what is

Attention Deficit Hyperactivity Disorder (ADHD)

ADHD is a neurodevelopmental disorder that affects roughly 5% of the school-aged population. In 2018, rates were approximately 8.4% among children and 2.5% among adults.[*]

ADHD involves a unique dysfunction in the brain’s executive system, influencing various behaviours in children, such as the ability to inhibit irrelevant thoughts when someone is speaking or during classroom lessons. They may be constantly fidgety, feel the need to move or get up during class, and interrupt the flow of the lesson with unrelated questions or impulsive answers.

Individuals with ADHD often struggle to distinguish what is important and should be the focus from what is insignificant, like sudden noises or passing car engines, which easily distract them from the lesson.

In essence, individuals with ADHD face challenges in self-regulating and disciplining their thoughts and attention to focus on the present moment, the here and now, such as the immediate lesson they need to learn for the next day. They often struggle to filter important information from distractions and maintain mental sequencing—knowing where to start and in what order to proceed.

Furthermore, ADHD affects emotional regulation and the ability for internal dialogue—understanding what they can or cannot do, should or should not do, and what they are capable or incapable of doing.

ADHD manifests in three primary types, and identifying the predominant type in each individual case is crucial for tailoring effective interventions and support strategies.

Inattentive Type ADHD (ADHD-I) presents unique challenges, usually related to sensory processing, but not only:

  • Smell: For instance, the child may become distracted by the smell of a sandwich from the person sitting next to them, causing them to lose focus on their current task.
  • Visual: During a teacher’s lecture, the child’s attention might shift away because he notices something stuck in the teacher’s teeth, or the fly that has suddenly appeared.
  • Tactile: Holding a cold metal sharpener after using a warm wooden pencil to write can disrupt his concentration.
  • Aural: A word he just heard from his mate sitting behind him might trigger him to start thinking about the game he watched the previous day. Or he hears a horn and forgets what he was saying or doing because he gets distracted by wondering what brand of car or motorcycle it might be.


In each scenario, the introduction of a new sensory stimulus, or thought overrides the previous one, leading to a loss of focus and the child forgetting what he was originally engaged in. His attention shifts from one stimulus to another uncontrollably, making it difficult for him to self-regulate and refocus on his original activity.

The student’s attention, however, can also be disrupted by

Internal thoughts: Thoughts that they are unable to control, such as for example, worrying that visiting his grandmother on Saturday might cause him to miss his online game with his friends.
Teachers often describe this type of student as “a daydreamer,” “lost in space,” “absent,” “somewhere else,” or “quiet but disengaged.”
Hyperactive and Impulsive Type ADHD (ADHD-HI): It’s the child who struggles to sit still, often getting up and moving around the classroom. He finds it challenging to maintain focus for extended periods and is frequently restless. His desire to quickly shift from one activity to another is evident; for instance, he might want to play at the park and then suddenly decide he wants to go to the beach. He tends to multitask: watching TV while playing with a ball, yet complains of boredom. He exhibits impulsivity in both speech and actions, such as impulsively telling the teacher to “shut up” and immediately regretting it. He acts on impulses physically as well, sometimes hitting others, grabbing toys from their hands, starting to eat before everyone is seated, or cutting into a birthday cake as soon as it’s presented.
Combined Type ADHD (ADHD-C): The child displays symptoms across all three forms of ADHD: namely: Inattention, Hyperactivity, and Impulsivity.

it's the child who...

…struggles to remain seated for extended periods, easily becoming distracted, and frequently shifts interests from one activity to another. Maintaining focus is challenging for him unless the subject deeply interests him. He often speaks impulsively, saying things he later regrets.
It’s the child who experiences frequent boredom and abrupt mood swings, oscillating between extreme happiness and sudden emotional lows. He engages in risky behaviours, showing a tendency towards impulsivity and constantly making demands, which can be exhausting for those around him. His surroundings are often disorganized, and he frequently forgets important items like lessons, notebooks, books, or jackets. He may not remember his homework assignments for the next day, his tests, or doesn’t take notes regularly, and struggles to maintain friendships.
Inevitably, the student faces both learning and behavioral challenges at school, leading to frequent complaints from teachers to the parents. They often remark that the student never seems to pay attention, doesn’t participate, and behaves as if they aren’t present. Alternatively, the student may repeatedly disrupt the lesson’s flow with unrelated remarks, constant restlessness, and off-topic questions.

a little more on ADHD

It is the only neurodevelopmental disorder where, in severe cases, when a child is unable to function within the school environment or follow social rules, medication becomes necessary.

In these instances, a developmental pediatrician (during infancy and early childhood) is essential, and as the child grows, a child psychiatrist should take over. A child on medication must be regularly monitored by the prescribing child psychiatrist, typically every 2 to 3 months, to account for growth and development.

It is equally essential for parents to attend counselling sessions with a psychologist, psychotherapist, or their child psychiatrist at least twice a month. It is critical that the family psychologist supporting the parents is familiar with this specific syndrome, understands its implications, and is knowledgeable about the effects of medication on a developing brain.

Additionally, all professionals working with ADHD must be well-informed about the latest research and updated data. The goal should be to provide the child with the right support framework, fostering healthy relationships not only with their parents but also with other family members, the school, and beyond.
Comorbidity (the coexistence) with other developmental disorders is common, which is why interdisciplinary diagnosis during preschool and before the start of formal schooling is crucial, along with ongoing monitoring by a child psychiatrist throughout childhood and adolescence. Later, continued monitoring by a psychiatrist is equally important, as the symptoms of this syndrome change in adulthood.

Note: There is also pseudo-ADHD, where a child may trigger ADHD-like behaviour due to significant negative experiences that emotionally impact them, such as severe emotional trauma, death, abandonment, divorce, relocation to a new school or neighbourhood or problematic family situations. These behaviours may appear suddenly in a child who previously did not exhibit such issues. For example, following the COVID-19 pandemic, there has been a notable increase in ADHD diagnoses worldwide among children and adolescents -particularly teenagers- who had not shown these characteristics before. Also, a child with Dyslexia or Developmental Language Disorder who lacks proper support at school and whose specific difficulties are not recognised may exhibit ADHD-like behaviours. If the child is consistently scolded, forced to repeat tasks, re-copy work, or kept in class during break time, these frustrations can lead to behaviours similar to those seen in ADHD. That is why early diagnosis, ideally from infancy, is crucial and should initially involve a Developmental Paediatrician to monitor the child’s progress. As the child begins school, a multidisciplinary diagnosis becomes essential, incorporating the expertise of a Child Psychiatrist. ADHD is the only neurodevelopmental disorder that may require medication and psychological support for the child, as well as parental counselling from psychotherapists specialising in ADHD families. Managing ADHD is a life-long priority and responsibility. Also, If ADHD-like behaviours suddenly develop, a thorough multidisciplinary assessment, which will scrutinize and analyse every aspect of the child’s circumstances, will inevitably highlight the real causes of these behaviours.

*46:523–532; Danielson, ML, et al. Journal of Clinical Child & Adolescent Psychology, Volume 47, 2018 – Issue 2 ) (DSM-5, 2013; J.S. Raiker, L.Greening, L. Stoppelbein, S. P. Becker, P.J. Fite , Α.M. Luebbe – Child Psychiatry Hum Dev (2015).

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