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Sadana Psychiatry

Understanding ADHD in Children and Adults

Sukhmani Sadana
Oct 22
4 min read

Updated: Oct 25

By Sukhmani Kaur Sadana, MD · Double board-certified in general psychiatry and child & adolescent psychiatry · Last reviewed October 22, 2026

ADHD (attention-deficit/hyperactivity disorder) is one of the most common conditions I evaluate, and one of the most misunderstood.

ADHD is not simply "hyperactivity," and it is not a lack of effort or discipline. It is a neurodevelopmental condition that affects:

  • Attention and focus

  • Impulse control

  • Executive functioning: planning, organizing, starting and finishing tasks, managing time

  • Emotional regulation

It affects both children and adults, often in quite different ways.

How common is ADHD?

In children: According to the CDC, an estimated 7 million U.S. children aged 3–17 (11.7%) have a current ADHD diagnosis, based on a 2024 national survey of parents. Boys (13%) are diagnosed more often than girls (7%).

Girls are thought to be under-recognized, partly because their symptoms are more often inattentive (quiet distraction, daydreaming, disorganization) than disruptive.

In adults: In a 2023 CDC survey, about 6% of U.S. adults (15.5 million) reported a current ADHD diagnosis, and about half of them were diagnosed at age 18 or older. Many adults recognize long-standing patterns only when life's demands grow or when their own child is evaluated.

What ADHD can look like at different ages

Children may struggle with:

  • Following instructions or finishing schoolwork

  • Sitting still, waiting their turn, or interrupting

  • Big emotional reactions and frustration

  • Friendships, because of impulsivity

Adolescents may struggle with:

  • Keeping up as schoolwork becomes more independent

  • Disorganization, missed assignments, procrastination

  • Risk-taking

ADHD in teens often occurs alongside anxiety or depression, so evaluating the whole picture matters.

Adults may struggle with:

  • Chronic disorganization and missed deadlines

  • Difficulty sustaining attention at work

  • Restlessness, impulsive decisions, or emotional reactivity

  • Strain in relationships and lower self-confidence after years of feeling "behind"

Left unrecognized, ADHD is associated with more difficulties at school and work, more accidents, and higher rates of substance use problems. That is one reason accurate diagnosis matters.

How ADHD is diagnosed

There is no blood test or brain scan for ADHD. Diagnosis is clinical, based on careful history and observation. Using the standard criteria, a clinician looks for:

  • A persistent pattern of inattention and/or hyperactivity-impulsivity

  • Symptoms that began before age 12, even if they weren't recognized until later

  • Symptoms in more than one setting, such as home and school, or work and home

  • Symptoms that have lasted more than 6 months

  • Clear interference with school, work, relationships, or daily life

For children, information from parents, teachers, and other caregivers is an important part of the process.

Equally important is looking for other conditions that can look like ADHD or occur alongside it, including anxiety, depression, trauma, learning disabilities, sleep problems, and some medical issues. Hearing and vision should also be checked. This is where a thorough psychiatric evaluation adds value: the goal is to explain why a child or adult is struggling, not just to count symptoms.

Treatment

ADHD treatment is individualized and usually involves more than one approach:

  • Education for the family or individual about how ADHD works

  • Behavioral strategies, including parent training in behavior management for younger children

  • School supports, such as accommodations through a 504 plan or IEP

  • Skills support for organization and time management, especially for teens and adults

  • Medication, when appropriate

The American Academy of Pediatrics recommends parent training in behavior management as the first-line treatment for preschool-aged children, and a combination of medication with behavioral approaches for school-aged children and teens. These treatments often work best together.

Medication can be very effective for many people with ADHD, but it is never automatic. When it is considered, we talk through benefits, risks, and alternatives, and monitor closely over time. Some ADHD medications are controlled substances. Any prescribing follows federal and Tennessee rules and requires regular follow-up visits.

Frequently asked questions

Is ADHD overdiagnosed?

It can be both underdiagnosed and overdiagnosed. Girls and adults are often missed, while symptoms caused by anxiety, poor sleep, or stress are sometimes mislabeled as ADHD. That is why a careful evaluation matters more than a quick checklist.

Can children outgrow ADHD?

Some symptoms, especially hyperactivity, often ease with age. Many people, however, continue to have symptoms such as inattention or disorganization into adulthood.

Is ADHD caused by bad parenting?

No. ADHD is a brain-based condition with a strong genetic component. Parenting strategies can help a child manage symptoms, but parenting does not cause ADHD.

Can you have ADHD without hyperactivity?

Yes. The predominantly inattentive presentation is common, especially in girls and adults.

Do you evaluate adults?

Yes. I am trained and board-certified in both adult and child and adolescent psychiatry.

If you are in Tennessee

If you or your child are struggling with attention, focus, or organization, a comprehensive evaluation can clarify whether ADHD is present, what else may be contributing, and what would help. You can reach us through our secure contact form.

This is general education, not medical advice. Talk to your own clinician about your child or yourself.

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