Top 11 ADHD Myths and Facts

If you’ve spent any time around schools, parks or other places children play, you’ve probably heard about ADHD – attention deficit hyperactivity disorder. “That boy is so hyper; he must have ADHD,” parents and teachers say, flinging around the label as casually as kids do with a ball. But what is ADHD really? According to a recent Centers for Disease Control and Prevention (CDC) report, 6.4 million children age 4-17 have been diagnosed with this chronic brain disorder, which shows up as inattention, hyperactivity and impulsive behavior, worse than the norm for kids. Undiagnosed and untreated, the condition can affect your child’s self-esteem, schoolwork and friendships. But every wiggle worm doesn’t have ADHD. Before you start wondering whether your child has ADHD, read on for the truth behind common myths.

1. Myth or Fact? ADHD is just a problem with organization.

Myth. 

While children with ADHD have difficulties organizing their time and activities, it’s not the cause of the disorder, says Ben Vitiello, M.D., a psychiatrist and chief of Child and Adolescent Treatment and Preventive Intervention Research at the National Institute of Mental Health (NIMH). A 2010 Michigan State University study found that a neurological problem contributes to ADHD symptoms by causing an imbalance in brain chemistry.

ADHD is due in part to a deficiency of the neurotransmitter serotonin (which helps with relaxation) and a child’s tendency to get distressed over social situations, the research showed.

But that’s not all: The brains of children with ADHD have thinner tissue and are less developed than those of children without the disorder, according to NIMH research.

Also, there’s often a 3-year delay in the development of an ADHD brain. This delay affects the front of the brain’s outer mantle, or cortex, which controls thoughts, attention and planning.

In addition, a 2010 study by Harvard University researchers showed that kids exposed to certain pesticides, called organophosphates, seem to be at increased risk of ADHD.

2. Myth or Fact? ADHD is a result of poor parenting. 

Myth.

Stow your suitcase – you’re not going on a guilt trip. ADHD is a neurological problem that has nothing to do with discipline, says Dr. Vitiello. When a child with ADHD shouts in the library, it’s not because his parents didn’t teach him better – it’s because he can’t control his impulses. In fact, strict parenting can make ADHD symptoms worse. The best approach for children with ADHD is to seek professional guidance, which can include drug therapy, psychotherapy and behavioral treatment, Dr. Vitiello says.

3. Myth or Fact? ADHD doesn’t affect girls.

Myth.

In fact, this harmful myth may explain why NIMH statistics show that boys are diagnosed four times more often than girls. Adults may ignore ADHD symptoms in girls because hyperactivity shows up “more often as hyper-talkativeness and hyper-reactivity” rather than rowdy behavior, says Kathleen Nadeau, a psychologist and director of Chesapeake ADHD Center in Silver Spring, Md. Hyper-reactivity is characterized by the tendency to be highly emotional and oversensitive, Nadeau says. As a result, girls with ADHD often have difficulty controlling their emotions in relationships, taking offense easily and escalating confrontations by making impulsive remarks. Like their male counterparts, however, girls with ADHD are often inattentive, meaning they’re unable to stay focused and tend to lose important items, says Nadeau, who is also co-founder of the nonprofit National Center for Gender Issues in ADHD, a group that educates the public on the prevalence of ADHD in girls. In girls, inattentiveness causes their self-esteem to suffer, putting them at risk for teen pregnancy, sexually transmitted diseases, anxiety and depression, Nadeau says. Here are some of the books that Dr. Nadeau has written on the subject.

4. Myth or Fact? ADHD is not the same thing as a learning problem.

Fact.

Kids with ADHD have attention problems, which may lead to troubles with schoolwork, but a learning disability is a different diagnosis, says Alice Medalia, Ph.D., psychologist and professor at Columbia University Medical Center’s Department of Psychiatry. Here’s a really great book that Dr. Medalia has written!

According to the CDC, 5% of children in this country have ADHD without a learning disability, 5% have a learning disability without ADHD, and 4% have both. However, even children with ADHD who don’t have a learning disability can have learning problems, usually related to listening and oral expression. In fact, half of children with ADHD have trouble with listening comprehension (understanding what people tell them), according to ADHD: Handbook for Diagnosis and Treatment by Russell A. Barkley, a research professor in the Department of Psychiatry at SUNY Upstate Medical University. Barkley also directed a 2002 study showing that ADHD kids have speech problems as well as difficulty processing what they hear in class and in social situations.

5. Myth or Fact? There are more symptoms than hyperactivity.

Fact.

It’s the most in-your-face symptom, but there are actually three ADHD subtypes, with varying degrees of hyperactivity, according to NIMH researchers:

• Predominantly hyperactive-impulsive: Children are mostly overactive and have trouble controlling their behavior.
• Predominantly inattentive: Children aren’t overactive but have trouble paying attention and remaining focused.
• Combined hyperactive-impulsive and inattentive: A combination of the two.

So why do many people associate ADHD just with extreme restlessness? Because “hyperactivity is so easily observed and so potentially disruptive, while inattention requires more thought and observation [to detect],” Nadeau says.

6. Myth or Fact? ADHD can be cured.

Myth.

If it seems that ADHD symptoms have vanished, you’re doing something right. Some medications and behavioral treatments can quiet ADHD symptoms or sharpen children’s focus and memory, helping students complete schoolwork and get along with kids who don’t have the disorder, psychologist Medalia says. But miracle cures for ADHD? “If you mean completely taking it away, [they don’t exist],” Medalia says.

7. Myth or Fact? Eating too much sugar causes ADHD.

Myth.

Many parents have watched their kids gobble down candy and moments later have ADHD-like behavior – bouncing off walls, shouting like maniacs and unable to focus. But sugary foods don’t cause ADHD, according to Medalia. A 1995 report published in the Journal of the American Medical Association concurs: Scientists analyzed 23 separate studies of sugar on the behavior or cognition of children and found that it doesn’t significantly affect how they act or think.

So what does Medalia tell concerned parents? “People often ask [whether too much sugar can cause ADHD], and the answer is always that healthy habits are the best way to go.”

8. Myth or Fact? ADHD can’t be treated without drugs.

Myth. 

Some children with ADHD can improve with behavioral treatment alone, Dr. Vitiello says. This includes making schedules, lists and charts to help kids stay organized and prioritize tasks like homework and household chores. To lessen the anxiety that often goes along with ADHD, doctors may also teach kids relaxation techniques. But some kids need medication. “You don’t use it in every case, of course – you have to evaluate each person individually,” he says. One of the most comprehensive studies ever done on the disorder – NIMH’s $11 million Multimodal Treatment Study of Children with ADHD (called the MTA study) – reports that overall, children’s ADHD symptoms improved more with medication or with a combination of behavioral treatment and medication than with behavioral treatment alone.

9. Myth or Fact? Brain scans can diagnose ADHD.

Myth. 

MRIs alone can’t tell whether a child has ADHD, because a diagnosis requires monitoring kids’ behavior, says NIMH’s Dr. Vitiello.

Doctors must detect a list of symptoms identified by the American Psychiatric Association, including restlessness and inability to focus, that are present for more than six months. Brain scans also aren’t precise enough to detect ADHD, says David Rabiner, Ph.D., a psychologist and professor at Duke University. The brains of children with ADHD appear too much like the brains of children with other mental disorders, he says. There are technologies, however, that can assist in making an ADHD diagnosis, he says. He’s a proponent of electroencephalographs (EEG), or neurofeedback, a noninvasive tool used to take images of the brain while a child performs various tasks that shows how the brain changes during these tasks.

10. Myth or Fact? Children with ADHD aren’t smart.

Myth.

Though children with ADHD often do poorly in school, the disorder has nothing to do with IQ, scientists say. And a high IQ alone doesn’t prevent a child with ADHD from experiencing the cognitive impairment associated with the disorder. In a 2009 Yale University study, 75% of kids with ADHD and a high IQ (scores of 120 and higher) still suffered from significant impairment in memory and cognitive tests, unlike people with similar IQs who didn’t have the disorder. However, other factors, particularly family relationships, can affect kids’ success over ADHD.

“The highly intelligent person with a more severe form of the disorder and a less supportive family may not do as well as one who doesn’t have such a high IQ but does have a supportive family,” Dr. Vitiello says.

11. Myth or Fact? Kids can’t outgrow ADHD.

Fact.

Symptoms of the disorder may fade, but it never goes away. Research has shown that ADHD often carries over from childhood into adolescence and adulthood, and some symptoms – inability to pay attention or focus, or uncontrolled behavior – can worsen with age. In fact, while NIMH statistics show that the disorder affects 3%-5% of preschool and school-age children, it impacts 4.4% of adults age 18-44. If untreated in adults, ADHD can lead to depression, anxiety and substance abuse, as well as work, legal, financial and personal problems. But the news isn’t all doom and gloom; children with ADHD can go on to live happy, successful lives. “The key is to learn how to manage the illness,” Medalia says.

“When people get good at managing symptoms of the illness – with medication, behavioral strategies and a good support system – they’re able to work toward and achieve the personal goals that are really meaningful to them,” she says.

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