Impulsivity and problems with controlling behaviors mean that a hyperactive child does things without anticipating what the results may be for the child itself and for others. Children with Attention Deficit Hyperactivity Disorder usually start performing a task before they have fully understood the instruction; often, they do not even wait until they hear all of it. They have difficulties with performing complex tasks. They find it more difficult to learn from previous experiences and general principles. They are more talkative, interrupt others, they do not wait for their turns in group situations. No wonder then that, more often than “healthy” children, ADHD children are not popular among their peers and provoke others to express negative opinions on them. They have shorter action delay time – they must immediately do whatever comes to their mind and they cannot wait for an award or a praise. In class situations, this often means interrupting the teacher or other children, or constant clamoring for being asked a question. Excessive impulsivity may, however, have more tragic consequences: hyperactive children are more prone to have serious, even deadly accidents, because they are more likely to run onto the road without checking if it is safe or if a car is coming.

Hyperactivity is excessive mobility that is not related to performing a task and which is annoying and vexing for the environment. A hyperactive child has difficulties with staying in one place, often runs, climbs pieces of furniture; in the case of older children and adolescents excessive mobility may be limited to wriggling and fidgeting on a chair, drawing, biting a pen or experiencing inner anxiety. What is characteristic, a hyperactive child’s activity is usually rather chaotic and does not seem to have a certain aim.

The prevalence of ADHD among school aged children is estimated between 3 and 8%, depending on the study and the applied diagnostic criteria, but only 20% of children affected by the disorder receive specialist treatment. Boys suffer from the disorder more often than girls, the relation being 9:2. Girls suffer more from difficulties with concentration; they have problems with learning but – since they are not troublesome in the sense of exhibiting challenging behaviors – they are not usually sent to a psychologist or a psychiatrist. It the case of boys, the most visible symptoms are those related to excessive impulsivity and excessive and uncontrolled mobility. Hyperactivity manifests itself differently depending on the age. In the case of most children, the first symptoms of the disorder are not identified and most parents seek help for their children only when the children’s impulsivity starts causing problems at school. This, however, does not mean that the symptoms of the disease start at the age of 7. Even in early childhood, characteristics of hyperactivity can be observable. When recalling the early period, parents often mention that their child was highly irritable had problems with sleeping and with appetite. In the pre-school age, the most visible symptoms are excessive mobility and emotionality, as well as issues with acquiring social norms. Extreme impulsivity of a hyperactive child may lead to conflicts with peers. In the school age, the child’s impaired functioning when compared to its peers becomes more and more visible. In lower classes, the predominant problem is motor hyperactivity and impulsivity. But attention deficits and problems with concentration become more and more difficult as they hinder learning and negatively affect the child’s results at school.

The symptoms of hyperactivity decrease with age. Excessive mobility is the first to go – the child who ran around the classroom when it attended the first class of the primary school, in the third class only wriggles. The ability to focus attention improves slower. In puberty, the symptoms of attention deficits still persist in more than 2/3 of the sufferers. In some cases, however, they persist even longer – about 70% of the sufferers still have the symptoms in adolescence and 30% in adulthood.

Hyperactive adolescents have many problems related to learning, their education results often beneath their potential abilities. They are less mature than their peers and have issues with social relations with them, as well as with the parents and teachers. They often suffer from low self-esteem. If ADHD persists longer, it poses an increased risk of developing antisocial behaviors, alcohol and drug addictions, depression, a greater risk of committing suicide. This is related to the inability of drawing and consistently realizing action plans.

Psychological consequences. It does not appear convincing that all the problems of a hyperactive child or adult are related to hyperactivity as a personal feature – usually the problems are simply the consequences of hyperactivity. A hyperactive child is very often punished for the symptoms of the disorder, it constantly receives a number of negative pieces of information about itself: that it is rude, lazy, does not listen to adults and interrupts. Basing on such information, the child creates an image of itself as a person worse than others, bad and unsuccessful. Depending on family conditions and personal features, the child either reacts aggressively or withdraws and gives up trying. In the case of some teenagers, the symptoms of disorders are minimal, but the teenagers still hold the “I-can’t-make-it” belief they acquired from their school failures. As many as 65% of hyperactive children brought to assistance centres, have problems with obedience and following instructions. They are stubborn, quick-tempered and often verbally aggressive in relation to their environment. The comorbidity of behavioral disorders very negatively affects the prognoses of ADHD sufferers. Children in which behavioral disorders coexist with hyperactivity are more likely to become addicted to psychoactive substances, to join criminal groups and to abandon school. The results of some studies indicate that such children usually come from psych-socially difficult environments or are raised in split families or families whose members are in conflict.     

The relations between a hyperactive child and its peers are turbulent. The child interrupts other children’s game, eager to take part in it, but it is not able to adjust to the game’s rules and tries to carry its own point. Therefore, relationships with peers are rather short-lasting. A hyperactive child does not have many friends, which additionally lowers its self-esteem. Such a child is often perceived by peers as a “clutz”, “wuss”, “gowk” for them to laugh at, as they are sure that the teacher will focus his or her attention on the hyperactive child anyway. It is rather difficult to change such a situation.   

It is also important to understand that hyperactive children, due to their hyperactivity, abstractedness and difficulties with planning and foreseeing the consequences of their behaviors, are more prone to accidents and accidental injuries than other children.

Causes of hyperactivity. Nowadays, it is generally agreed that the causes of ADHD do not lie in organic brain defects originating as a result of the influence of pathological factors in the perinatal period, but are very intensified, genetically conditioned personal traits. The brain of a hyperactive child matures in a different way. This is caused by changes within the genetic material, which in turn cause changes in the functioning of certain brain structures and in consequence – leads to disorders in metal processes. The course of ADHD argues for this explanation as the symptoms decrease or regress with age in a significant number of ADHD sufferers. The assumption that hyperactivity is a genetically conditioned feature is also supported by the results of research on the families of hyperactive children, which show that in such families not only hyperactivity occurs more often, but also other disorders, stemming from the impaired control of impulses and abstractedness, are more common. Recapitulating, a hyperactive child constantly interrupts, is not obedient, does not follow instructions, does not work in class, interrupts others, does not do homework, seems to be constantly far away with thoughts, often gets involved in fights at school and arguments with siblings. It is, however, worth emphasizing that little of this is the child’s fault. Also teachers who have problems with such a child and the child’s parents are not to be blamed.

How do you know it is ADHD? Hyperactivity is quite a conventional issue. Whenever we suspect hyperactivity, we should ask ourselves the question: is the hyperactivity we observe pathological? There is no standard examination or test that would tell us exactly which child is hyperactive and which is not. The intensity of symptoms may also differ depending on the situation; they intensify in the moments of increased mental effort or when constant concentration is required – listening to the teacher, reading a text filled with details, performing a monotonous task – and they can be really insignificant or totally absent in a new and interesting situation or in a one-to-one situation with an adult. We can speak of ADHD when the symptoms of the disorder are constant or nearly constant (although their intensity may still vary), i.e., they can be observed at school, at home and during playtime. Usually, the symptoms are the most intensified at school, as the child has to constantly concentrate and stay in one place. It is also worth stressing that ADHD appears early in childhood. It is a personal trait, which reveals itself more or less clearly in various situations. It can intensify significantly in stressful situations, in a big class, as a result of the change of teacher or in the case of family problems. In other situations, it can be less intensified, but usually it is impossible to say that there was the time in the child’s life – apart from very early childhood – when no symptoms were observable. If the child functioned relatively well at school and at home, had no attention disorders and was not hyperactive, and suddenly it started to have problems – it usually means that either it has been taken ill or that something dramatic happened in the child’s life. Obviously, in both of the aforementioned cases, we cannot speak of ADHD. In such cases, what the child experiences may be psychological disorders such as anxiety and depression – a sad and frightened child usually has problems concentrating or is physically agitated. The same applies to beaten and hurt children, but in such cases we rarely observe symptoms of impulsivity and attention distracted by external stimuli – such children are usually immersed in their own thoughts and problems.

Somatic diseases may be related to the symptoms of attention disorders secondary to the actual condition, so they should always be examined by a pediatrician. A child’s problems with behavior and learning may be caused by hearing or vision impairment. There may also be other reasons for which a child behaves as if it was hyperactive. For instance, a mentally deficient child who does not understand what is going on in class will also wriggle, get bored and interrupt. The situation can be very similar in the case of a very intelligent child who – having quickly picked up the subject of the lesson – will also get bored during subsequent revisions.

Assistance and treatment. Working with a hyperactive child requires, as a precondition, accepting the child’s otherness and difficulties, as well as the fact that the child may never be the perfect, dream child or learner whom you would like to have at home or in class. This helps to adjust the demands to reality and protects parents and teachers from experiencing failures. If the parents of a hyperactive 8-year-old assume that their aim is to make the child remember to do its homework every day without them having to see to this, they will fail. If they only try to teach the child to sit down to its homework after three reminders on their part, at the agreed time and with the child’s mother assisting at checking what there is to be done, they have a chance to be successful. If the child’s teacher assumes that his or her goal is to make the child sit still during the whole lesson, he or she will fail. If the teacher assumes that making the child stay seated or teaching it to come back to the desk after one admonishment is sufficient success, he or she may be successful.

Bringing up an ADHD child is difficult for a number of reasons, one of them being the fact that it does not hear about 50% of what is said to it and remembers only about 50% from what it heard. It is good to bear it in mind. Moreover, a hyperactive child cannot foresee the consequences of various behaviors – it sees no connection between running around in the classroom and the teacher’s anger, not because it does not know the principle but because it cannot apply it to an everyday situation. The child has difficulties planning and organizing things to be done. It is constantly lost in an overwhelming number of problems and pieces of information. One way of helping the child is to create an outer order for the child to rely on. Hyperactive children need coherent rules and detailed planning. They need clear expectations on the part of adults and fixed consequences of their behaviors – awards, praises and punishments for breaking the rules. Hyperactive children concentrate in calmer environments, when they are isolated from stimuli that distract them and when they are clearly said what they are to focus on. It is also helpful if, while doing the task, they receive additional encouragement. Children divide their time between their family and school. Therefore, the latter becomes the second most important environment in which hyperactive children spend a lot of their time. A school is a very demanding environment for such children: they are challenged with a number of difficult tasks, like focusing on a lesson, which is not always interesting, or restraining impulsivity and mobility. A school should be the place where teaching and educational methods efficient for hyperactive children are introduced. It is worth emphasizing that a hyperactive child can still achieve a lot if the learning conditions are comfortable enough.

In the case of ADHD, the basic treatment is multi-dimensional, with special attention paid to family counseling and parenting skills training. Not every hyperactive child requires pharmacological treatment; it is necessary only if the symptoms are very strong and other methods (like counseling, cooperation with the school, special forms of teaching) do not produce the desired result. It seems that only from every tenth to every twentieth child showing symptoms of hyperactivity should be treated.

ADHD is a complex of symptoms which a person can sometimes grow out from, but which are there and cannot be changed. What can be modified is the environment, which can be made more conducive to acquiring knowledge and getting along with others.