ADHD
ADHD in Children & Teens
A parent's guide to understanding attention deficit hyperactivity disorder: what it looks like, how it's diagnosed, and how we treat it at NS Psychiatry.
What Is ADHD?
Attention deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental conditions in children. It affects how the brain regulates attention, impulse control, and activity levels. ADHD is not a character flaw, a discipline problem, or something your child will simply “grow out of.” It is a medical condition with well-established diagnostic criteria and effective treatment options.
About 9.8% of children in the United States between ages 3 and 17 have been diagnosed with ADHD, which is roughly 6 million children. Boys are diagnosed nearly twice as often as girls, though this gap is narrowing as awareness of how ADHD presents differently in girls continues to grow. Many girls with ADHD are missed because they tend toward the inattentive type rather than the hyperactive behaviors that are more likely to draw attention in a classroom.
At NS Psychiatry, we evaluate and treat ADHD in children, adolescents, and adults. Jonathan Stevens, M.D., M.P.H. is Harvard-trained and triple board-certified in general psychiatry, child and adolescent psychiatry, and addiction medicine. Our entire team understands that getting the diagnosis right is the first and most important step. A thorough evaluation prevents misdiagnosis, identifies any co-occurring conditions, and gives your family a clear path forward.
Signs of ADHD by Age
Preschool (Ages 3-5)
At this age, some level of hyperactivity and impulsivity is developmentally normal, which makes ADHD harder to identify. Signs that may stand out include extreme difficulty sitting still during circle time or meals, inability to play quietly, frequent tantrums that seem disproportionate, and difficulty following even simple two-step instructions. These children may also have trouble in preschool settings and get feedback from teachers about behavior that seems different from their peers.
Elementary School (Ages 6-11)
This is when ADHD most commonly becomes apparent. The structure of school demands sustained attention, organization, and self-regulation in ways that preschool did not. Parents may notice that their child cannot complete homework without constant supervision, loses school supplies regularly, forgets to turn in assignments, has trouble making or keeping friends due to impulsive behavior, or receives repeated feedback from teachers about attention and focus. Report cards may describe a child who is “bright but not working to potential.”
Adolescence (Ages 12-17)
In teenagers, hyperactivity often decreases or turns inward. Instead of bouncing off the walls, teens may describe feeling restless or “revved up” internally. Inattention and executive function deficits become more prominent: difficulty managing time, procrastination, poor planning, missed deadlines, and academic performance that does not match their ability. Social difficulties, risk-taking behavior, low self-esteem, and co-occurring anxiety or depression are also common in teens with ADHD.
ADHD Treatment Options
Treatment for ADHD is not one-size-fits-all. The right plan depends on your child's age, the severity of symptoms, the type of ADHD, and whether any co-occurring conditions are present. At NS Psychiatry, every treatment plan is built under the clinical direction of Dr. Stevens and tailored to your child's specific needs.
Medication Management
Stimulant medications (such as methylphenidate and amphetamine-based medications) are the most well-studied and effective treatments for ADHD. They work by increasing dopamine and norepinephrine levels in the brain, improving focus, impulse control, and the ability to follow through on tasks. Non-stimulant options are also available for children who do not tolerate stimulants well or who have co-occurring conditions that make stimulants less appropriate.
We start with the lowest effective dose and adjust carefully based on how your child responds. Medication management follow-ups are typically monthly at first, then every two to three months once a stable regimen is established.
Behavioral Strategies and Parent Training
For younger children (under 6), behavioral interventions are typically recommended as the first line of treatment. This includes structured routines, positive reinforcement systems, and parent training in behavior management techniques. For school-age children and teens, behavioral strategies work alongside medication to address the organizational, social, and emotional challenges that medication alone does not fully resolve.
School Accommodations
Many children with ADHD benefit from accommodations at school, such as extra time on tests, preferential seating, and check-ins with teachers. We can support the process of requesting a 504 plan or IEP by providing the clinical documentation that schools require.
Coordinated Care
If your child is also seeing a therapist, pediatrician, or school psychologist, we coordinate with them (with your permission) to make sure everyone is aligned. A good treatment plan works best when all the adults in your child's life are on the same page.
ADHD Medication for Children
Medication is one of the most studied and effective treatments for ADHD in children and adolescents. Decades of clinical research show that the right medication, at the right dose, can significantly improve a child's ability to focus, control impulses, and function in school and social settings. We never take medication decisions lightly, particularly when the patient is a child.
There are two main categories of ADHD medication:
Stimulant medications, including methylphenidate-based options (such as Ritalin, Concerta, and Focalin) and amphetamine-based options (such as Adderall and Vyvanse), are the first-line treatment for ADHD. They work by increasing dopamine and norepinephrine availability in the brain, which helps regulate attention and impulse control. Stimulants have the strongest evidence base of any ADHD treatment, and most children respond well. Common side effects include decreased appetite and difficulty falling asleep, both of which can often be managed with dose adjustments or timing changes.
Non-stimulant medications such as atomoxetine (Strattera), guanfacine (Intuniv), and clonidine (Kapvay) are an option for children who do not tolerate stimulants well, have co-occurring conditions like anxiety or tics, or whose families prefer a non-stimulant approach. Non-stimulants generally take longer to reach full effectiveness but can be a good fit for certain patients.
At NS Psychiatry, we start low and go slow. We monitor your child closely during the first weeks of any new medication, adjusting the dose based on your feedback and their response. Follow-up visits are $225 and can often be done by telehealth, so you do not have to pull your child out of school for a medication check. Our goal is always the lowest effective dose with the fewest side effects.
When to See a Child Psychiatrist for ADHD
Pediatricians diagnose and treat ADHD every day, and for straightforward cases that may be enough. But there are situations where seeing a child psychiatrist makes a meaningful difference.
Consider a psychiatric evaluation if your child's pediatrician has tried one or two medications without clear improvement, if there is a question about whether ADHD is the correct diagnosis, if your child has co-occurring conditions like anxiety or depression alongside ADHD, if behavioral challenges are escalating at home or school, or if your child is very young and you want a specialist's opinion before starting medication.
A child psychiatrist has years of additional training beyond medical school and residency that focuses specifically on how mental health conditions develop and present in children and adolescents. Dr. Stevens completed his child and adolescent psychiatry fellowship at one of the top programs in the country, and every treatment plan at NS Psychiatry is built under his clinical direction.
If you have been waiting months for an appointment with another provider, we may be able to help sooner. Most new patients at NS Psychiatry are seen within 48 hours. You can book online or call us at (561) 781-9400.