One of the most misunderstood and frequently misinterpreted neurodevelopmental conditions of childhood, attention deficit hyperactivity disorder (ADHD) affects a child’s ability to regulate attention, control impulses and manage activity levels. Understanding it better enables parents to build their children’s confidence, resilience and success

Sushmita D, Kiran Balimane & Cynthia John

Attention deficit hyperactivity disorder (ADHD) is one of the most misunderstood and frequently misinterpreted neurodevelopmental conditions of childhood, often mistaken for naughtiness, laziness, or disobedience. “My child is always running around. He cannot sit for five minutes, keeps interrupting, and forgets frequently. Is he just very physically active or does he have ADHD?” This is a question many parents grapple with as they struggle to distinguish normal childhood exuberance from behaviour that indicates an underlying neurodevelopmental problem.

Childhood is naturally a time of boundless energy, curiosity and impulsiveness. But not every restless child has ADHD. A quiet child may also be struggling with attention difficulties. The crucial distinction is the persistence, intensity and impact of such behaviour on a child’s everyday life, learning and relationships. ADHD is a neurodevelopmental condition, rooted in how the brain manages attention, impulse control, motivation and emotion.

In Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), the American Psychiatric Association defines ADHD as “a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development”. In common parlance, this applies to children who struggle to pay attention, follow instructions, organise tasks and complete schoolwork. ADHD children act impulsively unmindful of consequences, and/or are constantly restless and unable to sit still. Some struggle with inattention, others display more pronounced hyperactivity and impulsivity. Many experience a combination of these symptoms.

In India, an estimated 1.3-28.9 percent of children and adolescents in K-12 education suffer ADHD, with “wide variance in data across studies conducted in different places, with regional variations and higher rates among males,” per the Journal of Indian Association for Child and Adolescent Mental Health (2025). The global prevalence rate of ADHD for children and adolescents is estimated at 8 percent with male children twice as likely to be diagnosed with ADHD than girls.

“ADHD is a common neurodevelopmental condition of childhood that impairs a child’s ability to regulate attention, control impulses and manage activity levels. Yet it is also one of the most over-simplified, misjudged and underdiagnosed conditions. Early expert diagnosis is an important first step towards providing appropriate support and remediation. However, an ADHD diagnosis does not diminish a child’s potential for learning, concentration or success. On the contrary, it helps parents and teachers understand why certain everyday tasks are more challenging for an ADHD child and to devise coping strategies. The focus should not be on labelling, but on understanding their needs and helping them realise their full potential,” says Dr. Tarun Singh, a Delhi-based consultant paediatrician and newborn specialist at Kalpavriksh Healthcare and Peadiamedics Healthcare.

Reena Chopra

Symptoms

ADHD manifests differently in children. While some struggle to sustain attention and complete tasks, others find it difficult to sit still, wait their turn or control impulsive behaviour. The key is to recognise persistent patterns that are at variance with age-appropriate behaviour and adversely impact and interfere with a child’s everyday life and routines.

“Every child has a unique personality. Some children are naturally more energetic, talkative or curious, while others are easily distracted or act impulsively. These behaviours, by themselves, are not proof of ADHD. What parents need to look for is persistent inattention, hyperactivity and/or impulsivity that is out of line with the child’s developmental age and begins to interfere with normal life,” says Reena Chopra, psychologist and founder, SAAR Holistic Wellness, Bhubaneswar.

Elaborating, Chopra flags symptoms and behaviour patterns parents must watch out for:

• Does the child frequently struggle to pay attention, follow instructions, complete tasks and control impulses, or occasionally? Consistency is key when distinguishing a persistent pattern of deviation from normal childhood behaviour.
• Are similar difficulties evident at home, in school and other social settings? ADHD symptoms generally manifest in more than one setting, although their intensity varies.
• Are these behaviours affecting the child’s academic learning, friendships, family relationships and ability to manage everyday routines? Is the child frequently getting into scrapes despite repeated reminders and efforts to help? Assessing the impact of these behaviours is crucial to understanding whether they are interfering with the child’s everyday functions, relationships and overall well-being.
• A child who is constantly running around and is hyperactive does not necessarily have ADHD. Some children naturally struggle with inattention, lose things, forget instructions, make careless mistakes and find it difficult to organise tasks.
• Even when several of these signals are present, a symptom checklist cannot establish an ADHD diagnosis. Sleep difficulties, anxiety, emotional stress, learning disorders and other developmental and medical problems stimulate similar behaviour. Parents should discuss persistent signals with a qualified healthcare professional, who will assess the child’s developmental history, behaviour across settings and impact on daily life followed up with a visit to a paediatrician, developmental paediatrician, child psychologist/psychiatrist.

Understanding ADHD

Experts classify ADHD into three types to identify distinct behaviour patterns. They include:

Hyperactive and impulsive ADHD. This is characterised by high physical activity, fidgeting, struggling to sit still, talking incessantly, interrupting people, and answering questions before giving others a chance.

Inattentive ADHD. Children tend to experience difficulty in focusing, make a lot of mistakes, are easily distracted, unable to organise themselves and their work, forget and lose possessions frequently.

Combined type ADHD. Many people display symptoms of both types and are likely to be diagnosed with combined type ADHD.

Dr. Tarun Singh

How parents can support children with ADHD

According to Dr. Tarun Singh, parenting a child with ADHD requires patience, understanding and willingness to change parental attitudes and perspectives. Dr. Singh shares some practical strategies to help parents look beyond challenging behaviour, understand their child’s difficulties and create environments in which they can realise their full potential.

Change your perspective. A child with ADHD doesn’t need stricter instructions or repeated reminders as much as they need help to develop life skills. The next time you feel like saying, “Just focus!”, pause and ask yourself: “What is making this difficult for my child, and what can I do to help?”

Sometimes, the most effective parenting response is not another instruction but a better understanding of brain processes underlying behaviour. When parents stop viewing ADHD-related difficulties as character flaws or deliberate disobedience, they help children develop the skills they need to manage daily and larger challenges.

Understand challenges. Attention, impulse control, planning and emotional regulation depend on interconnected neural networks. For ADHD children, some functions are more difficult to manage, particularly complex tasks, distractions and emotionally charged situations.

ADHD children also have emotions regulation difficulty. A minor disappointment can trigger an intense reaction, followed by regret once the child has calmed down. Understanding a rule and being able to follow it in the heat of the moment are different propositions. Help children practise how to pause, manage frustration and choose appropriate responses.

Understand how attention works. One of the most common questions parents ask is: “If my child can play a video game for two hours, why can’t she do her homework for 20 minutes?”

The answer is that attention is not simply an on-off switch. Engaging activities often provide novelty, immediate feedback and frequent rewards, making it easier to sustain interest. Homework, particularly when repetitive or challenging, demands greater effort to initiate and sustain attention.

For children diagnosed with ADHD, the difficulty is not necessarily inability to pay attention, but a struggle to regulate attention across different tasks. Telling a child, “You can focus when you want to,” may therefore overlook the real challenge. Instead, parents should break work into manageable tasks, reduce distractions and build-in short, planned breaks.

Help children manage emotions. A parent often interprets a child’s tantrums as defiance, but she may be struggling with intense frustration, impulsivity and difficulty calming down. Yet this does not mean that red lines should not be drawn. Children need clear limits and help to manage their emotions. When a child is overwhelmed, first focus on calming her. Once she is ready to talk, discuss what happened, reinforce expectations and practice a more appropriate response for next time around.

Use practical aids. Children with ADHD benefit from practical aids to remember, organise and follow through. They include:

• Visual schedules. Display daily routines visually so children know what comes next.
• Checklists. Break complex tasks into smaller jobs.
• Timers. Advise ADHD children how long an activity will last and when it is time to transition.
• Short, clear instructions. Give one or two instructions at a time rather than a long list.
• Predictable routines. Establish regular time windows for homework, meals, play and bedtime.
• Confer specific, immediate praise. Acknowledge the behaviour you want to encourage. For example, “You started your homework without a reminder — that was a great way to manage your task.” Specific praise helps children remember what they did well and which skills they can use again.

Distinguish between bad behaviour and inability to self-regulate. Before assuming that a child is being careless or disobedient, consider what is her impediment? Is she finding it difficult to start a task, remember instructions, organise steps, shift between activities, manage time or control an impulsive reaction? Is the assignment too overwhelming, or has frustration made it difficult to continue?

Such difficulties reflect executive function and self-regulation challenges rather than deliberate refusal to cooperate. Identifying specific obstacles enables parents to choose more effective responses.

Change how you react. Small changes in language communication can make everyday interactions constructive. Instead of saying, “Finish your homework,” try, “Let’s start with the first three questions.” Instead of asking, “How many times do I have to tell you?”, say, “What reminder would help you remember?”

Instead of saying, “Stop overreacting,” try, “I can see that you’re upset. Let’s calm down first.”

An important point to bear in mind is that, given care, empathy and consistent parenting support, children with ADHD can transform into successful adults. Australian swimming champion Michael Phelps who has won 23 Olympic gold medals — more than any Olympian in history — was diagnosed with ADHD at age nine. Ditto American gymnast Simone Biles who won several Olympic gold medals and world championships, celebrated comedy movie star Jim Carrey and Indian movie star Alia Bhatt and actor-director Shekhar Kapur.

With consistent support, appropriate expectation and a better understanding of ADHD, parents can help their children build confidence, resilience and succeed.

Strategies to improve children’s attention & focus

Children are naturally active and quick, and it is common — especially in this digital age — for them to become distracted easily, particularly while executing boring tasks. Rather than rushing to label them as inattentive or hyperactive, parents should explore ways to engage children through meaningful and age-appropriate activities. Pondicherry-based child psychologist Nivedha M. suggests simple, effective strategies to improve children’s focus and attention.

Start small and build gradually. Avoid overwhelming your child with lengthy tasks. For instance, if your child has four pages of homework to complete, begin with a manageable portion such as one page, and offer encouragement along the way. Once a child becomes comfortable completing smaller tasks, gradually increase the workload. The objective should be to help children experience success, develop persistence and learn to take on challenges one step at a time.

Use positive reinforcement. Acknowledge and reward your child’s efforts when she completes a task or makes progress. Praise, a favourite game, an enjoyable activity or other rewards encourage children to persevere with difficult tasks. As their capability to sustain attention improves, gradually increase expectations while continuing to acknowledge their efforts. Rewards work best when they are immediate, appropriate and linked to specific behaviours, such as starting homework on time or completing a task with fewer reminders.

Encourage meaningful activities. Help your child discover activities that capture her interest, whether it is an art or craft, singing, swimming, cooking or helping with household chores. Such activities provide opportunities to follow instructions, completing tasks and developing organisational skills. Observe which activities hold your child’s attention and use these interests to encourage engagement. Balance digital media screen time with physical activity, creative play, family interactions and adequate rest.

Praise effort, not just achievement. Children who struggle with attention become discouraged when they don’t complete tasks or meet expectations. Therefore, acknowledge their effort, persistence and small improvements rather than focusing on the final result. Saying, “You stayed with your homework even when it was difficult,” reinforces the value of perseverance. Gradually, help your child work towards greater independence and consistent performance.

However, if attention difficulties persist and interfere with learning or everyday life, consult a qualified healthcare professional/psychiatrist for a professional diagnosis and assessment.