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Public Speaking With ADHD: Top 8 Tips to Be Successful

Do you struggle with Attention Deficit Hyperactivity Disorder (ADHD)? Or perhaps, you know someone who is afflicted with this condition. This disorder is prevalent in childhood who have difficulty behaving or focusing at some point in their lives. This also carries on to adulthood.

This article will highlight the causes, challenges, and success even if you or your loved one is struggling with ADHD. Yes, public speaking with ADHD can be accomplished!

Public Speaking with ADHD: The Challenge

According to the CHADD , this is not a disorder that children grow out of. In most cases, children with ADHD struggle at home, with their peers, and even at school. If left untreated, this disorder will worsen and affect almost every aspect of your life. It can last until you reach adulthood. People with ADHD may struggle with relationships with peers, work, and home. It may be more noticeable at this point because, as a person ages, the demands of adulthood increase.

Per Mark Bertin, M.D . in Developmental Pediatrics, people with ADHD struggle with articulation, impairing their ability to produce sounds appropriate for their age. Furthermore, they have significant differences in vocal quality and fluency when speaking. People with ADHD have a higher pitch and volume when speaking than people who only have learning disabilities. They frequently pause and use many filler words, making them difficult to understand when conveying a message. 

Causes of ADHD

Most people thought that ADHD was caused by excessive television viewing, eating sweets, environmental and social factors, poverty, family, etc. This belief has been debunked by scientific research ; while it may exacerbate ADHD symptoms, claiming that they are the cause is always false.

Scientists are still trying to figure out what causes ADHD and how to reduce its chances. They may not have all the answers right now, but they know that genetics plays a significant role. Other than that, it could be caused by any of the following factors:

• Injured brain
• Early childhood or pregnancy exposure to environmental hazards
• Pregnancy and tobacco and alcohol use
• Premature delivery
• Low birth weight

Public Speaking with ADHD: Top 8 Tips to be Successful

Knowing all of the constraints and difficulties that ADHD can bring, it is now clear to us that having it can significantly impact your ability to speak publicly. Having ADHD is difficult, but there are things you can do to help yourself succeed in public speaking.

Here are the top 8 success tips:

1. Choose an interesting topic

When a person has ADHD, they are more likely to cling to their emotions. Instead of viewing it as a disadvantage, consider it an advantage! Choose a topic that interests you and helps you deliver a heartfelt speech. When you do this, your enthusiasm will spread throughout the audience.

If you've been assigned a dry subject, try to approach it creatively. Look for alternative approaches, ideas, or simply spin them creatively.

For example, you may be asked to speak about the history of Europe during the Middle Ages. This could be a boring subject. But what can you do to spice things up? Models, maps, and other creative props could be used! It's also a good idea to dress up in costume. That's great as long as you can deliver a presentation, no matter how creative it is!

2. Organize your talk

Make a mind map or outline of what you want to say and how you want to deliver it before drafting your speech. This can assist you in identifying the deficiencies in your presentation. It is also an excellent opportunity to seek help from your tutor, teacher, parent, or local librarian.

You should keep in mind that your topic should be concise rather than complex. If your structure is overly complicated, you will lose your audience. No matter how interesting your topic is, always avoid becoming overly complex.

When giving a speech or presentation, keep in mind that your goal is to keep it "short and sweet." When a person has ADHD, they are prone to flinging all of their ideas at once, which can be boring to the audience if you just repeat your ideas. To avoid this, always concentrate on the main points.

Consider rewriting your speech at least twice after you finish the first draft. Always keep in mind that the goal is to keep it brief. You should also emphasize your main points, clean up the organization, add more appropriate terms, etc. This can significantly improve your presentation skills.

4. Cue yourself

When it comes to public speaking, outlining cue cards is always a good idea. Whether you have ADHD or not, memorizing your speech word for word is dangerous. Put all the important points on cue cards, so you don't forget them.

It is also strongly advised that your cue cards be colorful. The same is true for highlighting the texts; doing so can help you instill in your mind that they are important. If you memorize your speech word for word, there is an adequate chance that your entire speech will be forgotten if you forget a few key terms. Moreover, it is a well-established fact that persons with ADHD have memory issues and easily forget things. You indeed need to familiarize yourself with your speech but don’t go for verbatim. 

5. Record yourself

You can record yourself while speaking using any device, such as a digital camera, video camera , Webcam , or cassette recorder. Following the recording, watch the videos and make notes on what you like and dislike about them.

This is one of the most effective methods for identifying mistakes that must be corrected and positive aspects maintained. You should consider what can be improved to make your speech more engaging. You should pay special attention to the beginning and end of the speech. Not only do your words matter, but so do your gestures.

This process can help you familiarize your speech and identify your loopholes. This will stick with you if you watch the recorded video several times!

6. Keep constant eye contact

While you can't really practice in front of an audience, you can use your stuffed animals on your bed to practice if you are a young person. Place them in front of you as you deliver your speech, and imagine that they are the real human beings who will be watching your public speaking.

Maintain constant eye contact to train yourself to do so on the speech day. If you're going to hold your notes, practice maintaining eye contact after you've raised your head from the script.

For more information surrounding this subtopic, check out the article, " 9 Tips To Improve Eye Contact During a Presentation "

7. Practice your timing

When it comes to public speaking, timing is everything as noted in the article Why Is Time Management Important in a Presentation . In that case, you will understand why speakers must stick to their allotted time.

People with ADHD frequently speak faster than normal, causing them to fall short of the time allotted and their speech to appear ineffective. Because they are nervous and want to leave the stage as soon as possible, they will frequently go from silent to lightning fast.

You'll need a small digital timer or a stopwatch on your phone to practice. You must speak slowly enough to be understood while speaking quickly enough to avoid going overboard. Time management is critical and should not be overlooked.

8. Visualize success

Imagine yourself succeeding rather than failing to deliver an effective speech the night before your speech. Visualize yourself in the classroom presenting and everyone is paying attention to you as you maintain constant eye contact. Imagine that everything you prepared for would be a success.

Believing in yourself is an important component of being a good public speaker. Believe me when I say that you are capable of much more than you believe. You've done enough preparation for the entire speech; trust yourself that you'll be able to deliver it effectively!

Public Speaking with ADHD: Final Thoughts

If you have ADHD, you know how difficult performing certain tasks and activities can be. You simply have to believe that you can be effective in public speaking with enough effort and determination.

One of the keys is following these 8 tips for becoming successful in public speaking if you have ADHD. It takes time to become an expert in the field of public speaking. But, in the end, you will notice that you are becoming more successful and public speaking will become much easier for you.

For more resources to develop your public speaking skills while you are in the comforts of your own home, please check out the article ‘ Online Resources for Public Speaking ’. You may also visit one of my articles on ' How Do I Stop My Heart From Racing When Public Speaking? '

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10 Essential Classroom Accommodations for ADHD

Go to that individualized education program meeting prepared..

Posted September 30, 2021 | Reviewed by Chloe Williams

• What Is ADHD?
• Find a therapist to help with ADHD
• Young people in the education system with attention deficit/hyperactivity disorder (ADHD) have the right to receive accommodations.
• Accommodations that may help students with ADHD include getting extra time to complete assignments and having special seating arrangements.
• Having the teacher provide study guides or notes, taking breaks from the classroom and using the buddy system can also help.

Thank goodness society has finally come to celebrate neurodiversity . Or rather, they’ve decided to finally acknowledge that there are people who think or learn differently from the majority by inventing an ultra-lengthy neologism.

Regardless, this long-overdue recognition has led to the realization and embracing that conventional methods of classroom instruction simply do not suffice for the “neurodivergent.” As such, accommodations or changes that remove the barriers to learning for the neurodiverse are in order and, thankfully, welcomed. Children or young people in the education system with an attention deficit hyperactivity disorder (ADHD) diagnosis have the right to receive accommodations under two federal laws, the Individuals with Disabilities Education Act and Section 504 of the Rehabilitation Act.

If your child has just been diagnosed with ADHD, or it’s time for that annual Individualized Education Program (IEP) review or re-evaluation of an IEP, there may be accommodations that can set them up for success this school year. Below are 10 accommodations that can make all the difference.

Time Management Accommodations

1. Extra Time to Complete Assigned In-Class Work, Homework and Tests

Struggling with time management skills or perceiving/judging time are common ADHD issues. This accommodation can also facilitate test-taking anxiety , challenges with initiation, and deficits in processing speed.

2. Pomodoro Method

The ADHD brain loves rest. I think we can all relate to that. It’s not because it’s “lazier” than other brains but because the ADHD brain “battery” is much smaller than neurotypical brains. Consequently, it gets depleted faster and needs breaks to “recharge” more frequently. Allowing special education instructors to implement the Pomodoro method in school is a great way to recharge. The Pomodoro method typically recommends setting a timer for 25 minutes and taking a 5-minute break, but for young people with ADHD, the time should be altered to support their attention deficit. I recommend 15 minutes of work with a 3-minute break for young people aged 8 to 18. Remember, it’s all about neurodiversity, so tweak as you see fit.

Environmental Accommodations

3. Seating Placement in the Classroom Matters

Being easily distracted and struggling to sit through long classes has always been a hallmark sign of ADHD. Limiting distractions is an easy way to reduce inattention, disruptive behavior, and urges to engage in impulsive acts. Make sure they’re not seated in high traffic areas (close to the classroom door). Seating should also be away from distractions, like windows, heating/air conditioning vents, speakers, and disruptive peers.

Tools and Equipment Accommodations

4. Fidget Chairs

People with ADHD, predominantly hyperactive-impulsive types, have difficulty sitting still, not fidgeting , squirming, and controlling their bodies in general. Special seating accommodations that allow them to expend their excess energy while remaining in their seat are a godsend for teachers and peers alike. Fidget chair bands enable them to bounce their feet without being disruptive. Motion stools, wobble cushions, and balance ball chairs are all teacher-approved.

5. Accommodations for Writing Difficulties

Children with ADHD will also often struggle with dysgraphia , which is described as a learning disability that involves impaired ability to produce legible and automatic letter writing and often numeral writing. Pencil grips, slant boards, graphic organizers, and highlighted paper can all help make writing less anxiety-provoking.

Working Memory Deficit Accommodations

6. Reduce Memory Load

Working memory is often a significant impairment in children with ADHD. Short-term memory deficits can plague these individuals and can often affect their ability to study and memorize information for tests. Have the teacher provide class notes and study guides. It’s even beneficial to have another diligent peer or “class scribe” volunteer their notes for your child’s review. All of this can be done while maintaining your child’s privacy.

Anxiety Accommodations

It often goes unrecognized that ADHD frequently co-exists with other anxiety disorders like generalized anxiety, social anxiety , and panic disorder. The stress of not being able to focus, forgetting tasks, assignments, and responsibilities, and being overwhelmed by seemingly never-ending external stimuli is overwhelming, to say the least.

7. Taking Breaks from the Classroom

Allowing your child to leave the classroom may seem like a slippery slope that could easily be taken advantage of, but it’s necessary. Allowing them to get some water, walk down the hallway, have a quick snack, go to the bathroom, or visit the guidance counselor is often needed when struggling with ADHD and anxiety. The classroom is overwhelming and often overstimulating. A quick “calm-down” or “reset” is typically all it takes to regain focus and composure. If you’re nervous about this accommodation, limit the number of times it can be utilized as well as the length of time throughout the school day.

8. ADHD and Social Anxiety

Social anxiety is like the bully that won’t leave ADHD in peace. Studies have found that social anxiety disorder had a high rate of co-occurrence with ADHD. This makes classroom presentations a panic-ridden and even traumatizing experience for individuals struggling with severe cases of both. Ask teachers if they would be willing to allow your child to record their presentation at home to edit it as needed or if they would be willing to let the child only present in private. It’s best to seek out cognitive behavioral therapists to help the child overcome their social anxiety so that this does not have to become a lasting accommodation. The goal should be to overcome the fear with the right mental health professional support but have the proper accommodations in place in the interim.

Socialization Supports

9. Buddy System

Children with ADHD typically struggle with switching gears or managing “transitions” — changing classes, switching subjects, starting assignments, etc. In addition to giving kids a heads up about transition time, for example, “five more minutes before recess ends,” having a school-assigned peer to assist them can also make the shift go much more smoothly.

10. Have the Teacher Assign Your Child a Special Role During Class

It’s well documented that ADHD kids are unfortunately targets for bullies. Whether they are often reprimanded by teachers or struggle with impulsive behaviors that garner negative attention, it doesn’t change that they are and can regularly feel ostracized or generally disliked. Needless to say, this is awful for their self-esteem . Having their teacher point out that your child has a “special” role or job can help offset the negative attention due to their other misunderstood behaviors. Ask the teacher to name your child “Student Helper,” “Paper Passer,” (passes out all papers), “Nurse Buddy" (walk other kids to the nurse), “Line Leader ,” or “Teacher’s Assistant.”

https://adayinourshoes.com/iep-504-accommodations-strategies/

Kailey Spina Horan, Ph.D., LMHC is the founder of True North Mental Health Counseling PLLC in Briarcliff Manor, NY, a practice dedicated to treating children, teens, young adults, and families.

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Understanding the Impact of Employees with ADHD in the Workplace

“There are times no matter how hard I try to work nothing is going to happen, but I think there are times when I can accomplish so much more than most people,” Christensen says.

A couple of months ago, Christensen’s company began allowing her to work an alternate schedule. Her workday is now broken up into two four-hour blocks—she spends mornings at the office and works late evenings at home. The schedule was originally implemented so Christensen could spend more time with her children. But it has had a positive impact on her productivity as a marketing/media professional with ADHD.

“My boss and I have discovered I am much more focused as a result of having less time at the office to work with,” Christensen says. “I literally accomplish in my half-days at work close to what I used to in a full, eight-hour stretch.”

Christensen says that’s because she feels “a greater sense of urgency. I appreciate the flexibility and want my employer to feel like it is working, and I more clearly recognize distractions for what they are when the clock is ticking.”

ADHD is a complex neurobehavioral condition—75 percent to 80 percent of the cause is ascribed to genetics—that should be diagnosed by a health professional. It’s typically treated with medication and behavior therapy.

“The symptoms of ADHD are chronic, pervasive and impairing and are relatively unchanged since childhood,” says Dr. David W. Goodman, M.D., an assistant professor at Johns Hopkins University School of Medicine and director of the Adult Attention Deficit Disorder Center of Maryland in Baltimore. “It’s not a condition that comes and goes.”

Employees with ADHD might display inattentiveness and distractibility, impulsivity, hyperactivity, chronic forgetfulness, difficulty with details and paperwork, poor time management and difficulties with co-workers.

“They may be fidgety and restless, so they click their pen or tap their feet or shuffle their papers around a lot more than anybody else,” Goodman says. “They have difficulty organizing and planning, so tasks tend to get thrown together at the last minute.”

According to the 2008 World Health Organization (WHO) World Mental Health Survey Initiative , 5.2 percent of working adults in the U.S. have ADHD.

Impact at Work

According to the WHO study, people with ADHD work 22 fewer days per year than non-ADHD counterparts.

A 2008 survey of adults with ADHD by Titusville, N.J.-based McNeil Pediatrics found that among employed participants, more than half (56 percent) said their ADHD “strongly impacts their ability to succeed at work.”

In addition, the survey found that a majority of adults with ADHD who are employed “feel they have to work harder and/or longer than their co-workers to accomplish similar work” and half of those employed “worry ADHD symptoms affect opportunities for promotions.” McNeil Pediatrics makes Concerta, a leading ADHD drug.

Meanwhile, three-quarters of respondents said they have the most trouble staying on task at work. Others listed work-related challenges such as concentrating on what others are saying, wrapping up projects, following through on tasks, sitting still in meetings and organizing projects.

Half of the participants said they had been terminated from a previous job; 60 percent of them believe their ADHD symptoms contributed to their dismissal.

“I can’t tell you how many people are about to lose their job, [but] they get treated and their performance improves and they get promotions,” Goodman told SHRM Online .

That’s why he says it’s important for employees to be identified, evaluated and treated.

Legal Issues to Consider

Lynne Eisaguirre, a former employment attorney and Golden, Colo.-based workplace issues expert, says employers should not “guess” that someone has ADHD, try to diagnose this disability or try to “help” someone they believe has ADHD.

“Many other conditions can mimic ADHD behavior,” Eisaguirre says. “To treat someone differently because you believe they have ADHD, or even if you know because they’ve told you that they have ADHD, would be discrimination and stereotyping based upon disability.”

Any request for accommodation under the Americans with Disabilities Act should come from the employee, not the employer. If you believe that an employee is not performing well—for any reason—Eisaguirre recommends asking: “Is there anything that I’m doing or that anyone else is doing here at work that’s interfering with your success?”

If the employee volunteers something, “you can, of course, be compassionate,” Eisaguirre says, “but again, wait for them to ask for what they need.”

If an employee indicates that he or she needs help getting tasks completed, employers can turn to the Job Accommodation Network for free guidance on accommodating employees with ADHD .

Careers that Work

Individuals with ADHD can certainly be successful.

In recent years, several high-profile people have publicly disclosed they have ADD/ADHD. They include swimmer and U.S. gold medalist Michael Phelps, “Deal or No Deal” game show host Howie Mandel , former quarterback Terry Bradshaw, and David Neeleman, former CEO of Jet Blue Airways.

Dr. David Whitehouse, chief medical officer for Santa Ana, Calif.-based OptumHealth Behavioral Solutions, says employees with ADHD should avoid jobs that require constant attention to details and minutia and should opt for jobs that require high energy and intelligence.

Goodman says a lot of these people end up in sales "because they’re great talkers,” but added that the problem is they often "drive their managers crazy because they don’t get their paperwork done" because they really like going from task to task.

In addition to sales, Goodman says people with ADHD can probably “do reasonably well” as teachers because teachers often have a time-limited period where they “have to be on” and then get a break to regroup and get ready for the next activity.

“Certainly you will run into problems with these people if you put them in a telephone call answering center and tell them they can’t move and have to answer one call after another,” Whitehouse says.

And because employees with ADHD frequently need more sleep, giving a senior executive with ADHD a 40-page report to read the evening before a major decision-making meeting is probably not a good idea. “Under that kind of deadline pressure working late at night, they are probably not going to do well,” Whitehouse adds.

Pamela Babcock is a freelance writer based in the New York City area.

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Advice for teaching and mentoring ADHD folks & advice for teaching with ADHD

The "this doesn't prepare them for the real world" argument., key points:.

• Asking people to maintain eye contact, punishing or judging those who are unable to stand still at a podium, and other assessment criteria for public speaking are all ableist.  
• Build in flexibility to presentations: allow presenters to present how they need to and ask about their access needs in advance.
• Think creatively about communication in general and question whether the public speaking rules and standards you were taught are rooted in ableist, colonial, racist, and deeply exclusionary practices.
• Remind yourself of the overall goal: sharing information and connecting with others. Do not force disabled folks to fit the mold. Work with them to ensure their success.

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All Ableist Grading Breaking Things Down Conveying Information Dissertations And Theses Final Projects Focus Giving Feedback Giving Instructions Grading Helping ADHD Folks Organize How ADHD Can Affect Communication Just Try Harder Mentoring Public Speaking Rsd UDL

There's a reason theADHDAcademic is an anonymous account and there's a reason why this website will remain anonymous.  That said, there are some basics it might be helpful to know about me: I am white. I am a cis-female. I am based in the United States. ​ I wasn't diagnosed with ADHD (mixed) until my last year as an undergraduate, just a few months before I graduated.

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ADHD and classroom challenges

What teachers can do to help children with adhd, classroom accommodations for students with adhd, teaching techniques for students with adhd, teaching students with adhd.

Dealing with attention deficit hyperactivity disorder in the classroom? These tips for teachers can help you overcome common challenges and help kids with ADHD succeed at school.

If you’re a teacher, you know these kids: The one who stares out the window, substituting the arc of a bird in flight for her math lesson. The one who wouldn’t be able to keep his rear end in the chair if you used Krazy Glue. The one who answers the question, “What body of water played a major role in the development of the Ancient Egyptian civilization?” with “Mrs. M, do you dye your hair?”

Students who exhibit ADHD’s hallmark symptoms of inattention, hyperactivity, and impulsivity can be frustrating. You know the brainpower is there, but they just can’t seem to focus on the material you’re working hard to deliver. Plus, their behaviors take time away from instruction and disrupt the whole class.

Students with ADHD may:

• Demand attention by talking out of turn or moving around the room.
• Have trouble following instructions, especially when they're presented in a list, and with operations that require ordered steps, such as long division or solving equations.
• Often forget to write down homework assignments, do them, or bring completed work to school.
• Often lack fine motor control, which makes note-taking difficult and handwriting a trial to read.
• Have problems with long-term projects where there is no direct supervision.
• Not pull their weight during group work and may even keep a group from accomplishing its task.

Think of what the school setting requires children to do: Sit still. Listen quietly. Pay attention. Follow instructions. Concentrate. These are the very things kids with attention deficit hyperactivity disorder (ADHD or ADD) have a hard time doing—not because they aren’t willing, but because their brains won’t let them. That doesn’t make teaching them any easier, of course.

Children and teens with ADHD often pay the price for their problems in low grades, scolding and punishment, teasing from their peers, and low self-esteem. Meanwhile, you, the teacher, feel guilty because you can’t reach the child with ADHD and wind up taking complaints from parents who feel their kids are being neglected in the classroom. But it doesn’t have to be this way. There are strategies you can employ to help students with ADHD overcome learning challenges, stay focused without disrupting others, and succeed in the classroom .

So how do you teach a kid who won't settle down and listen? The answer: with a lot of patience, creativity, and consistency. As a teacher, your role is to evaluate each child's individual needs and strengths. Then you can develop strategies that will help students with ADHD focus, stay on task, and learn to their full capabilities.

Successful programs for children with ADHD integrate the following three components:

• Accommodations: what you can do to make learning easier for students with ADHD.
• Instruction: the methods you use in teaching.
• Intervention: How you head off behaviors that disrupt concentration or distract other students.

Your most effective tool, however, in helping a student with ADHD is a positive attitude. Make the student your partner by saying, “Let's figure out ways together to help you get your work done.” Assure the student that you'll be looking for good behavior and quality work and when you see it, reinforce it with immediate and sincere praise. Finally, look for ways to motivate a student with ADHD by offering rewards on a point or token system.

Dealing with disruptive classroom behavior

To head off behavior that takes time from other students, work out a couple of warning signals with the student who has ADHD. This can be a hand signal, an unobtrusive shoulder squeeze, or a sticky note on the student's desk. If you have to discuss the student's behavior, do so in private. And try to ignore mildly inappropriate behavior if it's unintentional and isn't distracting other students or disrupting the lesson.

Speak to a Licensed Therapist

As a teacher, you can make changes in the classroom to help minimize the distractions and disruptions of ADHD.

• Seat the student with ADHD away from windows and away from the door.
• Put the student with ADHD right in front of your desk unless that would be a distraction for the student.
• Seats in rows, with focus on the teacher, usually work better than having students seated around tables or facing one another in other arrangements.
• Create a quiet area free of distractions for test-taking and quiet study.

Information delivery

• Give instructions one at a time and repeat as necessary.
• If possible, work on the most difficult material early in the day.
• Use visuals: charts, pictures, color coding.
• Create outlines for note-taking that organize the information as you deliver it.

Student work

• Create worksheets and tests with fewer items, give frequent short quizzes rather than long tests, and reduce the number of timed tests.
• Test students with ADHD in the way they do best, such as orally or filling in blanks.
• Divide long-term projects into segments and assign a completion goal for each segment.
• Accept late work and give partial credit for partial work.

Organization

• Have the student keep a master binder with a separate section for each subject, and make sure everything that goes into the notebook is put in the correct section. Color-code materials for each subject.
• Provide a three-pocket notebook insert for homework assignments, completed homework, and “mail” to parents (permission slips, PTA flyers).
• Make sure the student has a system for writing down assignments and important dates and uses it.
• Allow time for the student to organize materials and assignments for home. Post steps for getting ready to go home.

Teaching techniques that help students with ADHD focus and maintain their concentration on your lesson and their work can be beneficial to the entire class.

Starting a lesson

• Signal the start of a lesson with an aural cue, such as an egg timer, a cowbell or a horn. (You can use subsequent cues to show how much time remains in a lesson.)
• Establish eye contact with any student who has ADHD.
• List the activities of the lesson on the board.
• In opening the lesson, tell students what they're going to learn and what your expectations are. Tell students exactly what materials they'll need.

Conducting the lesson

• Keep instructions simple and structured. Use props, charts, and other visual aids.
• Vary the pace and include different kinds of activities. Many students with ADHD do well with competitive games or other activities that are rapid and intense.
• Have an unobtrusive cue set up with the student who has ADHD, such as a touch on the shoulder or placing a sticky note on the student's desk, to remind the student to stay on task.
• Allow a student with ADHD frequent breaks and let him or her squeeze a rubber ball or tap something that doesn't make noise as a physical outlet.
• Try not to ask a student with ADHD perform a task or answer a question publicly that might be too difficult.

Ending the lesson

• Summarize key points.
• If you give an assignment, have three different students repeat it, then have the class say it in unison, and put it on the board.
• Be specific about what to take home.

More Information

• Attention-Deficit/Hyperactivity Disorder (AD/HD) - Tips and resources for teachers. (Center for Parent Information and Resources)
• In the Classroom: Ideas and Strategies for Kids with ADD and Learning Disabilities - Suggestions for teaching children with ADHD. (Child Development Institute)
• Motivating the Child with Attention Deficit Disorder - How ADHD symptoms interfere with classroom expectations and how to realistically motivate a child. (LD Online)
• Step-by-Step Guide for Securing ADHD Accommodations at School - Meeting your child’s educational needs with ADHD accommodations at school. (ADDitude)
• Contents of the IEP - Guide to developing an Individualized Education Program (IEP) with school staff to address your child’s educational needs. (Center for Parent Information and Resources)
• Neurodevelopmental Disorders. (2013). In Diagnostic and Statistical Manual of Mental Disorders . American Psychiatric Association. Link
• Teaching Children with Attention Deficit Hyperactivity Disorder: Instructional Strategies and Practices– Pg 1. (2008). [Reference Materials; Instructional Materials]. US Department of Education. Link
• Gaastra, G. F., Groen, Y., Tucha, L., & Tucha, O. (2016). The Effects of Classroom Interventions on Off-Task and Disruptive Classroom Behavior in Children with Symptoms of Attention-Deficit/Hyperactivity Disorder: A Meta-Analytic Review. PLOS ONE, 11(2), e0148841. Link
• CDC. (2019, November 7). ADHD in the Classroom . Centers for Disease Control and Prevention. Link

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Attention deficit disorder (ADHD or ADD) is more complex and nuanced than most people realize. Its symptoms may be mild, moderate, or severe. More often than not, it coexists with other conditions, including learning disabilities. And many of its challenges are “invisible” or easily blamed on laziness.

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Disentangling ADHD's Presentation-Related Decision-Making—A Meta-Analytic Approach on Predominant Presentations

Marcel schulze.

1 Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany

David Coghill

2 Department of Pediatrics, University of Melbourne, Melbourne, VIC, Australia

3 Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia

4 Murdoch Children's Research Institute, Melbourne, VIC, Australia

Alexandra Philipsen

Associated data.

The datasets analyzed in this article are not publicly available. Requests to access the datasets should be directed to [email protected] .

Background: Deficient decision-making (DM) in attention deficit/hyperactivity disorder (ADHD) is marked by altered reward sensitivity, higher risk taking, and aberrant reinforcement learning. Previous meta-analysis aggregate findings for the ADHD combined presentation (ADHD-C) mostly, while the ADHD predominantly inattentive presentation (ADHD-I) and the predominantly hyperactive/impulsive presentation (ADHD-H) were not disentangled. The objectives of the current meta-analysis were to aggregate findings from DM for each presentation separately.

Methods: A comprehensive literature search of the PubMed (Medline) and Web of Science Database took place using the keywords “ADHD,” “attention-deficit/hyperactivity disorder,” “decision-making,” “risk-taking,” “reinforcement learning,” and “risky.” Random-effects models based on correlational effect-sizes were conducted. Heterogeneity analysis and sensitivity/outlier analysis were performed, and publication biases were assessed with funnel-plots and the egger intercept.

Results: Of 1,240 candidate articles, seven fulfilled criteria for analysis of ADHD-C ( N = 193), seven for ADHD-I ( N = 256), and eight for ADHD-H ( N = 231). Moderate effect-size were found for ADHD-C ( r = 0.34; p = 0.0001; 95% CI = [0.19, 0.49]). Small effect-sizes were found for ADHD-I ( r = 0.09; p = 0.0001; 95% CI = [0.008, 0.25]) and for ADHD-H ( r = 0.1; p = 0.0001; 95% CI = [−0.012, 0.32]). Heterogeneity was moderate for ADHD-H. Sensitivity analyses show robustness of the analysis, and no outliers were detected. No publication bias was evident.

Conclusion: This is the first study that uses a meta-analytic approach to investigate the relationship between the different presentations of ADHD separately. These findings provide first evidence of lesser pronounced impairment in DM for ADHD-I and ADHD-I compared to ADHD-C. While the exact factors remain elusive, the current study can be considered as a starting point to reveal the relationship of ADHD presentations and DM more detailed.

Introduction

ADHD is a neurodevelopmental disorder associated with inappropriate levels of inattention and/or hyperactivity/impulsivity ( 1 ). Subtypes are categorized depending on the degree of inattention and/or hyperactivity in predominantly inattentive presentation (ADHD-I), predominantly hyperactive/impulsive presentation (ADHD-H), and the combined presentation (ADHD-C) ( 2 ). ADHD as a disorder has been considered by some to be primarily a disorder of executive dysfunction ( 3 ). Among these, dysfunction in inhibition, working memory, and task switching are most consistently reported ( 4 ). However, the relationship between executive dysfunction and ADHD is not that simple because not all of those with ADHD exhibit executive dysfunction ( 5 ). There are now several other conceptualizations that address this heterogeneity and propose multiple pathway models ( 5 , 6 ). According to these models, ADHD can arise from dysfunction across several different pathways that include executive and non-executive dysfunctions as well pathways that emphasize motivational aspects accompanied with suboptimal reward processes, delay aversion, that is, the drive toward immediate reinforcement, and to escape the negative affect induced by delay ( 7 ). These latter two pathways are mediated by deficits on mesocortical control circuits for the cognitive pathway and by alterations in meso-limbic reward circuits for the motivational pathway.

Decision-making (DM) can be viewed as choosing one specific action among others after evaluating the potential outcomes, preferences, and context. This encompasses scenarios ranging from simple perceptual decisions to complex learned situations (e.g., reinforcement learning) as well as risky DM, all of which have been studied empirically ( 8 , 9 ). To optimally decide for the best outcome, an interplay of cognitive functions have to take place. These comprise of self-referential processes, for example, reflections on autobiographical past and prospection about possible future events. Further, working memory, inhibition, and planning, as well as value estimation, outcome appraisal, and learning need to work together, further underline the complexity of the DM process. However, a decision does not necessarily always depend on all aforementioned cognitive functions. Dependent on the task, different types of DM can be distinguished: those who predominantly require “cool aspects” of cognitive control mediated by dorsolateral prefrontal cortex (DLPFC) can be differentiated by those scenarios predominantly requiring affect regulation, that is, motivational aspects mediated by ventral medial prefrontal cortex (VMPFC) ( 4 , 10 , 11 ). Tasks involving cool aspects of DM are the Cambridge gambling task, game of dice task, make-a-match game, and probabilistic discounting task. All these tasks share the feature that a fast-intuitive strategy can be applied, since the learned outcome is based on associations ( 4 , 12 , 13 ). Tasks involving hot aspects are, for example, the Iowa gambling task, balloon analog risk task, door-opening task, and card-playing task. These tasks are solved best by applying a slow analytical strategy, that is, based on rule learning. Cool aspects of DM are deficient in ADHD in terms of less rational choices and lower risk adjustment compared to controls ( 14 ). Also, when the task is more progressed and the participants become more used to it, those with ADHD perform worse than controls, that is, riskier ( 15 ). In tasks that involve more analytical rule learning, for example, the Iowa gambling task, children/adolescents with ADHD show more risky behavior, choose less often the advantageous decks compared to controls, and are sensitive to the frequency and not to the magnitude of a punishment ( 16 ). However, there are studies showing no differences in terms of risky behavior and the amount of choices for the advantageous decisions. Further, ADHD-subtype comparisons revealed no differences. Other tasks, for example, the door-opening task and the balloon analog risk task, show higher risk-taking behavior in ADHD. While Groen et al. reported weaker evidence for adults compared to children/adolescents, no age moderation effect was reported in a meta-analytic study by Groen et al. ( 14 ) and Jackson and MacKillop ( 17 ). In their case-control delay discounting the meta-analytic model, an effect-size (ES) of d = 0.43 was reported ( 17 ). Another meta-analysis reported an odd ratio of 1.9 for single choice paradigms (i.e., choose one option among two rewards with different size and delay to delivery) and standardized mean difference for temporal discounting paradigms of 0.43 for ADHD vs. controls ( 18 ). In conclusion, patients with ADHD show deficient DM on both the cool and hot aspects of executive functioning. Despite methodological differences in task design and heterogeneity in study samples, the effects found appear to be relatively robust throughout development in ADHD. We are currently lacking a systematic investigation of the single presentations since reviews and meta-analyses and most of the single studies have considered all groups in one analysis and do not differentiate between the different ADHD presentations ( 14 , 17 ). Some studies have reported that ADHD subtypes differ in their correlation to DM ( 19 , 20 ). Since there is no analysis available, the aim of the current review is to provide a quantitative overview of DM in the ADHD-I, ADHD-H and, ADHD-C separately. We hypothesize stronger ESs for the ADHD-C presentation.

Search Strategies

This study followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) ( Figure 1 ) to achieve a high standard of reporting ( 21 ). A comprehensive literature search of the PubMed (Medline) and Web of Science Database took place using the keywords “ADHD,” “attention-deficit/hyperactivity disorder,” “decision-making,” “risk-taking,” “reinforcement learning,” and “risky” in all possible combinations. The search was conducted in July 2020 with no time interval specified. Reference lists of obtained articles were also considered.

Prisma flow diagram.

Study Selection

Studies were included if they met the following criteria: (1) a publication of the research paper in a peer-reviewed journal, (2) standardized ADHD-diagnostic/assessment procedures (i.e., structured or semi-structured interviews or ADHD-specific questionnaires) according to DSM IV/V [see ( 22 , 23 ) for an overview], (3) tasks including risk-taking behavior, rewards and DM, and (4) comparison to a healthy, typically developing group. Studies were excluded if (1) the predominant presentations of ADHD subtypes were not considered in the analysis or (2) ESs were not reported. See Figure 2 for a schematic overview of study inclusion/exclusion.

Forest plot of the effect-sizes and 95% confidence intervals for ADHD-combined presentation.

Recorded Variables

The recorded variables from each study were: sample size, mean age of the participants, type of control group, kind of DM-task, and metric for calculation of ES. Data were extracted from each study by one of the authors (MS) and checked by another author (SL) to minimize data selection errors.

Meta-Analytic Approach

To calculate a random-effects model, correlational ESs were extracted. If only F -or t -values were provided, correlation coefficients were obtained according to the following formula ( 24 ):

If partial eta squared were provided, it was transformed to Cohens' f/Cohens' d and finally to the correlation coefficients using the following formula ( 25 , 26 ):

where, a is a correction factor for cases of unbalanced numbers of participants between the groups ( 27 ). The meta-analytic procedure was realized using R-software library package metafor [version 2.0-0 ( 28 )]. Sampling variances weighted by sample size were determined by Hunter and Schmidt method because this method estimates the average correlation with the least error with comparative accuracy as, for example, Hedges and Vevea ( 29 ). Heterogeneities were assessed with Q and I2 statistics ( 30 ). Conventions were followed by the interpretation of I2: values of 0.25, 0.50, and 0.75 correspond to low, moderate, and high between-trial heterogeneities ( 30 ). To evaluate the influence of an individual study on the overall effect, leave-one-out analysis (repeat the ES-calculation while omitting a study at a time) using dmetar was performed ( 31 ). Outlier detection was performed using “find.outlier” -function in dmetar. In the case of the presence of outlier, the study was excluded, and the ES-calculation was repeated. The publication bias was assessed with funnel-plots and an egger intercept. Since study inclusion is not determined by age, age was included as a moderator variable in a mixed-effects model if heterogeneity is present.

Included Studies and Sample Characteristics

The literature search resulted in a final set of seven studies for ADHD-C (mean age: 12.9, SD: 4.7), eight studies for ADHD-H presentation (man age: 12.2, SD: 4.7), and seven studies for ADHD-I presentation (mean age: 12.5, SD: 5.0) (see search flow diagram in Figure 2 ). Total sample size comprised of 193 patients for ADHD-C presentation, 265 patients for ADHD-I, and 231 patients for ADHD-H presentation. Except for one study, where performance of DM was compared to oppositional defiant disorder ( 32 ), all studies used a healthy age-matched control group. The following paradigms were applied: temporal discounting task ( 19 , 33 , 34 ), Iowa gambling task ( 32 ), game of dice task ( 35 ), make a match game ( 15 ), probabilistic game task ( 36 ), and card task ( 37 ) (see Table 1 for an overview).

Study-Overview.

f, female; Std, standard deviation; DM, decision making; ODD, oppositional defiant disorder .

Meta-Analytic Findings

Adhd-c presentation.

Moderate ES for ADHD-C presentation was found: r = 0.34 (95% CI = [0.19, 0.49], p = <0.001). No significant heterogeneity is present (Q = 0.81, p = 0.99, I 2 = 0%). Visual inspection of the funnel-plots and the egger intercept (z = 0.2, p = 0.84) suggesting the absence of a publication bias (see Figure 2 ). Influence analysis, that is, leave one out sensitivity analysis, showed that the result is not driven by a single study (see Figure 5 ). No outlier was identified.

ADHD-H Presentation

The main ES for the ADHD-H presentation was r = 0.1 (95% CI = [−0.012, 0.32], p = 0.0001). The forest plot with the within-study ES and aggregated ES is presented in Figure 3 . Moderate heterogeneity is present in the study sample (Q = 21.1, p = 0.003, I 2 = 61.02%, df = 7). Since we included pediatric and adult studies in the analysis, we performed a moderator analysis with age, suggesting that age has no influence on the heterogeneity, Q(df = 1)=1.24, p = 0.26. Visual inspection of the funnel-plots and the egger intercept (z = −0.47, p = 0.64) suggesting the absence of a publication bias (see Figure 5 for the funnel-plots). Influence analysis, that is, leave-one out analysis, suggests general robustness of the result. Outlier analysis could not detect any outlier in the current analysis.

Forest plot of the effect-sizes and 95% confidence intervals for ADHD-hyperactivity/impulsive-presentation.

ADHD-I Presentation

For ADHD-I presentation an ES of r = 0.09 (95% CI = [0.008, 0.25], p = 0.0001) was found (see Figure 4 for forest plot). Low heterogeneity is present in this sample (Q = 10.1, p = 0.12, I 2 = 29.59%, df = 6). No publication bias is evident as visual inspection of the funnel-plots (see Figure 5 ) and Eggers intercept (z = 0.11, p = 0.9) suggest. Moderator with age as regressor show no moderate influence, Q(df = 1) = 0.03, p = 0.85. Influence analysis showed general robustness of the results, and no outlier was detected.

Forest plot of the effect-sizes and 95% confidence intervals for ADHD-inattention-presentation.

Results of leave-one-out analysis.

Since the majority of published studies report associations of DM and ADHD-C presentation, the aim of the current study was to investigate DM separately for the ADHD-C, ADHD-I, and ADHD-H presentation. Moderate ES was found for ADHD-C ( r = 0.34), small ES for ADHD-H ( r = 0.1), and ADHD-I ( r = 0.09). Heterogeneity was moderate in ADHD-H and low for ADHD-I and ADHD-C. In all analyses, no outlier studies were evident. The ES for ADHD-C were comparable to other meta-analyses, which also report medium ES, for example, d = 0.43 ( 17 ), SMD = 0.43, and O R = 1.9 ( 18 ). For the first time, we report ES for the predominant presentations separately. The smaller ES for ADHD-I and ADHD-H might be a hint that these presentations are less impaired dependent on the context DM is needed. According to Sonuga-Barke's dual pathway model, ADHD is associated with deficits on the motivational and cognitive/executive pathways. More specifically, the model proposes that delay aversion and poor inhibitory control are independent coexisting characteristics of ADHD. Deficient delay aversion is mediated by the mesolimbic structures that are associated with dopaminergic reward circuits (e.g., nucleus accumbens). Poor inhibitory control is mediated by aberrant connectivity from mesocortical structures to the prefrontal cortex ( 6 ). Delay aversion and poor inhibitory control are differentially expressed dependent on the DM type. When confronted with a delay, ADHD patients with delay aversion react with a negative emotional response and tend to choose the impulsive element of a decision, that is, the smaller sooner reward over a larger longer reward ( 38 ). In scenarios, where the delay cannot be overcome with an impulsive choice, the perception might switch away from the task and to the environment. In such delay situations, an increase in general activity and inattention arise ( 38 , 39 ). As suggested by Sonuga-Barke ( 38 ), the context of delay-rich scenarios decides whether ADHD patients may be a delay-averse subtype (hence, reacting with impulsivity), whereas more pervasive expressions might reflect other executive deficits associated with inhibitory dysfunction.

In our sample, three studies used delay-rich paradigms, that is, temporal discounting ( 19 , 33 , 34 ), whereas the other studies modulated the height of an immediate reward dependent on the decision made. In delay-rich scenarios, the ADHD-C presentations seem to show more deficient DM-performance compared to ADHD-I and ADHD-C. In other words, ADHD-C presentations may be more sensitive to delay-rich scenarios; hence, it may be more associated with a delay-averse subtype as suggested by Sonuga-Barke. When the delay is rather small as in Scheres et al. ( 19 ), where a small delay of 60 s is used, the difference in DM-performance between the ADHD presentations decreases. Future studies are needed to explore the specific effect of the delay-length on ADHD-presentations. Delay-discounting paradigms are associated with hot executive functions that encompass emotions, motivation, and the interplay of desire for an immediate gratification and long-term rewards ( 40 ). Carefully interpreted, the delay in DM scenarios may have higher impact on performance in ADHD-C presentations compared to ADHD-I/H presentations. The cool aspects of executive functions are associated with slow, analytical strategies and are dependent of inhibition, planning, and working memory ( 40 ). In our analysis, different paradigms were used that rely on cool executive functions: game of dice task ( 35 ), make-a-match game ( 15 ), and probabilistic-game tasks ( 36 ). While the ADHD-I presentation was associated with the smallest ES for the game of dice task ( r = 0.28) and probabilistic-game task ( r = 0.09), it was also associated with highest ES for the make-a-match task ( r = 0.41). These differences could be due to diagnostical differences, that is, used instruments and experience in rating ADHD-symptoms across studies ( 22 ). Alternatively, the paradigms used in the studies may differ in the requirements of executive functions, for example, the game of dice task and the probabilistic-game task rely more on guessing the outcome and may be lower working memory demanding. In contrast, the make-a-match game, where two matching cards have to be found, needs higher working memory capacity.

According to the neuroeconomic model proposed by Sonuga-Barke and Fairchild ( 41 ), deficient DM in ADHD can be mediated by disruptions in three neuronal subsystems, which interact with each other: disrupted connectivity within the default mode network, dorsal-frontostriatal activations, and dopamine dysregulation in ventral frontostriatal networks ( 7 , 41 ). In brief, an aberrant connectivity pattern in the default-mode network is associated with impaired self-referential thoughts, poor goal setting/implementation, and unstable value hierarchies. Also, impaired cognitive functioning is associated with deficient DLPFC-activation (part of the dorsal frontostriatal system), as for instance difficulties in updating working memory about different choice options. Impairments in the ventral frontostriatal network are associated with prospective behavior, that is, predicting future rewards. Taken together, DM in ADHD can be associated with impairment in the different functions necessary for DM. Distinctive neuronal activation patterns between ADHD-C and ADHD-I presentations compared to healthy controls could be differentiated. While both ADHD-I and ADHD-H presentations have been characterized by atypical connectivity throughout the brain, the combined presentation has been associated with more deviant connectivity in the default-mode network ( 42 ). In terms of DM, this could mean that the degree of impairment of the default-mode network in the ADHD-I and ADHD-H presentation might not result in the same behavioral consequences compared to ADHD-C presentation. This may lead to better goal setting/implementation and more stable value hierarchies in ADHD-I/H, compared to ADHD-C presentation. Further, ADHD-I has been shown to be associated with aberrant activation in dorsolateral prefrontal regions, which is proposed as a region that is important for cognitive functioning, for example, inhibition, working memory, and planning in the neuroeconomic model. To address the relationship of ADHD presentations, DM, and core separable neuropsychological functions, such as working memory, inhibition, and sustained attention, it seems prudent to calculate ES between DM and neuropsychological functions and between ADHD symptoms and neuropsychological functions, respectively. However, most of the included studies did not provide appropriate measurements, and therefore it was not possible to extract metrics in a sufficient manner for a proper ES calculation.

The relationship between neuropsychological functioning and ADHD symptoms seem not to be as directly dependent on each other as usually often assumed. Based on heterogeneity of impairment in cognitive functions, studies have identified distinct ADHD groups (independent of ADHD presentations). While some patients do show intact neuropsychological functioning in some aspects of cognition, others do not appear to have any cognitive deficits in commonly assessed domains ( 5 , 43 ). Coghill and colleagues have proposed a model that considers that ADHD symptoms do not arise as a direct consequence of cognitive deficits rather that symptoms and cognition are relatively independent constructs with their causal roots in distinct aspects of brain structure and function ( 44 ). Therefore, it will be important to investigate the different neuropsychological functions needed for DM separately in the three different ADHD presentations. It will also be important to investigate the ways that the different ADHD presentations and their associated patterns of DLPFC activation, as well as frontostriatal systems (as mentioned above) contribute to problems with DM.

Limitations

Since the majority of published studies include mostly the combined type or fail to differentiate between the different ADHD presentations, the number of included studies in the current analysis and the total sample size is rather small. In future studies, researchers should include data relating to the different ADHD presentations and provide metrics on the association of ADHD presentations and DM. Another limitation is the absence to control for diagnostical instruments used to assess ADHD symptoms. There may be certain variability in the diagnostical validity of the symptoms due to the use of different diagnostical tools and also the experience of the staff to rate symptoms for interview-based assessments. Unfortunately, due to the limited number of included studies, we could not assess the impact of the used diagnostical instruments. Further, ADHD subtypes are not discrete entities that are constant over time. When followed over time, patients may switch from one subtype to another, for example, from ADHD-C to ADHD-I ( 45 , 46 ). This suggests when looking at DM in ADHD, subtype classification might not necessarily be the primary factor for a differentiation of DM performance across patients. We argue to also consider, for example, neuropsychological scores and comorbidities for a more comprehensive analysis. Further, the number of subjects per ADHD presentation might be imbalanced in the original studies, considering the prevalence of each ADHD presentation ( 47 ). Another limitation is that most of the studies ( 32 , 37 ) include DM tasks that require cool aspects of executive functioning. It cannot be ruled out whether the current results are biased for this type of DM tasks. The small sample size hindered subanalysis on task designs that could potentially separate tasks requiring cool and hot aspects.

This is the first study to use a meta-analytic approach to investigate the relationship of ADHD-C, ADHD-I, and ADHD-H presentations in DM separately. While meta-analytic evidence in the literature shows deficient DM in ADHD-C presentations, it appears less clear in comparison to ADHD-I and ADHD-H presentations. The current meta-analysis provides rather limited evidence, but cautiously interpreted, it might be that patients with ADHD-I and ADHD-H presentations show less impairment in DM skills. However, the interplay between the triad of ADHD-presentation-specific symptoms, DM skills and neuropsychological functions are complex and not yet fully understood. The current study is considered as a starting point to clarify the relationship of ADHD presentations and DM. Since the current evidence is rather limited, future work is needed to support our findings and clarify the interplay.

Data Availability Statement

Author contributions.

MS and SL: literature search, figures, data analysis, data interpretation, and writing. DC and AP: data interpretation, writing, and supervision. All authors contributed to the article and approved the submitted version.

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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How do you give a presentation to someone with ADHD?

Table of Contents

• 1 How do you give a presentation to someone with ADHD?
• 2 What is the most important thing in preparing presentation?
• 3 How can I communicate better with ADHD?
• 4 What is the 10 20 30 rule?
• 5 What makes a presentation good or bad?
• 6 How can I make my presentation more interactive?
• 7 What’s the best way to work with someone with ADHD?
• 8 Why do people with ADHD have a hard time paying attention?

There’s little time to get your points across, so short and sweet is the key.

• Choose an interesting topic. Having ADHD, we tend to wear our emotions on our sleeves.
• Organize your talk.
• Cue yourself.
• Record yourself.
• Keep constant eye contact.
• Practice your timing.
• Visualize success.

What is the best way to prepare for a presentation?

How to Prepare for a Presentation, Even if You’re Nervous

• Create a thesis.
• Structure the presentation with the audience’s knowledge level in mind.
• Don’t overload your presentation with examples or facts.
• Rehearse with the technology.
• Arrive early.
• Add a CTA, if applicable.
• Be realistic about public speaking nerves.

What is the most important thing in preparing presentation?

Tip 1: Know your audience​ The first and most important rule of presenting your work is to know your audience members. If you can put yourself in their shoes and understand what they need, you’ll be well on your way to a successful presentation. Keep the audience in mind throughout the preparation of your presentation.

How do you prepare your audience to listen to a presentation?

Try using these 10 tricks to command your audience’s attention:

• Start off with something shocking.
• Tell a story.
• Go off script.
• Use emotional inflections in your voice.
• Use the power of louds and softs.
• Alternate your pacing.
• Call out individuals in the audience.
• Set up some jokes.

How can I communicate better with ADHD?

Improving your communication skills when you have ADHD

• Communicate face to face whenever possible. Nonverbal cues such as eye contact, tone of voice, and gestures communicate much more than words alone.
• Listen actively and don’t interrupt.
• Ask questions.
• Request a repeat.
• Manage your emotions.

What should you not say to someone with ADHD?

“Could You Not?” 6 Things Not to Say to Someone with ADHD

• “Don’t use your ADHD as an excuse for _______” Believe it or not, there’s a difference between giving an explanation and giving an excuse.
• “You don’t have ADHD, you’re just (insert adjective here)”
• “Don’t be lazy”
• “Everyone has trouble paying attention sometimes”

What is the 10 20 30 rule?

It’s quite simple: a PowerPoint presentation should have 10 slides, last no more than 20 minutes, and contain no font smaller than 30 points.

Which is the 6 by 6 rule for presentations?

Stick to the basics when it comes to transitions between slides. A good way to keep yourself in line is by remembering the 666 rule. Presentation University recommends slides shave no more than six words per bullet, six bullets per image and six word slides in a row.

What makes a presentation good or bad?

Use stories to create an emotional connection to the message. Great presentations are stories. b) Information – Not volumes of information, but important or interesting information that is relevant. c) Memorable – They contain graphics, images, and facts in such a way that they’re easy to remember.

What is a perfect presentation?

Good presentations are memorable. They contain graphics, images, and facts in such a way that they’re easy to remember. A week later, your audience can remember much of what you said. Great presentations are motivating.

How can I make my presentation more interactive?

8 Ways to Make Your Presentation More Interactive

• Break the ice. Each of your audience members comes to your presentation in a completely different mood.
• Tell stories.
• Add videos.
• Embrace the power of non-linear presenting.
• Ask questions during your presentation.
• Poll the audience.
• Share the glory.

How do you capture your audience in 30 seconds?

12 Ways to Hook an Audience in 30 Seconds

• Use a contrarian approach.
• Ask a series of rhetorical questions.
• Deliver a compelling sound bite.
• Make a startling assertion.
• Provide a reference to a historical event.
• Use the word imagine.
• Add a little show business.
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• Patient Care & Health Information
• Diseases & Conditions
• Attention-deficit/hyperactivity disorder (ADHD) in children

In general, a child shouldn't receive a diagnosis of attention-deficit/hyperactivity disorder unless the core symptoms of ADHD start early in life — before age 12 — and create significant problems at home and at school on an ongoing basis.

There's no specific test for ADHD , but making a diagnosis will likely include:

• Medical exam, to help rule out other possible causes of symptoms
• Information gathering, such as any current medical issues, personal and family medical history, and school records
• Interviews or questionnaires for family members, your child's teachers or other people who know your child well, such as caregivers, babysitters and coaches
• ADHD criteria from the Diagnostic and Statistical Manual of Mental Disorders DSM-5 , published by the American Psychiatric Association
• ADHD rating scales to help collect and evaluate information about your child

Diagnosing ADHD in young children

Although signs of ADHD can sometimes appear in preschoolers or even younger children, diagnosing the disorder in very young children is difficult. That's because developmental problems such as language delays can be mistaken for ADHD .

So children preschool age or younger suspected of having ADHD are more likely to need evaluation by a specialist, such as a psychologist or psychiatrist, speech pathologist, or developmental pediatrician.

Other conditions that resemble ADHD

A number of medical conditions or their treatments may cause signs and symptoms similar to those of ADHD . Examples include:

• Learning or language problems
• Mood disorders such as depression or anxiety
• Seizure disorders
• Vision or hearing problems
• Autism spectrum disorder
• Medical problems or medications that affect thinking or behavior
• Sleep disorders
• Brain injury
• Care at Mayo Clinic

Our caring team of Mayo Clinic experts can help you with your Attention-deficit/hyperactivity disorder (ADHD) in children-related health concerns Start Here

Standard treatments for ADHD in children include medications, behavior therapy, counseling and education services. These treatments can relieve many of the symptoms of ADHD , but they don't cure it. It may take some time to determine what works best for your child.

Stimulant medications

Currently, stimulant drugs (psychostimulants) are the most commonly prescribed medications for ADHD . Stimulants appear to boost and balance levels of brain chemicals called neurotransmitters. These medications help improve the signs and symptoms of inattention and hyperactivity — sometimes effectively in a short period of time.

Examples include:

• Amphetamines. These include dextroamphetamine (Dexedrine), dextroamphetamine-amphetamine (Adderall XR, Mydayis) and lisdexamfetamine (Vyvanse).
• Methylphenidates. These include methylphenidate (Concerta, Ritalin, others) and dexmethylphenidate (Focalin).

Stimulant drugs are available in short-acting and long-acting forms. A long-acting patch of methylphenidate (Daytrana) is available that can be worn on the hip.

The right dose varies from child to child, so it may take some time to find the correct dose. And the dose may need to be adjusted if significant side effects occur or as your child matures. Ask your doctor about possible side effects of stimulants.

Stimulant medications and certain health risks

Some research indicates that using ADHD stimulant medications with certain heart problems may be a concern, and the risk of certain psychiatric symptoms may be increased when using stimulant medications.

• Heart problems. Stimulant medication may cause an increased blood pressure or heart rate, but the increased risk of serious adverse effects or sudden death is still unproved. However, the doctor should evaluate your child for any heart condition or family history of heart disease before prescribing a stimulant medication and monitor your child during stimulant use.
• Psychiatric problems. Stimulant medications may rarely increase the risk for agitation or psychotic or manic symptoms with stimulant medications use. Contact the doctor immediately if your child has sudden new or worsening behavior or sees or hears things that aren't real while taking stimulant medication.

Other medications

Other medications that may be effective in treating ADHD include:

• Atomoxetine (Strattera)
• Antidepressants such as bupropion (Wellbutrin SR, Wellbutrin XL, others)
• Guanfacine (Intuniv)
• Clonidine (Catapres, Kapvay)

Atomoxetine and antidepressants work slower than stimulants do and may take several weeks before they take full effect. These may be good options if your child can't take stimulants because of health problems or if stimulants cause severe side effects.

Suicide risk

Although it remains unproved, concerns have been raised that there may be a slightly increased risk of suicidal thinking in children and teenagers taking nonstimulant ADHD medication or antidepressants. Contact your child's doctor if you notice any signs of suicidal thinking or other signs of depression.

Giving medications safely

It's very important to make sure your child takes the right amount of the prescribed medication. Parents may be concerned about stimulants and the risk of abuse and addiction. Stimulant medications are considered safe when your child takes the medication as prescribed by the doctor. Your child should see the doctor regularly to determine if the medication needs to be adjusted.

On the other hand, there's concern that other people might misuse or abuse stimulant medication prescribed for children and teenagers with ADHD . To keep your child's medications safe and to make sure your child is getting the right dose at the right time:

• Give medications carefully. Children and teens shouldn't be in charge of their own ADHD medication without proper supervision.
• At home, keep medication locked in a childproof container. And store medication away from the reach of children. An overdose of stimulant drugs is serious and potentially fatal.
• Don't send supplies of medication to school with your child. Deliver any medication yourself to the school nurse or health office.

ADHD behavior therapy

Children with ADHD often benefit from behavior therapy, social skills training, parent skills training and counseling, which may be provided by a psychiatrist, psychologist, social worker or other mental health professional. Some children with ADHD may also have other conditions such as an anxiety disorder or depression. In these cases, counseling may help both ADHD and the coexisting problem.

Examples of therapy include:

• Behavior therapy. Teachers and parents can learn behavior-changing strategies, such as token reward systems and timeouts, for dealing with difficult situations.
• Social skills training. This can help children learn appropriate social behaviors.
• Parenting skills training. This can help parents develop ways to understand and guide their child's behavior.
• Psychotherapy. This allows older children with ADHD to talk about issues that bother them, explore negative behavior patterns and learn ways to deal with their symptoms.
• Family therapy. Family therapy can help parents and siblings deal with the stress of living with someone who has ADHD .

The best results occur when a team approach is used, with teachers, parents, therapists and physicians working together. Educate yourself about ADHD and available services. Work with your child's teachers and refer them to reliable sources of information to support their efforts in the classroom.

New medical device

The U.S. Food and Drug Administration approved a new medical device to treat children with ADHD who are 7 to 12 years old and not taking ADHD prescription medicine. Only available by prescription, it's called the Monarch external Trigeminal Nerve Stimulation (eTNS) System.

About the size of a cell phone, the eTNS device can be used at home under parental supervision, when the child is sleeping. The device generates low-level electrical stimulation which moves through a wire to a small patch placed on the child's forehead, sending signals to areas of the brain related to attention, emotion and behavior.

If eTNS is being considered, it's important to discuss precautions, expectations and possible side effects. Get complete information and instructions from your health care professional.

Ongoing treatment

If your child is being treated for ADHD , he or she should see the doctor regularly until symptoms have largely improved, and then typically every three to six months if symptoms are stable.

Call the doctor if your child has any medication side effects, such as loss of appetite, trouble sleeping or increased irritability, or if your child's ADHD symptoms have not shown much improvement with initial treatment.

More Information

Attention-deficit/hyperactivity disorder (ADHD) in children care at Mayo Clinic

• Psychotherapy

Lifestyle and home remedies

Because ADHD is complex and each person with ADHD is unique, it's hard to make recommendations that work for every child. But some of the following suggestions may help create an environment in which your child can succeed.

Children at home

• Show your child lots of affection. Children need to hear that they're loved and appreciated. Focusing only on the negative aspects of your child's behavior can harm your relationship and affect self-confidence and self-esteem. If your child has a hard time accepting verbal signs of affection, a smile, a pat on the shoulder or a hug can show you care. Look for behaviors for which you can compliment your child regularly.
• Find ways to improve self-esteem. Children with ADHD often do well with art projects, music or dance lessons, or martial arts classes. Choose activities based on their interests and abilities. All children have special talents and interests that can be fostered. Small frequent successes help build self-esteem.
• Use simple words and demonstrate when giving your child directions. Speak slowly and quietly and be very specific and concrete. Give one direction at a time. Stop and make eye contact with your child before and while you're giving directions.
• Identify difficult situations. Try to avoid situations that are difficult for your child, such as sitting through long presentations or shopping in malls and stores where the array of merchandise can be overwhelming.
• Use timeouts or appropriate consequences for discipline. Start with firm, loving discipline that rewards good behavior and discourages negative behavior. Timeouts should be relatively brief, but long enough for your child to regain control. The idea is to interrupt and defuse out-of-control behavior. Children can also be expected to accept the results of the choices they make.
• Work on organization. Help your child organize and maintain a daily assignment and activities notebook or chart and be sure your child has a quiet place to study. Group objects in the child's room and store them in clearly marked spaces. Try to help your child keep his or her environment organized and uncluttered.
• Try to keep a regular schedule for meals, naps and bedtime. Children with ADHD have a hard time accepting and adjusting to change. Use a big calendar to mark special activities that will be coming up and everyday chores. Avoid or at least warn children of sudden transitions from one activity to another.
• Encourage social interaction. Help your child learn social skills by modeling, recognizing and rewarding positive interactions with peers.
• Adopt healthy lifestyle habits. Make sure your child is rested. Try to keep your child from becoming overtired because fatigue often makes ADHD symptoms worse. It's important that your child eat a balanced diet for healthy development. In addition to its health benefits, regular exercise may have a positive effect on behavior when added to treatment.

Children in school

Learn all you can about ADHD and opportunities that are available to help your child be successful. You are your child's best advocate.

• Ask about school programs. Schools are required by law to have a program to make sure children who have a disability that interferes with learning get the support they need. Your child may be eligible for additional services offered under federal laws: Section 504 of the Rehabilitation Act of 1973 or the Individuals with Disabilities Education Act (IDEA). These can include evaluation, curriculum adjustments, changes in classroom setup, modified teaching techniques, study skills instruction, use of computers, and increased collaboration between parents and teachers.
• Talk to your child's teachers. Stay in close communication with teachers and support their efforts to help your child in the classroom. Be sure teachers closely monitor your child's work, provide positive feedback, and are flexible and patient. Ask that they be very clear about their instructions and expectations.

Alternative medicine

There's little research that indicates that alternative medicine treatments can reduce ADHD symptoms. Before considering any alternative interventions, talk with your doctor to determine if the therapy is safe. Some alternative medicine treatments that have been tried, but are not yet fully proved scientifically, include:

• Yoga or meditation. Doing regular yoga routines or meditation and relaxation techniques may help children relax and learn discipline, which may help them manage their symptoms of ADHD .
• Special diets. Most diets promoted for ADHD involve eliminating foods thought to increase hyperactivity, such as sugar, and common allergens, such as wheat, milk and eggs. Some diets recommend avoiding artificial food colorings and additives. So far, studies haven't found a consistent link between diet and improved symptoms of ADHD , though some anecdotal evidence suggests diet changes might make a difference in children with specific food sensitivities. Caffeine use as a stimulant for children with ADHD can have risky effects and is not recommended.
• Vitamin or mineral supplements. While certain vitamins and minerals from foods are necessary for good health, there's no evidence that supplemental vitamins or minerals can reduce symptoms of ADHD . "Megadoses" of vitamins — doses that far exceed the Recommended Dietary Allowance (RDA) — can be harmful.
• Herbal supplements. There is no evidence to suggest that herbal remedies help with ADHD , and some may be harmful.
• Proprietary formulations. These are products made from vitamins, micronutrients and other ingredients that are sold as possible treatment supplements for children with ADHD . These products have had little or no research and are exempt from Food and Drug Administration oversight, making them possibly ineffective or potentially harmful.
• Essential fatty acids. These fats, which include omega-3 oils, are necessary for the brain to function properly. Researchers are still investigating whether these may improve ADHD symptoms.
• Neurofeedback training. Also called electroencephalographic (EEG) biofeedback, in these sessions a child focuses on certain tasks while using a machine that shows brain wave patterns. More research is needed to see if this works.

Coping and support

Caring for a child with ADHD can be challenging for the whole family. Parents may be hurt by their child's behavior, as well as by the way other people respond to it. The stress of dealing with ADHD can lead to marital conflict. These problems may be compounded by the financial burden that ADHD can place on families.

Siblings of a child with ADHD also may have special difficulties. They can be affected by a brother or sister who is demanding or aggressive, and they may also receive less attention because the child with ADHD requires so much of a parent's time.

Many resources are available, such as social services or support groups. Support groups often can provide helpful information about coping with ADHD . Ask your child's doctor if he or she knows of any support groups in your area.

There also are excellent books and guides for both parents and teachers, and internet sites dealing exclusively with ADHD . But be careful of websites or other resources that focus on risky or unproved remedies or those that conflict with your health care team's recommendations.

Strategies for coping

Many parents notice patterns in their child's behavior as well as in their own responses to that behavior. Both you and your child may need to change behavior. But substituting new habits for old ones takes a lot of hard work.

Be realistic in your expectations for improvement — both your own and your child's. And keep your child's developmental stage in mind. Set small goals for both yourself and your child and don't try to make a lot of changes all at once.

• Stay calm and set a good example. Act the way you want your child to act. Try to remain patient and in control — even when your child is out of control. If you speak quietly and calmly, your child is more likely to calm down too. Learning stress management techniques can help you deal with your own frustrations.
• Take time to enjoy your child. Make an effort to accept and appreciate the parts of your child's personality that aren't so difficult. One of the best ways to do this is simply to spend time together. This should be a time without the distraction of other children or adults. Try to give your child more positive than negative attention every day.
• Strive for healthy family relationships. The relationship among all family members plays a big part in managing or changing the behavior of a child with ADHD . Couples with a strong bond often find it easier to face parenting challenges than those whose bond isn't as strong. It's important for partners to take time to nurture their own relationship.
• Give yourself a break. Give yourself a break now and then. Don't feel guilty for spending a few hours apart from your child. You'll be a better parent if you're rested and relaxed. Don't hesitate to ask relatives and friends for help. Make sure that babysitters or other caretakers are knowledgeable about ADHD and mature enough for the task.

Preparing for your appointment

You're likely to start by taking your child to a family doctor or pediatrician. Depending on the results of the initial evaluation, your doctor may refer you to a specialist, such as a developmental-behavioral pediatrician, psychologist, psychiatrist or pediatric neurologist.

What you can do

To prepare for your child's appointment:

• Make a list of any symptoms and difficulties your child has at home or at school.
• Prepare key personal information, including any major stresses or recent life changes.
• Make a list of all medications, vitamins, herbs or other supplements that your child is taking and the dosages.
• Bring any past evaluations and results of formal testing, if you have them, and school report cards.
• Make a list of questions to ask your child's doctor.

Questions to ask your child's doctor may include:

• Other than ADHD , what are possible causes for my child's symptoms?
• What kinds of tests does my child need?
• What treatments are available, and which do you recommend?
• What are the alternatives to the primary approach that you're suggesting?
• My child has other health problems. How can I best manage these conditions together?
• Should my child see a specialist?
• Is there a generic alternative to the medicine you're prescribing for my child?
• What types of side effects can we expect from the medication?
• Are there any printed materials that I can have? What websites do you recommend?

Don't hesitate to ask questions anytime you don't understand something.

What to expect from your doctor

Be ready to answer questions your doctor may ask, such as:

• When did you first notice your child's behavior issues?
• Do the troubling behaviors occur all the time or only in certain situations?
• How severe are your child's difficulties at home and at school?
• What, if anything, appears to worsen your child's behavior?
• What, if anything, seems to improve your child's behavior?
• Does your child consume caffeine? How much?
• What are your child's sleep hours and patterns?
• How is your child's current and past academic performance?
• Does your child read at home? Does he or she have trouble reading?
• What discipline methods have you used at home? Which ones are effective?
• Describe who lives at home and a typical daily routine.
• Describe your child's social relationships at home and at school.

Your doctor or mental health professional will ask additional questions based on your responses, symptoms and needs. Preparing and anticipating questions will help you make the most of your time with the doctor.

• Attention-deficit/hyperactivity disorder. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. https://dsm.psychiatryonline.org. Accessed Jan. 26, 2019.
• Brown A. Allscripts EPSi. Mayo Clinic, Rochester, Minn. Oct. 9, 2018.
• AskMayoExpert. Attention-deficit/hyperactivity disorder. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2017.
• Voight RG, et al., eds. Attention-deficit/hyperactivity disorder. In: American Academy of Pediatrics Developmental and Behavioral Pediatrics. 2nd ed. Itasca, IL: American Academy of Pediatrics; 2018.
• Attention-deficit/hyperactivity disorder. National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtml. Accessed Jan 26, 2019.
• My child has been diagnosed with ADHD ― Now what? Centers for Disease Control and Prevention. https://www.cdc.gov/ncbddd/adhd/treatment.html. Accessed Jan. 26, 2019.
• What is ADHD? American Psychiatric Association. https://www.psychiatry.org/patients-families/adhd/what-is-adhd. Accessed Jan. 26, 2019.
• ADHD. National Alliance on Mental Illness. https://www.nami.org/Learn-More/Mental-Health-Conditions/ADHD/Overview. Accessed Jan. 26, 2019.
• Ra CK, et al. Association of digital media use with subsequent symptoms of attention-deficit/hyperactivity disorder among adolescents. JAMA. 2018;320:255.
• For parents and caregivers. National Resource Center on ADHD. https://chadd.org/for-parents/overview/. Accessed Jan. 28, 2019.
• Complementary and integrative approaches for ADHD: What the science says. National Center for Complementary and Integrative Health. https://nccih.nih.gov/health/providers/digest/adhd-science. Accessed Jan. 28, 2019.
• Bikic A, et al. Meta-analysis of organizational skills intervention for children and adolescents with attention-deficit/hyperactivity disorder. Clinical Psychology Review. 2017;52:108.
• Partain PI, et al. New stimulant formulations for pediatric attention-deficit/hyperactivity disorder: A case-based approach for the primary care provider. Current Opinion in Pediatrics. 2019;31:166.
• Attention-deficit/hyperactivity disorder: Data and statistics. Centers for Disease Control and Prevention. https://www.cdc.gov/ncbddd/adhd/data.html. Accessed Jan. 30, 2019.
• Weydert JA, et al. Integrative medicine in pediatrics. Advances in Pediatrics. 2018;65:19.
• Catala-Lopez F, et al. The pharmacological and non-pharmacological treatment of attention deficit hyperactivity disorder in children and adolescents: A systematic review with network meta-analyses of randomised trials. PloSOne. 2017;12:e0180355.
• Mazhar H, et al. Complementary and alternative medicine use in pediatric attention-deficit hyperactivity disorder (ADHD): Reviewing the safety and efficacy of herbal medicines. Current Developmental Disorders Reports. 2016;3:15.
• Ahn J, et al. Natural product-derived treatments for attention-deficit/hyperactivity disorder: Safety, efficacy, and therapeutic potential of combination therapy. Neural Plasticity. 2016;2016:1320423.
• American Academy of Pediatrics. Media and young minds. Pediatrics. 2016;138:e20162591.
• Voight RG, et al., eds. Complementary health approaches in developmental and behavioral pediatrics. In: American Academy of Pediatrics Developmental and Behavioral Pediatrics. 2nd ed. Itasca, IL: American Academy of Pediatrics; 2018.
• Moran LV, et al. Psychosis with methylphenidate or amphetamine in patients with ADHD. New England Journal of Medicine. 2019;380:1128.
• Berger S. Attention deficit hyperactivity disorder medications in children with heart disease. Current Opinion in Pediatrics. 2016;28:607.
• Storebo OJ, et al. Methylphenidate for attention deficit hyperactivity disorder (ADHD) in children and adolescents ― Assessment of adverse events in non-randomised studies. Cochrane Database of Systematic Reviews. https://www.cochranelibrary.com/. Accessed April 1, 2019.
• Bhagia J (expert opinion). Mayo Clinic, Rochester, Minn. May 13, 2019.
• Monarch eTNS System (classification order letter). DEN180041. U.S. Food and Drug Administration. https://www.fda.gov/about-fda/cdrh-transparency/evaluation-automatic-class-iii-designation-de-novo-summaries. Accessed June 5, 2019.

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Slide Decks To Use

Dr. Faraone prepared these slides in the hopes that they will be useful educators. They can be used by anyone free of charge.

The ADHD Evidence Project provides information, not advice about healthcare decisions. If you need advice about healthcare decisions, ask your healthcare provider.

About the Author

We curate evidence by systematically reviewing the scientific literature to select studies meeting a very high level of evidence. We limit our curation to two types of evidence: meta-analyses and very large studies. Meta-analyses combine

Stephen Faraone, PhD

Distinguished Professor and Vice Chair of Research of Psychiatry and Behavioral Sciences Professor of Neuroscience and Physiology , Professor of Neuroscience Graduate Program

Slides to Download

Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam,

This set of slides provides an overview of the diagnosis and treatment of ADHD.   It can be used as a presentation meant to be given by someone with prior knowledge of these topics.  Feel free to add or delete slides to this set to accommodate your audience.

La Declaration de Consensus International sur le Trouble Déficit d’Attention Hyperactivité:​Implications pour le Diagnostic et le Traitement

Ces diapositives constituent une introduction à la Déclaration de consensus internationale sur le TDAH. Elles décrivent les méthodes et les résultats les plus pertinents pour le diagnostic et le traitement de ce trouble. Le texte qui accompagne chaque diapositive est la manière dont les diapositives ont été présentées par le Professeur Faraone lors du "Symposium international sur le TDAH".

International Consensus Statement

This set of 370 slides is not meant to be a single presentation.  Instead, it is meant to provide slides that describe the findings reported in the International Consensus Statement of ADHD.  Educators can use these slides to create presentations crafted for their educational goals.

La Declaration de Consensus International sur le Trouble Deficit d’Attention Hyperactivityé:​ Implications pour le Diagnostic et le Traitement

The ADHD Evidence Project seeks to improve the lives of people with ADHD.   

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• The ADHD Evidence Project | Copyright ©2023    | All rights reserved.
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Diagnosing ADHD in Adults

You keep losing your keys, feel you can never finish anything at work, or maybe have had a family member say “you might have ADHD.”  Whatever the reason, getting a proper diagnosis of ADHD is the first step of getting treatment.  It is important to ultimately gaining control over symptoms that wreak havoc in your life, personally and professionally.

Finding a qualified mental health professional

Finding a clinician that is especially familiar with ADHD is key to a good diagnosis. Seeking out hospital and University Centers, gaining referrals from your doctor, or getting suggestions from support group members are all ways to start your search. Don't be discouraged if you have to look outside your home town to find someone that meets these qualifications.

The American Psychiatric Association provides clinical guidelines for the diagnosis of ADHD in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition  (DSM-5).  This manual provides symptoms which the doctor will be looking for in their diagnosis.

Patient interview

The clinician will review the diagnostic criteria and determine if any apply to the individual. They will look at how the symptoms affect the patient’s life. The interview will review the patient’s personal, medical, and psychiatric history from childhood to the present.  Patients should also bring up what issues led them to make the decision to have an evaluation.

Interview of a loved one

Often people with ADHD will have holes in their memory or they will downplay symptoms.  A significant other such as a partner, sibling, parent, or longtime friend can help fill in these gaps.

Behavior scale

Often patients will receive rating scales for themselves and for a loved one or significant other to complete. Rating scales are separate from an in-person interview. They provide information comparing people with ADHD to people without ADHD.

Medical Examination

Patients undergoing evaluation for ADHD should also receive a medical examination. Thyroid problems and seizure conditions can cause symptoms that resemble those of ADHD.  Physical examinations cannot confirm a diagnosis of ADHD, but they can rule out physical causes of ADHD symptoms.

Screening for co-existing conditions

If a patient is treated for ADHD but the symptoms are not caused by ADHD, the treatment is not going to be successful.  Doctors will also look to see if any co-existing conditions exist.  Often if the co-existing condition is not treated then the treatment for ADHD will not be as effective.

Many people find that having a diagnosis of ADHD helps them make sense of their life and past decisions. You will want to discuss treatment options with your doctor.  Treatment can include lifestyle changes, medication, and therapy, and often includes more than one component.

Although there is no single medical, physical, or genetic test for ADHD, a diagnostic evaluation can be provided by a qualified mental health care professional or physician who gathers information from multiple sources. These sources include ADHD symptom checklists, standardized behavior rating scales, a detailed history of past and current functioning, and information obtained from family members or significant others who know the person well. Some practitioners will also conduct tests of cognitive ability and academic achievement in order to rule out a possible learning disability. ADHD cannot be diagnosed accurately just from brief office observations or  simply by talking to the person. The person may not always exhibit the symptoms of ADHD during the office visit, and the diagnostician needs to take a thorough history of the individual’s life. A diagnosis of ADHD must include consideration of the possible presence of co-occurring conditions.

Clinical guidelines for a diagnosis of ADHD are provided by the American Psychiatric Association in the diagnostic manual  Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition  ( DSM-5 ). These established guidelines are widely used in research and clinical practice. During an evaluation, the clinician will try to determine the extent to which these symptoms currently apply to the adult and if they have been present in childhood. In making the diagnosis, adults should have at least five of the symptoms present. These symptoms can change over time, so adults may fit different presentations from when they were children.

The  DSM-5  lists three presentations of ADHD—Predominantly Inattentive, Hyperactive-Impulsive and Combined. The symptoms for each are adapted and summarized below.

ADHD predominantly inattentive presentation

• Fails to give close attention to details or makes careless mistakes
• Has difficulty sustaining attention
• Does not appear to listen
• Struggles to follow through with instructions
• Has difficulty with organization
• Avoids or dislikes tasks requiring sustained mental effort
• Loses things
• Is easily distracted
• Is forgetful in daily activities

ADHD predominantly hyperactive-impulsive presentation

• Fidgets with hands or feet or squirms in chair
• Has difficulty remaining seated
• Runs about or climbs excessively in children; extreme restlessness in adults
• Difficulty engaging in activities quietly
• Acts as if driven by a motor; adults will often feel inside as if they are driven by a motor
• Talks excessively
• Blurts out answers before questions have been completed
• Difficulty waiting or taking turns
• Interrupts or intrudes upon others

ADHD combined presentation

• The individual meets the criteria for both inattention and hyperactive-impulsive ADHD presentations.

These symptoms can change over time, so adults may fit different presentations from when they were children.

A diagnosis of ADHD is determined by the clinician based on the number and severity of symptoms, the duration of symptoms and the degree to which these symptoms cause impairment in various areas of life, such as home, school or work; with friends or relatives; or in other activities. It is possible to meet diagnostic criteria for ADHD without any symptoms of hyperactivity and impulsivity. The clinician must further determine if these symptoms are caused by other conditions, or are influenced by co-existing conditions.

Several of the symptoms must have been present prior to age 12. This generally requires corroboration by a parent or some other informant. It is important to note that the presence of significant impairment in at least two major settings of the person’s life is central to the diagnosis of ADHD. Impairment refers to how ADHD interferes with an individual’s life. Examples of impairment include losing a job because of ADHD symptoms, experiencing excessive conflict and distress in a marriage, getting into financial trouble because of impulsive spending, failure to pay bills in a timely manner or being put on academic probation in college due to failing grades. If the individual exhibits a number of ADHD symptoms but they do not cause significant impairment, s/he may not meet the criteria to be diagnosed with ADHD as a clinical disorder.

Internet self-rating scales

There are many Internet sites about ADHD that offer various types of questionnaires and lists of symptoms. Most of these questionnaires are not standardized or scientifically validated and should not be used to self-diagnose or to diagnose others with ADHD. A valid diagnosis can only be provided by a qualified, licensed professional.

Who is qualified to diagnose ADHD?

For adults, an ADHD diagnostic evaluation should be conducted by a licensed mental health professional or a physician. These professionals include clinical psychologists, physicians (psychiatrist, neurologist, family doctor or other type of physician) or clinical social workers.

Whichever type of professional is chosen, it is important to ask about their training and experience in working with adults with ADHD. Many times the professional’s level of knowledge and expertise about adult ADHD is more important for obtaining an accurate diagnosis and effective treatment plan than the type of professional degree. Qualified professionals are usually willing to provide information about their training and experience with adults with ADHD. Reluctance to provide such information in response to reasonable requests should be regarded with suspicion and may be an indicator that the individual should seek out a different professional.

How do I find a professional qualified to diagnose ADHD?

Ask your personal physician for a referral to a health care professional in your community who is qualified to perform ADHD evaluations for adults. It may also be helpful to call a local university-based hospital, a medical school or a graduate school in psychology for recommendations. If there is an ADHD support group in your area, it may be very helpful to go there and talk with the people attending the group. Chances are that many of them have worked with one or more professionals in your community and can provide information about them. Most insurance plans list professionals by specialty and can assist those who participate in their plans to find a health care professional. Finally, there are many internet sites that list providers of ADHD services, including CHADD’s professional directory.

How do I know if I need an evaluation for ADHD?

Most adults who seek an evaluation for ADHD experience significant problems in one or more areas of living. The following are some of the most common problems:

• Inconsistent performance in jobs or careers; losing or quitting jobs frequently
• History of academic and/or career underachievement
• Poor ability to manage day-to-day responsibilities, such as completing household chores, maintenance tasks, paying bills or organizing things
• Relationship problems due to not completing tasks
• Forgetting important things or getting upset easily over minor things
• Chronic stress and worry due to failure to accomplish goals and meet responsibilities
• Chronic and intense feelings of frustration, guilt or blame

A qualified professional can determine if these problems are due to ADHD, some other cause or a combination of causes. Although some ADHD symptoms are evident since early childhood, some individuals may not experience significant problems until later in life. Some very bright and talented individuals, for example, are able to compensate for their ADHD symptoms and do not experience significant problems until high school, college or in pursuit of their career. In other cases, parents may have provided a highly protective, structured and supportive environment, minimizing the impact of ADHD symptoms until the individual has begun to live independently as a young adult.

How should I prepare for the evaluation?

Most people are a little nervous and apprehensive about being evaluated for any type of condition such as ADHD. This is normal and should not stop anyone from seeking an evaluation if s/he is having significant problems in life and ADHD is suspected. Unfortunately, some of the common misconceptions about ADHD, such as “it only occurs in children” or “the person is just looking for an excuse,” make many people reluctant to seek help.

Many professionals find it helpful to review old report cards and other school records dating back to kindergarten or even the preschool years. If such records are available, they should be brought to the first appointment. Copies of reports from any previous psychological testing should also be brought to the appointment. For adults who experience problems in the workplace, job evaluations should be brought for review if available.

Many professionals will ask the individual to complete and return questionnaires before the evaluation and to identify a spouse or other family member who can also participate in parts of the evaluation. Timely completion and return of the questionnaires will expedite the evaluation.

What is a comprehensive evaluation?

Although different clinicians will vary somewhat in their procedures and testing materials, certain protocols are considered essential for a comprehensive evaluation. These include a thorough diagnostic interview, information from independent sources such as the spouse or other family members, DSM-5 symptom checklists, standardized behavior rating scales for ADHD and other types of psychometric testing as deemed necessary by the clinician. These are discussed in more detail below.

The diagnostic interview: ADHD symptoms

The single most important part of a comprehensive ADHD evaluation is a structured or semi-structured interview, which provides a detailed history of the individual. The interviewer asks a pre-determined, standardized set of questions in order to increase reliability and decrease the chances that a different interviewer would come up with different conclusions. The clinician covers a broad range of topics, discusses relevant issues in detail and asks follow-up questions to ensure that all areas of interest are covered. The examiner will review the diagnostic criteria for ADHD and determine how many of them apply to the individual, both at the present time and since childhood. The interviewer will further determine the extent to which these ADHD symptoms are interfering with the individual’s life.

The diagnostic interview: screening for other psychiatric disorders

The examiner will also conduct a detailed review to see if other psychiatric disorders that may resemble ADHD or commonly co-exist with ADHD are present. ADHD rarely occurs alone, and research has shown that more than two-thirds of people with ADHD have one or more co-existing conditions. The most common include depression, anxiety disorders, learning disabilities and substance use disorders. Many of these conditions have symptoms that can mimic ADHD symptoms, and may, in fact, be mistaken for ADHD. A comprehensive evaluation includes screening for co-existing conditions. When one or more co-existing conditions are present along with ADHD, it is essential that all are diagnosed and treated. Failure to treat co-existing conditions often leads to failure in treating the ADHD. And, crucially, when the ADHD symptoms are a secondary consequence of depression, anxiety or some other psychiatric disorder, failure to detect this can result in incorrect treatment of the individual for ADHD. Other times, treating the ADHD will eliminate the other disorder and the need to treat it independently of ADHD.

The examiner is also likely to ask questions about the person’s history of health, development going back to early childhood, academic and work experience, driving history, drug and alcohol abuse, family and/or marital life and social history. The examiner will look for patterns that are typical in individuals with ADHD and also try to determine if factors other than ADHD may be causing symptoms that look like ADHD.

Participation of loved ones

It is also essential for the clinician to interview one or more independent sources, usually a significant other (spouse, family member, parent or partner) who knows the person well. This procedure is not to question the person’s honesty, but rather to gather additional information. Many adults with ADHD have a spotty or poor memory of their past, particularly from childhood. They may recall specific details but forget diagnoses they were given or problems they encountered. Thus, the clinician may request that the individual being evaluated have his or her parents fill out a retrospective ADHD profile describing childhood behavior.

Many adults with ADHD may also have a limited awareness of how ADHD-related behaviors cause problems for them and have impact on others. In the case of married or cohabitating couples, it is to the couple’s advantage for the clinician to interview them together when reviewing the ADHD symptoms. This procedure helps the non-ADHD spouse or partner develop an accurate understanding and an empathetic attitude concerning the impact of ADHD symptoms on the relationship, setting the stage for improving the relationship after the diagnostic process has been completed. If it is not possible to interview the loved ones, having them fill out checklists of symptoms is a good alternative.

Many adults with ADHD may feel deeply frustrated and embarrassed by the ongoing problems caused by the disorder. It is very important that the person being evaluated discuss these problems openly and honestly and not hold back information due to feelings of shame or fear of criticism. The quality of the evaluation and the accuracy of the diagnosis and treatment recommendations will be largely determined by the accuracy of the information provided to the examiner.

Standardized behavior rating scales

A comprehensive evaluation can include one or more standardized behavior rating scales. These questionnaires use research comparing behaviors of people with ADHD to those of people without ADHD. Scores on the rating scales are not considered diagnostic by themselves but serve as an important source of objective information in the evaluation process. Most clinicians ask the individual undergoing the evaluation and the individual’s significant other to complete these rating scales.

Additional testing

Depending on the individual and the problems being addressed, additional psychological, neuropsychological or learning disabilities testing may be used as needed. These do not diagnose ADHD directly but can provide important information about ways in which ADHD affects the individual. The testing can also help determine the presence and effects of co-existing conditions. For example, in order to determine whether the individual has a learning disability, the clinician will usually give a test of intellectual ability as well as a test of academic achievement.

Medical examination

If the individual being evaluated has not had a recent physical exam (within 6–12 months), a medical examination is recommended to rule out medical causes for symptoms. Some medical conditions, such as thyroid problems and seizure disorders, can cause symptoms that resemble ADHD symptoms. A medical examination does not confirm ADHD but is extremely important in helping to rule out other conditions or problems.

Concluding the evaluation

Towards the end of the evaluation the clinician will integrate the information that has been collected through diverse sources, complete a written summary or report, and provide the individual and family with diagnostic opinions concerning ADHD as well as any other psychiatric disorders or learning disabilities that may have been identified during the course of the assessment. The clinician will then review treatment options and assist the individual in planning a course of appropriate medical and psychosocial intervention. Afterward, the clinician will communicate with the individual’s primary care providers, as deemed necessary.

For more information

Barkley, RA. (2014).  Attention-deficit hyperactivity disorder, fourth edition: A handbook for diagnosis and treatment.  New York, NY: Guilford Press.

Wolraich, M. & DuPaul, G. (2010).  ADHD diagnosis and management: A practical guide for the clinic and the classroom.  Baltimore, MD: Brooks Publishing.

Centers for Disease Control and Prevention (CDC). Attention-Deficit/Hyperactivity Disorder.      www.cdc.gov/ncbddd/adhd/diagnosis.html 

• Visit the NRC on Social Media

The information provided by CHADD’s National Resource Center on ADHD is supported by Cooperative Agreement Number NU38DD000002 funded by the Centers for Disease Control and Prevention (CDC). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the CDC or the Department of Health and Human Services (HHS).

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Treatment of ADHD

• Behavior Therapy, including Training for Parents

Medications

Parent education and support, tips for parents.

Get information and support from the National Resource Center on ADHD

My Child Has Been Diagnosed with ADHD – Now What?

When a child is diagnosed with attention-deficit/hyperactivity disorder (ADHD), parents often have concerns about which treatment is right for their child. ADHD can be managed with the right treatment. There are many treatment options, and what works best can depend on the individual child and family.  To find the best options, it is recommended that parents work closely with others involved in their child’s life—healthcare providers, therapists, teachers, coaches, and other family members.

Types of treatment for ADHD include

• Behavior therapy, including training for parents; and
• Medications.

Treatment recommendations for ADHD

For children with ADHD younger than 6 years of age, the American Academy of Pediatrics (AAP) recommends parent training in behavior management as the first line of treatment, before medication is tried. For children 6 years of age and older, the recommendations include medication and behavior therapy together — parent training in behavior management for children up to age 12 and other types of behavior therapy and training for adolescents.  Schools can be part of the treatment as well. AAP recommendations also include adding behavioral classroom intervention and school supports.  Learn more about how the school environment can be part of treatment .

Good treatment plans will include close monitoring of whether and how much the treatment helps the child’s behavior, as well as making changes as needed along the way. To learn more about AAP recommendations for the treatment of children with ADHD, visit the Recommendations page .

Behavior Therapy, Including Training for Parents

ADHD affects not only a child’s ability to pay attention or sit still at school, it also affects relationships with family and other children.  Children with ADHD often show behaviors that can be very disruptive to others. Behavior therapy is a treatment option that can help reduce these behaviors; it is often helpful to start behavior therapy as soon as a diagnosis is made.

The goals of behavior therapy are to learn or strengthen positive behaviors and eliminate unwanted or problem behaviors. Behavior therapy for ADHD can include

• Parent training in behavior management;
• Behavior therapy with children ; and
• Behavioral interventions in the classroom .

These approaches can also be used together. For children who attend early childhood programs, it is usually most effective if parents and educators work together to help the child.

Children younger than 6 years of age

For young children with ADHD, behavior therapy is an important first step before trying medication because:

• Parent training in behavior management gives parents the skills and strategies to help their child.
• Parent training in behavior management has been shown to work as well as medication for ADHD in young children.
• Young children have more side effects from ADHD medications than older children.
• The long-term effects of ADHD medications on young children have not been well-studied.

Behavior Therapy for Younger and Older Children with ADHD [PDF – 466 KB]

School-age children and adolescents

For children ages 6 years and older, AAP recommends combining medication treatment with behavior therapy. Several types of behavior therapies are effective, including:

• Behavioral interventions in the classroom;
• Peer interventions that focus on behavior; and
• Organizational skills training.

These approaches are often most effective if they are used together, depending on the needs of the individual child and the family.

Learn more about behavior therapy

Learn more about ADHD treatment and support in school

Read about the evidence for effective therapies for ADHD

Medication can help children manage their ADHD symptoms in their everyday life and can help them control the behaviors that cause difficulties with family, friends, and at school.

Several different types of medications are FDA-approved to treat ADHD in children as young as 6 years of age :

• Stimulants are the best-known and most widely used ADHD medications. Between 70-80% of children with ADHD have fewer ADHD symptoms when taking these fast-acting medications.
• Nonstimulants were approved for the treatment of ADHD in 2003. They do not work as quickly as stimulants, but their effect can last up to 24 hours.

Medications can affect children differently and can have side effects such as decreased appetite or sleep problems. One child may respond well to one medication, but not to another.

Healthcare providers who prescribe medication may need to try different medications and doses. The AAP recommends that healthcare providers observe and adjust the dose of medication to find the right balance between benefits and side effects. It is important for parents to work with their child’s healthcare providers to find the medication that works best for their child.

CDC funds the National Resource Center on ADHD (NRC), a program of Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD). The NRC provides resources, information, and advice for parents on how to help their child.  Learn more about the services of the NRC .

The following are suggestions that may help with your child’s behavior:

• Create a routine. Try to follow the same schedule every day, from wake-up time to bedtime.
• Get organized . Encourage your child to put schoolbags, clothing, and toys in the same place every day so that they will be less likely to lose them.
• Manage distractions. Turn off the TV, limit noise, and provide a clean workspace when your child is doing homework. Some children with ADHD learn well if they are moving or listening to background music. Watch your child and see what works.
• Limit choices. To help your child not feel overwhelmed or overstimulated, offer choices with only a few options. For example, have them choose between this outfit or that one, this meal or that one, or this toy or that one.
• Be clear and specific when you talk with your child. Let your child know you are listening by describing what you heard them say. Use clear, brief directions when they need to do something.
• Help your child plan. Break down complicated tasks into simpler, shorter steps. For long tasks, starting early and taking breaks may help limit stress.
• Use goals and praise or other rewards. Use a chart to list goals and track positive behaviors, then let your child know they have done well by telling them or by rewarding their efforts in other ways. Be sure the goals are realistic—small steps are important!
• Discipline effectively. Instead of scolding, yelling, or spanking, use effective directions , time-outs or removal of privileges as consequences  for inappropriate behavior.
• Create positive opportunities. Children with ADHD may find certain situations stressful. Finding out and encouraging what your child does well—whether it’s school, sports, art, music, or play—can help create positive experiences.
• Provide a healthy lifestyle. Nutritious food, lots of physical activity , and sufficient sleep are important; they can help keep ADHD symptoms from getting worse.

ADHD in Adults

ADHD lasts into adulthood for at least one-third of children with ADHD 1 . Treatments for adults can include medication, psychotherapy, education or training, or a combination of treatments. For more information about diagnosis and treatment throughout the lifespan, please visit the websites of the National Resource Center on ADHD  and the National Institutes of Mental Health

More information

For more information on treatments, please click one of the following links:

National Resource Center on ADHD

National Institute of Mental Health

Information for parents from the American Academy of Pediatrics

References:

• Barbaresi WJ, Colligan RC, Weaver AL, Voigt RG, Killian JM,  Katusic SK.  Mortality, ADHD, and psychosocial adversity in adults with childhood ADHD: A prospective study. Pediatrics 2013;131(4):637-644.

What parents can expect in behavior therapy

Parents typically attend 8-16 sessions with a therapist and learn strategies to help their child. Sessions may involve groups or individual families.

• The therapist meets regularly with the family to monitor progress and provide support
• Between sessions, parents practice using the skills they’ve learned from the therapist

After therapy ends families continue to experience improved behavior and reduced stress.

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What Is Combined Type ADHD?

Signs of combined type adhd.

• Expectations and Management

Frequently Asked Questions

Combined type attention deficit hyperactivity disorder (ADHD) is the most common of the three presentations of ADHD. The others are predominantly inattentive presentation and predominantly hyperactive-impulsive presentation. As the name suggests, people with combined type ADHD show both inattentive and hyperactive symptoms.

Although it's difficult to say what percentage of people with ADHD have combined type, one small study estimates that about 70% of adults with ADHD had combined type.

Verywell / Joules Garcia

Treating combined-type ADHD can be challenging since there are two different symptom sets. However, this type is not necessarily worse or more disruptive than other presentations of ADHD.

This article will review the symptoms of combined-type ADHD, as well as treatment options and how to cope.

The DSM-5 ADHD criteria outlines two sets of symptoms for people with ADHD. A diagnosis can be made if a person under the age of 17 has six or more of the outlined symptoms in one category for the past six months, or if an adult has five of the symptoms. People with combined-type ADHD meet the criteria for both sets of symptoms.

Inattentive Symptoms

People who have predominantly inattentive ADHD mostly have trouble paying attention and following through. The symptoms of inattentiveness include:

• Difficulty paying attention or listening
• Losing important items
• Being easily distracted
• Forgetfulness
• Having trouble paying attention
• Appearing not to be listening
• Making careless mistakes
• Avoiding tasks that require focus

Hyperactive-Impulsive Symptoms

People who primarily have hyperactive or impulsive-type ADHD often have more physical symptoms. These can include:

• Squirming or fidgeting
• Inability to remain seated
• Running or climbing inappropriately, or (in adults) restlessness
• Trouble staying quiet
• Appearance of being driven by "a motor" or often “on the go”
• Being overly talkative
• Inability to wait their turn
• Interrupting frequently

What to Expect from Someone with Combined Type ADHD

People with combined-type ADHD are often impulsive and hyper. They might have difficulty reaching their full potential at school or work because their symptoms interfere with their ability to complete tasks. In some other cases, they have trouble making friends, although many kids with ADHD form meaningful friendships.

Children with ADHD are at increased risk for other conditions, including learning disorders, depression , anxiety, or behavioral problems. Because of that, the American Academy of Pediatrics recommends that all kids with ADHD be screened for additional conditions. Knowing all the conditions that a child is navigating can help you develop a treatment plan that will work for them.

You should also work with your child and their therapist to develop healthy ways of coping with excess energy or impulsiveness . Kids with ADHD are at increased risk for injury. Be proactive in talking to your child about safety measures, like always wearing a helmet while riding a bike.

How to Treat Combined Type ADHD

Combined type ADHD is treated with medications that can help reduce symptoms, and behavioral adaptations that can help a person control the symptoms they still have.

If you’re the parent of a child with combined-type ADHD, you can also benefit from training and therapy that teach you how to more effectively engage with your child. In addition, you can request that their school help make behavioral accommodations to help your child succeed. 

Medication treatments

• Stimulants : These medications , including Ritalin ( methylphenidate ) and Adderall ( amphetamine and dextroamphetamine ), can quickly reduce ADHD symptoms in as many as 80% of kids with ADHD.
• Non-stimulants : These medications, including Strattera ( atomoxetine ) and Qelbree (viloxazine), work more slowly but the effects may last longer.

In some cases, your healthcare provider may recommend a combination of stimulant and non-stimulant treatments. 

Behavioral interventions

People, especially children, with combined type ADHD benefit from behavioral interventions that help them succeed at school and in other settings. These can include:

• Behavioral therapy : This aims to increase positive behaviors and decrease negative or risky behaviors. 
• Social skills training : Therapy that helps people better understand and abide by social cues. 
• Organizational skills training : Helps the person develop methods to combat forgetfulness and disorganization.

Combined type ADHD is one of three presentations of ADHD laid out in the DSM-5. To be diagnosed with combined type ADHD, a person needs to exhibit both hyperactive/impulsive and inattentive symptoms.

Although a person with combined-type ADHD has two types of symptoms, their ADHD is not necessarily worse than that of people with a single presentation. Medications and behavioral interventions can help people with combined-type ADHD succeed in school, work, and social settings.

A Word From Verywell

Getting a diagnosis of combined-type ADHD might come as a relief, or it can seem overwhelming. Remember that there are treatments—both medical and behavioral—that can support people with ADHD in reaching their full potential. The key is finding a treatment regimen that works for you or your child. 

Combined type ADHD might seem more complex than having just one presentation. However, it does not necessarily mean that the symptoms are more disruptive than in someone with only one type of presentation. Talk with your healthcare provider to get a better idea of what your diagnosis of combined type ADHD means, and how best to manage it. 

Researchers aren’t sure what causes ADHD, although it’s believed that both genetic and environmental factors are at play. There’s also no way to prevent combined type ADHD, so after a diagnosis, it’s best to focus on managing symptoms and finding a treatment plan that works for you.

Treatment can help people with combined type ADHD manage their symptoms effectively. Unfortunately, there's no cure for ADHD. About one-third of people who are diagnosed with ADHD in childhood will outgrow their symptoms by their time they are adults. For others, the presentation of symptoms may change as they grow up.

Combined type ADHD is the most common subtype. Overall, ADHD affects about 11% of school-aged children and 4% of adults. One small study of adults with ADHD found that 70% had combined type ADHD.

Johns Hopkins Medicine. Attention-deficit/hyperactivity disorder (ADHD) in children .

AAFP National Research. DSM-5 diagnostic criteria for ADHD .

Salvi V, Migliarese G, Venturi V, et al. ADHD in adults: clinical subtypes and associated characteristics .  Riv Psichiatr . 2019;54(2):84-89. doi:10.1708/3142.31249

Centers for Disease Control and Prevention. (CDC). Symptoms and diagnosis of ADHD .

Centers for Disease Control and Prevention. (CDC). Other concerns and conditions with ADHD .

Centers for Disease Control and Prevention. (CDC). Treatment of ADHD .

By Kelly Burch Kelly Burch is has written about health topics for more than a decade. Her writing has appeared in The Washington Post, The Chicago Tribune, and more.

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Controlling slides shared by another participant

A presenter in a meeting or webinar can give slide control to other participants, so that others can control the progression of slides for the presenter or when they are presenting their portion of the presentation. This avoids the need to ask the presenter to change the slide when they are ready, interrupting the flow of the meeting and presentation. Slide control can be given to multiple participants in a meeting, or multiple panelists in a webinar.

This article contains:

How to assign slide control

How to use slide control, prerequisites for slide control.

• Zoom desktop client for Windows and macOS: Global minimum version or higher
• Google Slides
• Microsoft PowerPoint
• Office 365 PowerPoint

Limitations of using slide control

• Assigning slide control can be done when sharing an entire screen or the specific Keynote, PowerPoint, or Google Sheets window.
• When using Google Slides, the presentation must be shared in Slideshow view , as Presenter view is not supported. 
• When using Keynote, the presentation must be played in fullscreen view, as Play Slideshow in Window is not supported.  

How to enable slide control

To enable or disable Slide Control for all users in the account:

• Sign in to the Zoom web portal as an admin with the privilege to edit account settings.
• In the navigation menu, click Account Management then Account Settings .
• Click the Meeting tab.
• Under In Meeting (Basic) , click the Slide Control toggle to enable or disable it.
• If a verification dialog displays, click Enable or Disable to verify the change.

To enable or disable Slide Control for a group of users:

• Sign in to the Zoom web portal as an admin with the privilege to edit groups.
• In the navigation menu, click User Management then Group Management .
• Click the applicable group name from the list.
• If a verification dialog displays, click Enable or Disable to verify the change. Note : If the option is grayed out, it has been locked at the account level and needs to be changed at that level.

To enable or disable Slide Control for your own use:

• Sign in to the Zoom web portal.
• In the navigation panel, click Settings .
• If a verification dialog displays, click Enable or Disable to verify the change. Note : If the option is grayed out, it has been locked at either the group or account level. You need to contact your Zoom admin.

How to use slide control in a meeting or webinar

• Start or join a meeting or webinar.
• Begin sharing a Keynote, PowerPoint, or Google Slides presentation. Note : For more tips on sharing a presentation, please see our specific articles for sharing Keynote , PowerPoint , and Google Slides presentations

• This option will only be available when you are in full-screen presentation mode. 
• This option works when sharing an entire screen or the specific Keynote, PowerPoint, or Google Sheets window.
• Select one or more participants you wish to give slide control. The slide control button will update with the number of participants with slide control next to the icon.

After you’ve assigned slide control to a participant, they will retain slide control for the duration of this current session, even if you stop and start sharing again (version 5.13.0 and higher). The slide controls will disappear if you exit presentation mode, but they will re-appear when you begin presenting again. You can revoke an individual’s access by clicking their name in the list, or revoke all access by clicking the Stop Slide Control button or stopping sharing completely.

When you’ve been given access to slide control and the presenter enters presentation mode, a banner notification will appear, informing you of the new access. The slide controls will appear just below the banner, in the bottom-left corner of the presentation view.

• Alternatively, you can use the left and right buttons on your keyboard to move the presentation backwards or forwards.

'Life was pretty good': Why Trump voters are sticking with him after indictments

CLAREMONT, N.H. - Little more than two months before people start voting, Donald Trump and his Republican rivals are increasingly focused on a pivotal constituency: Trump voters.

"We have to slam it on Election Day," Trump said Saturday during a Veterans Day speech devoted mainly to military policy but which included a copious amount of politics and attacks on President Joe Biden.

As he does in nearly every speech, Trump cited his large lead in the polls, and told supporters they are essential to his hopes of winning the Republican presidential nomination, starting with the Jan. 15 caucuses in Iowa .

Republican rivals say Trump is the wrong choice for the times - and could find himself to be a multi-convicted felon by the time the general election rolls around in a year.

'Life was pretty good'

In chilly New Hampshire on Saturday, loyal Trump voters said they are inclined to stick with him because the economy and foreign policy appeared to be better back in his day.

“A lot of people in the middle class realize -wait a second- life was pretty good under Trump, and they really get it,” said Steve Paul, 56, an IT worker who drove two hours from his home in the White Mountains, through a mix of wintery weather, to see Trump.

Paul and others who lined up on the sidewalk outside Stevens High School in Claremont to see Trump cited high energy costs as another key point of pain with the current economy. 

“He's proven himself,” said 72-year-old retiree Bob Stransbery. “You may not like what he says a lot of times and he may say random things but when he says he's gonna do something he does and he backs it up.”

'A line in the sand'

During his speech, Trump again claimed that Hamas would not have attacked Israel and Ukraine would not have attacked Russia if he were president.

Both are unproveable assertions, but Trump backers believe in his claims about foreign policy.

Stransbery, a U.S. veteran who served 20 years in the Navy and 10 in the Air Force, said other countries are “walking on the United States because nobody would draw a line in the sand and stick to it."

Protesters: Trump belongs in prison

Trump also has his share of opponents, some of whom showed up in Claremont to protest his appearance.

“The fact that [Trump] has the audacity to set foot in Claremont at this time, when I don't feel like he deserves to be anywhere but in prison,” said Nancy Braus, 69, who traveled from Gilford, Vermont, to stand among the crowd of some two dozen who carried anti-Trump signs.

Braus, who identifies as progressive and said she has written Sen. Bernie Sanders in for president the past two elections, said Trump "did commit an insurrection" through his supporters' attack on the U.S. Capitol on Jan. 6, 2021 .

"He led it; he encouraged it; he instructed all of the people that were there as to how to behave and what to do," she said.

National Democrats said Trump is an extremist who has disparaged members of the military and failed to follow through on improved services for veterans.

Sen. Tammy Duckworth, D-Ill., a veteran, said "the five-deferment draft-dodger" has called "American war heroes who gave their lives for our country ‘suckers’ and ‘losers,'" during a New Hampshire Democratic Party press call Friday.

Duckworth added that Trump's "dangerous rhetoric on the campaign trail" continues to prove that "if he were elected president, Trump would pursue an extreme agenda.”

A battleground city and state

Trump spoke in a New Hampshire city that has been ambivalent about him.

During the 2016 election, the then-New York businessman became the first Republican in two decades to win the most votes in the city of Claremont.

In 2020, Biden won the city back for Democrats.

Though not a fan of President Joe Biden, Braus said her vote in the 2024 election will be more about keeping Trump out of office . 

“This year it’s about fears, not hope," she said. "If we vote for Joe Biden, it’s for fears not hopes, because he doesn’t have the vision.”

The trials of Trump

The most unique aspect of this race: The frontrunner faces up to four criminal trials during the campaign year.

Trump supporters say they are unfazed by all the criminal cases against Trump, and accept his claim that Biden and the Democrats are using the legal system to play politics.

The former president has been charged with conspiracies to overturn the 2020 election in Washington, D.C., and Georgia; improper hush money payments in New York; and mishandling classified documents in Florida.

Neil West, 44, who said he himself has a felony conviction, wouldn’t hold it against the former President if he was convicted in any of the trials.

“I would still vote for him. Absolutely,” West, who stood near the front of the line at Trump’s rally Saturday, said. “Just because you have a felony doesn’t mean you’re bad. I’m not a bad person and I’ve been in a lot of trouble. I took awhile to learn.”

While he understands the trials might deter some people from backing Trump, he believed issues like inflation would ultimately motivate more voters.

“Everywhere everything's going up but the paychecks stay the same. We just fight to stay afloat,” he said. “When he was in office, everything seemed to be running good."

DeSantis, Haley vie to appeal to Trump voters

While Trump seeks to hold onto his base, other Republican presidential candidates look to chip away past Trump voters who are willing to consider alternatives.

Florida Gov. Ron DeSantis said Trump failed to follow though on many promises, from curbing federal spending to building a complete wall along the U.S.-Mexico border. He also says that Trump is lying about his record.

"Don't whiz on my leg and tell me that it’s raining, okay?” DeSantis said during a stop in Iowa.

Former South Carolina Gov. Nikki Haley , who has stressed that federal spending continued to go up on Trump's watch, noted that she does better in polling against Biden than Trump or other Republican candidates.

"Republicans need to start winning," Haley told told Fox News this week.

Ramaswamy, Scott, Christie try to make inroads as Trump leads

Businessman Vivek Ramaswamy is probably Trump's biggest supporter among the field of challengers.

Of the dozen or so Trump supporters USA TODAY spoke with at the Claremont event, most said that if the former president wasn’t on the ballot, they would vote for entrepreneur Ramaswamy because of his business chops and right-of Trump policy views.

South Carolina Sen. Tim Scott, R-S.C. , who has the flu and is off the campaign trail this weekend, has also questioned Trump's ability to win a general election.

Former New Jersey Gov. Chris Christie , who is in Israel this weekend, said this week that voters and everyone else needs to come grips with the prospect that a convicted felon could be nominated for president.

"Our front-runner is out on bail in four different jurisdictions - think about that!" Chris Christie said during a New Hampshire town hall. "And we don't talk about it?"