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Attention-deficit/hyperactivity disorder (ADHD) is a chronic disorder that affects millions of American children, and it can persist into adulthood.

Problems generally associated with ADHD include inattention, hyperactivity and impulsive behavior. They can affect nearly every aspect of life. Children and adults with ADHD autism often struggle with low self-esteem, troubled personal relationships and poor performance in school or at work.

At various times, ADHD has been called attention-deficit disorder (ADD), hyperactivity, and even minimal brain dysfunction. But ADHD is the preferred term because it more accurately describes all aspects of the condition. Most doctors believe that a child shouldn't receive a diagnosis of ADHD unless the core symptoms of ADHD appear early in life and create significant problems at home and at school on an ongoing basis.

ADHD symptoms fall into two broad categories:

* Inattention
* Hyperactivity-impulsive behavior

In general, children are said to have ADHD autism if they show six or more signs or symptoms from each category for at least six months. These symptoms must significantly affect a child's ability to function in at least two areas of life — typically at home and at school. This helps ensure that the problem isn't with only a particular teacher or with only parents. Children who have problems in school but get along well at home or with friends are not considered to have ADHD. The same is true of children who are hyperactive or inattentive only at home but whose schoolwork and friendships aren't affected by their behavior.

In most children diagnosed with ADHD autism, signs and symptoms appear before the age of 7, although they sometimes may occur even earlier.

Inattention
Signs and symptoms of inattention may include:

* Often fails to pay close attention to details or makes careless mistakes in schoolwork or other activities
* Often has trouble sustaining attention during tasks or play
* Seems not to listen even when spoken to directly
* Has difficulty following through on instructions and often fails to finish schoolwork, chores or other tasks
* Often has problems organizing tasks or activities
* Avoids or dislikes tasks that require sustained mental effort, such as schoolwork or homework
* Frequently loses needed items, such as books, pencils, toys or tools
* Can be easily distracted
* Forgetful often

Hyperactivity-impulsiveness
Signs and symptoms of hyperactivity-impulsive behavior may include:

* Fidgets or squirms frequently
* Often leaves his or her seat in the classroom or in other situations when remaining seated is expected
* Often runs or climbs excessively when it's not appropriate or, if an adolescent, might constantly feel restless
* Frequently has difficulty playing quietly
* Always seems on the go
* Talks excessively
* Blurts out the answers before questions have been completely asked
* Frequently has difficulty waiting for his or her turn
* Often interrupts or intrudes on others' conversations or games

Most healthy children exhibit many of these behaviors at one time or another. For instance, parents may worry that a 3-year-old who can't listen to a story from beginning to end or finish a drawing may have ADHD autism. But preschoolers normally have a short attention span and aren't able to stick with one activity for long. This doesn't mean they're inattentive — it simply means they're normal preschoolers.

Even in older children and adolescents, attention span often depends on the level of interest in a particular activity. Most teenagers can listen to music or talk to their friends for hours but may be a lot less focused about homework.

The same is true of hyperactivity. Young children are naturally energetic — they often wear their parents out long before they're tired. And they may become even more active when they're tired, hungry, anxious or in a new environment. In addition, some children just naturally have a higher activity level than others. Every child is unique. Children should never be classified as having ADHD just because they're different from their friends or siblings.

Most children with ADHD don't have all the signs and symptoms of the disorder, and they may be different in boys and girls. Boys are more likely to be hyperactive, and girls tend to be inattentive. In addition, girls who have trouble paying attention often daydream, but inattentive boys are more likely to play or fiddle aimlessly. Boys also tend to be less compliant with teachers and other adults, so their behavior is often more conspicuous.

ADHD always begins in childhood, but it may persist into adult life. The core signs and symptoms of distractibility, hyperactivity and impulsive behavior are the same for adults as for children, but they often manifest themselves differently and far more subtly in adults. Hyperactivity, in particular, is generally less overt in adults. Children may race around madly; adults are more likely to be restless and to have trouble relaxing.

On the other hand, problems with organization and concentration often increase as people get older when their lives become more complicated and demanding. Adults diagnosed with ADHD often say that their biggest frustration is their inability to focus and to prioritize, leading not only to missed deadlines but also to forgotten meetings and social engagements.

As difficult as this is, the impulsive behavior of some adults with ADHD can be even more problematic. The inability to control impulses, which some experts say may be the defining characteristic of ADHD, can range from impatience waiting in line or driving in heavy traffic to mood swings, intense outbursts of anger, blurting out rude remarks and having troubled relationships.

One set of guidelines used to diagnose adult ADHD, called the Utah criteria, lists the following as characteristic of adults with the disorder:

* A childhood history of ADHD
* Hyperactivity and poor concentration
* Inability to complete tasks
* Mood swings
* Hot temper
* Inability to deal with stress
* Impulsivity

ADHD is not caused by poor parenting, too much sugar, or vaccines.

ADHD has biological origins that aren't yet clearly understood. No single cause of ADHD has been identified, but researchers have been exploring a number of possible genetic and environmental links. Studies have shown that many children with ADHD have a close relative who also has the disorder.

Although experts are unsure whether this is a cause of the disorder, they have found that certain areas of the brain are about 5% to 10% smaller in size and activity in children with ADHD. Chemical changes in the brain have been found as well.

Recent research also links smoking during pregnancy to later ADHD in a child. Other risk factors may include premature delivery, very low birth weight, and injuries to the brain at birth.

Some studies have even suggested a link between excessive early television watching and future attention problems. Parents should follow the American Academy of Pediatrics' (AAP) guidelines, which say that children under 2 years old should not have any "screen time" (TV, DVDs or videotapes, computers, or video games) and that kids 2 years and older should be limited to 1 to 2 hours per day, or less, of quality television programming.

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