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Attention Deficit Hyperactivity Disorder (ADHD)

Dr. Yuval Raveh, Specialist in Child and Adolescent Psychiatry, Director of the Department of Child and Adolescent Psychiatry in the Ministry of Health
15 June 2025

Despite the widespread belief that more people are being diagnosed with ADHD today, studies show that the percentage of people with the disorder remains stable. Increased awareness and public discourse in recent years are behind the rising number of people seeking a professional diagnosis. ADHD is a complex disorder that significantly impacts the lives of anyone suffering from it. An accurate diagnosis and suitable treatment can significantly improve the individual’s quality of life while helping maximize potential.

ADHD is a common neuro-developmental disorder that generally begins in early childhood and frequently continues into adulthood. It is characterized by attention difficulties, hyperactivity, and impulsivity. The incidence of the disorder ranges between 5% and 10% of the population of school-age children.

Three types

  1. ADHD combined is the most common type, characterized by hyperactivity, impulsivity, and distraction.
  2. ADHD is primarily inattentive, the most common disorder among females.
  3. ADHD is primarily hyperactive and impulsive; this type is more common among males.

It is important to note that the severity of ADHD is determined based on the level of impairment in daily function. Early diagnosis and treatment are essential to prevent the development of problems such as low self-image, learning difficulties, behavior difficulties or avoidant behavior.

Symptoms

The long list of symptoms can be divided into the following main categories:

  • Attention difficulties: short attention span, easily distracted and organizational difficulties.
  • Hyperactivity: excessive movement; difficulty sitting in place.
  • impulsivity: difficulty waiting in line or interrupting others.

Causes

Causes include a combination of genetics and environmental factors. Studies indicate significant genetic involvement, with a high incidence of the disorder in families with a history of ADHD. In addition, a link was found between changes in cerebrovascular activity, particularly hypoactivity of the anterior areas of the brain responsible for behavioral delays, and executive function.

At the present time, we are hearing about an increasing number of people of all ages who believe they have ADHD. Some attribute certain problems they have in focusing or learning to ADHD and self-diagnose themselves as having ADHD. As a result, the impression has formed that more people in recent years have been diagnosed with ADHD than in the past. Actual studies and data show that the percentage of individuals with ADHD has not changed but rather that awareness has increased and the discourse on the subject has caused more people to seek a professional diagnosis.

Attention Deficit Disorder, also known as ADHD (Attention Deficit Hyperactivity Disorder), is a neurodevelopmental disorder that usually begins in early childhood and continues in most cases (about 60%) into adulthood. ADHD may manifest itself in 3 main areas:

  • Impulsivity
  • Hyperactivity
  • Inattention

Types of ADHD

ADHD primarily inattentive

The most common disorder among females.

ADHD primarily hyperactive and impulsive

This type is more common among males.

ADHD combined

The most common type of ADHD. Characterized by hyperactivity, impulsivity, and inattention.

Incidence of ADHD

ADHD is a common disorder. Approximately 5%-10% of school-age children suffer from it.

ADHD is occasionally accompanied by significant mental morbidity such as learning disabilities, behavior disorders, anxiety, tic disorder, addictions etc. In these cases, the treatment will be carried out according to relevant clinical priorities and considerations. Sometimes all disorders are treated at the same time, and sometimes they begin treating the main disorder. Depending on the treatment outcome, progress is made to treat the other disorders. There are cases in which treatment of the main disorder will also result in an improvement of the symptoms of the other disorders.

Good to know

In the past, the term ADD, Attention Deficit Disorder, was widely used to note a disorder primarily inattentive. Today, all disorders are known as ADHD (Attention Deficit Hyperactivity Disorder), with the specific type of disorder mentioned alongside.

The severity of the disorder

The severity of the disorder is generally categorized based on the degree of impaired function.

  • Mild disorder.
  • Moderate disorder.
  • Severe disorder.

Note

Note

Early and relevant diagnosis is critical. A lack of an appropriate diagnosis and treatment increases the risk of developing avoidant behavior and poor self-image, which are difficult to treat, as well as academic gaps, behavioral difficulties and social difficulties. Early diagnosis and treatment can allow your child to maximize their potential, gain more control over their lives and prevent the development of poor self-image.

Causes of ADHD

Recent studies indicate that the disorder is the result of a combination of genetics and congenital as well as acquired environmental factors, and is linked to a change in the cerebroneural activity in individuals with ADHD.

Genetic causes

ADHD is hereditary. The chance of parents and siblings of children with ADHD of being diagnosed as well is twice as high as the chance in the general population.

Studies conducted among adopted children reveal a higher incidence of ADHD among children whose biological parents suffer from this disorder, and who were adopted by parents who do not suffer from the disorder as compared to children who were adopted by parents who suffer from ADHD, whose biological parents do not suffer from the disorder.

Twin studies revealed that when one twin suffers from ADHD, there is a 50% chance that his identical twin will also suffer from the disorder, while in fraternal twins and non-twin siblings the chance is only 9%.

Cerebroneural activity

ADHD is linked to a change in nervous system activity. The currently accepted scientific theory indicates that anterior areas of the brain, which are responsible for behavioral inhibition and executive skills, operate at a lower intensity in the brains of people who suffer from the disorder. Studies indicate a lower activity of systems related to three types of chemical substances (neurotransmitters):

  • Dopamine.
  • Seratonin.
  • Norepinephrine.

These theories are supported by the fact that stimulants from the class of stimulants such as Ritalin and amphetamines cause hyperactivity of these three systems, and are extremely effective in treating the disorder. These drugs reduce restlessness and hyperactivity in individuals suffering from ADHD, while causing arousal in individuals who do not suffer from ADHD.

Environmental causes during or after pregnancy

Several factors may increase the risk of developing ADHD during pregnancy, including:

  • Consumption of alcohol, drugs or heaving smoking by the mother.
  • Premature infant or low birth weight.

Symptoms of ADHD

The following symptoms typically manifest before the age of twelve:

  • Inattention

    • Short attention span.
    • Errors caused by inattention.
    • Difficulty in focusing, even when speaking directly to a person.
    • Difficulty in following instructions.
    • Difficulty in completing tasks.
    • Organizational difficulties.
    • Avoidance of activities that require prolonged cognitive effort (such as homework).
    • Tendency to forget items.
    • Inattention.
    • Tendency to lose items.

  • Hyperactivity and impulsivity

    • Exaggerated movement of body parts, rocking in a chair.
    • Getting up in situations that require sitting.
    • Running and climbing that is inappropriate for the situation.
    • Difficulty in persisting in quiet activity.
    • Constantly in motion.
    • Talkative.
    • Responds to a question before the question has been completed.
    • Difficulty in waiting on line.
    • Bullying.
    • Interrupting others.

How children with ADHD feel

Children who suffer from attention deficit disorder sometimes describe a feeling of injustice, in both the social and academic arenas. They experience difficulties that cause frustration and problems integrating into society and in academic progress.

In the social arena: they often try harder than everyone else, but fail to "maximize their potential", resulting in tremendous frustration. They try to be good friends, but are told that they do not respect private space. They "react from the gut", impulsively, without thinking before they speak. They occasionally misinterpret social situations. They intend to play with their brother or friend, but they end up being explosive, aggressive and impulsive and are once again treated as "bad kids".

In academics: they try to carry out a task, but describe feeling like they have a "mess in their head" and are unable to remember the instructions. They intend to do homework but are distracted and do other things.

Note

Note

Hyperactivity and impulsivity are prominent behavioral symptoms, so a child who displays these symptoms will be diagnosed at an earlier age than children who mainly deal with distractions. Inattention is a less visible symptom so the diagnosis in such cases is often made at an older age.