensive behavioral therapy, can help.

  • 6
    Difficulty falling asleep
    Dad and daughter

    Sleep disorders are a common childhood ADHD complication, affecting 25 to 50% of kids with ADHD. Signs include trouble falling asleep as well as staying asleep. One study found half of children with ADHD had sleep-disordered breathing. Restless legs syndrome and periodic leg movement syndrome, which impair sleep, are also common in ADHD children. Poor sleep can worsen ADHD symptoms, such as hyperactivity, inattentiveness and impulsivity. On the other hand, addressing and treating sleep problems can help reduce ADHD symptoms. Check with your doctor if you notice your ADHD child having trouble with sleep.

  • 7
    Binge eating
    Child overeating junk food

    Children and adolescents with ADHD are almost four times more likely than children without ADHD to have eating disorders, such as binge eating or overeating. ADHD symptoms, such as impulsivity and inattention may play a role in children being unable to control their eating. Researchers find that stimulant medication, such as methylphenidate (Ritalin), can increase the ability of children to resist impulsive eating and to wait and plan for more nutritious meals. If your child with ADHD is struggling with eating issues, contact your doctor.

  • 8
    Difficulty connecting with other people
    girl sad in class

    About 25% of children with ADHD also have signs of autism spectrum disorder (ASD). These include problems with social skills, avoiding eye contact, and being sensitive to stimuli like noise and touch. Some ASD and ADHD symptoms overlap, such as hyperactivity, impulsiveness and inattention; also, both ASD and ADHD children may hyper-focus on tasks. An ADHD child may have trouble making friends, often due to impulsivity (such as not being able to take turns); the ASD child may have no interest in engaging with others. A specialist in both ASD and ADHD can help differentiate, diagnose and treat these conditions in your child.

  • 9
    Obsessive counting or other rituals
    Row of colorful sweet jellybeans being arranged by color on gray background

    Obsessive compulsive disorder is a type of anxiety disorder that commonly overlaps with ADHD and is marked by frequent, obsessive and compulsive thoughts and behaviors. About 21% of children with OCD also have ADHD, with symptoms often appearing by age 5, or even earlier. Signs to watch for include using repetitive words, having repetitive thoughts, or engaging in compulsive behavior like hand-washing, cleaning or counting. Stimulant medication used to treat ADHD can worsen OCD symptoms, so it's important to work with a professional who knows how to treat children when these disorders co-occur.

  • 10
    Facial or vocal tics
    blond 8 year old boy making zany face

    Some children with ADHD develop tics—sudden, non-rhythmic, repeated movements or sounds, such as eye-blinking, throat-clearing, sniffing, grimaces, or vocalizing words or phrases. Only about 1% of children with ADHD develop the most severe tic disorder, Tourette syndrome. However, 60 to 80% of children with Tourette syndrome have ADHD. When both conditions occur, experts say to treat ADHD first, since relieving its symptoms may reduce stress and help children be able to control tics. Tics often disappear on their own by adulthood.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Dec 4
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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