Your child can't sit still. They are talking a mile a minute. Are they just a high-energy kid? Or do they have ADHD?
Hyperactivity is just one sign of ADHD. Kids who have it seem to always be on the move.
Kids who are hyperactive also tend to be impulsive. They may interrupt conversations. They may play out of turn.
Adults can also have this type of ADHD, called hyperactive-impulsive. But it’s less common because hyperactivity tends to lessen with age.
So how do you know whether your child has hyperactive-impulsive ADHD? And if your child does, what treatments can help?
Signs of Hyperactive-Impulsive ADHD
No single test can confirm that your child has this type of ADHD. Your doctor will first try to rule out other things that can cause hyperactivity. It could be stress or emotional issues. The behavior might simply be appropriate for their age. Sometimes vision problems or learning disabilities can make it hard for a child to sit still.
The doctor will also look for at least six of these symptoms of hyperactivity and impulsivity:
- Fidgeting or squirming (not being able to sit still)
- Nonstop talking
- Trouble sitting still and doing quiet tasks, such as reading
- Running from place to place; acting like they are driven by a motor
- Constantly leaving their seat, jumping or climbing on furniture and other inappropriate places
- Not having patience
- Blurting out comments at inappropriate times
- Interrupting conversations or speaking out of turn
- Trouble waiting for a turn or standing in line
Many children who like to run and jump may be high-energy. But that doesn’t mean they are hyperactive. To count as ADHD, symptoms have to be on the extreme side and have to cause problems in the child’s life. Also, they have to have been doing this for at least 6 months.
Inattentive ADHD
There is another type of ADHD called inattentive ADHD. Children who have inattentive ADHD have trouble focusing. They are also easily distracted.
A child with hyperactive-impulsive ADHD may not always show many signs of inattention. They may not necessarily have trouble focusing or becoming easily distracted.
But many kids have a combination of hyperactive-impulsive and inattentive ADHD (called the "combined type"). They may be always on the go and have trouble focusing.
What Causes Hyperactive-Impulsive ADHD?
The causes of ADHD aren't clear. Scientists say it is due in large part to genes that are passed down from parent to child. But experts aren't sure yet which specific genes make it more likely to get ADHD. A child is more likely to have ADHD if a close family member has it.
Other things that may influence ADHD risk include:
- Cigarette smoking and alcohol use during pregnancy
- Being born premature
- Low birth weight
- Being exposed to lead during early childhood
- Brain injuries
Many parents claim sugar makes their child hyperactive. But there is no evidence that refined sugar causes ADHD or makes it worse.
There may be a link between ADHD and food additives such as artificial colors and preservatives. But that has not been confirmed.
ADHD Treatments
Once your child is diagnosed with hyperactive-impulsive ADHD, the next step is to treat it. Every child’s treatment plan can be different. Sometimes it takes trying a few things to find the right one.
ADHD treatment usually starts with medication. A few ADHD medicines are available.
Stimulant drugs. Despite their name, stimulant drugs don’t rev up or excite kids with ADHD. They calm them down. These medications include:
- Dexmethylphenidate (Focalin, Focalin XR)
- Dextroamphetamine/amphetamine (Adderall, Adderall XR)
- Lisdexamfetamine (Vyvanse)
- Methylphenidate (Concerta, Quillivant XR, Ritalin)
- Serdexmethylphenidate/dexmethylphenidate (Azstarys)
They come in different forms, including:
- Pills (tablets and chewables)
- Capsules
- Liquids
- Skin patches
No stimulant has been proven to work better than others. Each child responds differently to these medicines.
Nonstimulant drugs. Although nonstimulant medicines may not work as well as stimulants, they have fewer side effects. This type of medication includes:
- Atomoxetine (Strattera).
- Clonidine ER (Kapvay)
- Guanfacine ER (Intuniv)
- Viloxazine (Qelbree)
High blood pressure medicines are another choice. These drugs can help control impulsivity and hyperactivity symptoms.
- Clonidine (Catapres, Kapvay)
- Guanfacine (Intuniv, Tenex )
Antidepressants. Drugs that affect mood, including bupropion (Wellbutrin), can sometimes help with ADHD symptoms.
Often, a child will need a combination of medicine and other treatments. You may need to work with your doctor to adjust the medicine as your child's symptoms change.
Parents and pediatricians should watch carefully for side effects from medicine. Common ADHD stimulant drug side effects include:
- Loss of appetite
- Weight loss
- Slowed growth
- Disrupted sleep
- Irritability
- Tics
- Anxiety
Stimulant medications have also been linked to more serious side effects, including:
- Heart problems
- Psychiatric problems (such as hallucinations or hearing voices)
Strattera and antidepressant medications also may cause suicidal thoughts in children and teenagers.
Because of these rare risks, it's important to call your doctor right away if you notice any unusual symptoms in your child. While taking these medicines, kids should have the following carefully checked:
- Height
- Weight
- Blood pressure
- Heart rate
Along with medicine, behavior therapy can help with hyperactivity. A psychologist or therapist can help kids with ADHD learn how to spot and control their hyperactive and impulsive behaviors.
Kids can learn how to create and follow routines. They can also work to improve their social skills. Parents and teachers can use a system of rewards and consequences to reinforce good behaviors.