ADHD Warning Signs and Red Flags in Children and Adolescents

Anxiety and DepressionThe following symptoms and behaviors may indicate the presence of an executive functioning disorder, such as ADHD. An evaluation by a licensed psychologist or other medical provider can help determine if ADHD is the cause of these difficulties, and the specific sub type of ADHD. Additionally, many other conditions can have executive functioning impacts, and a psychologist can help determine what is impacting you or your family member.

*Teacher reports of behaviors in class: When children transition from preschool and early elementary school into later elementary and middle school, they are expected to sit at their desk for longer periods, and switch between subjects and classes more frequently. These expectations can be difficult to uphold for an individual with executive functioning differences, and can lead to impulsive behaviors (talking out of turn, getting out of seat, pestering classmates) or inattentive behaviors (daydreaming, not completing assignments, lost materials). Teachers often see the disruption to academics and others’ learning, and report these behaviors to parents and administrators.

*Failure to follow multi-step directions: It can be very exasperating for a parent who asks their child “Please bring your shoes upstairs, put on your pjs, and brush your teeth” to then walk upstairs 10 minutes later and find the child playing with legos, shoes cast aside, midway through putting on their pajamas. Holding each of these steps in a child’s short-term memory can be hard, but it can be near impossible for a child with ADHD or executive functioning differences.

*Frequently losing or misplacing items: Memory problems are very unusual in children and adolescents. Rather, losing or misplacing items at this stage of life is more indicative of an attention problem, as attention is required to note where the item is stored both initially and upon recall.

*Difficulties in making and sustaining friendships: Children with ADHD typically have very high social motivation and strive to connect with peers. However, difficulties with impulsivity (not taking turns in games and activities, interrupting others when talking) or attention (forgetting friendship commitments) can often impact social connections. Social skills groups and instruction is often helpful.

*Anxiety and depression: Children who get into trouble for impulsive or inattentive behaviors – behaviors they cannot help, or struggle with greatly – can start to develop low self-image and low self-esteem. This can impact their confidence, as well as increase their worries and general anxiety regarding school and interactions. They can start to isolate and withdraw from others, or demonstrate tearfulness and irritability. An appropriate diagnosis and intervention can help improve these symptoms.