ADHD, internationally known as Attention Deficit Hyperactivity Disorder (ADHD), is known as “Hyperactivity Disorder” in our professional diagnostic standards, or “ADHD” for short. ADHD is one of the most common chronic brain development and behavioral disorders in childhood, and is the most common mental illness in childhood, with cognitive deficits and behavioral outcomes that affect many aspects of functioning. The prevalence of school-age children in China is about 3~10%. Among them, 50~80% of children with ADHD can last until adolescence, and 30~50% or more can enter adulthood. I. Clinical manifestations 1. Attention deficit: It is difficult to maintain sustained concentration of attention, and it is natural to devote oneself to things of great interest, but it is difficult to concentrate on new or less interesting things. In class, doing homework or doing other things that require energy, it is more difficult to concentrate, and easy to be attracted by irrelevant stimuli. Tends to be inattentive and careless in doing homework, often losing school supplies. Absentmindedness and seeming to listen during conversations. Some children or to some special interest in things can produce a strong motivation, make the concentration time may be longer, such as in watching favorite cartoons or play computer games may be focused, can not therefore rule out the diagnosis of ADHD. 2, excessive activity: manifested by excessive activity levels that are not commensurate with age and development. This kind of excessive activity has no clear purpose, especially in situations that require the child to restrain his or her motor behavior, such as in the classroom, at gatherings, and in front of guests. Always in a state of non-stop activity and talking. During class, the child is in a constant state of movement, unable to sit still, and interferes with other students by wiggling his or her buttocks in the chair. After class, the child runs and climbs, takes risks, yells, attracts attention, and never stops, as if driven by a motor. At home is also energetic, moving non-stop, often can not be quiet to write homework, write and play. 3, impulsive: manifested in doing things without considering the consequences. They may say inappropriate things out of turn or give wrong answers without listening to the question. It is difficult to wait quietly in line and interrupt others’ conversations. Poor self-control, dramatic mood changes, easily excited, low tolerance for frustration, often overreacting to unpleasant stimuli. What they ask for must be met immediately, or they make a lot of noise. When doing homework or taking tests, they often finish in a hurry, hand in their papers first, and are unwilling to check even if they have time. Second, secondary effects 1, school dysfunction: Although most children with ADHD have normal intelligence, they often have poor academic performance because of their inability to concentrate. Academic performance fluctuates greatly and is very unstable. Often, as the grade increases, the poor academic performance will become more and more obvious. Difficulty in interpersonal relationships: they do not listen to others, their behavior is unpredictable and easy to break out, and they easily get into conflicts with others. Exhibit characteristics such as less giving, cooperation, sharing and partaking. Mistakes made are mostly due to lack of consideration rather than intentionality. Even when well-intentioned, their behavior is often annoying and a source of annoyance to parents, teachers and classmates. They are often criticized by parents and teachers, rejected by classmates, seldom make friends, and often feel unhappy. This often causes their self-esteem to be hurt and their learning to be even worse. 3. High tendency and risk of accidents: 50% of ADHD children are considered to have a tendency to have accidents due to impulsivity, lack of prior thinking and planning. Hyperactive-impulsive behavior may also develop into a pattern of irresponsible and risk-taking behavior in adults. Accompanying disorders: About 80% of children with ADHD have another psychological disorder, the most common being oppositional defiant disorder and conduct disorder, anxiety disorder and depression. ADHD is a polygenic genetic disease caused by the interaction of multiple risk genes and environmental factors. Its pathogenesis has a well-established biological basis, and studies have shown that children with ADHD have significantly smaller prefrontal, basal ganglia, and cerebellar volumes than normal control children, and their local blood perfusion is reduced. Frontal lobe dysfunction is thought to be the primary cause of behavioral patterns in children with ADHD. Factors that jeopardize neurological development before or after birth (maternal complications, low birth weight, malnutrition, asphyxia, maternal alcohol use during pregnancy, smoking, etc.) may increase the risk of ADHD. Diet, allergies, and lead play a very minor, if not near-zero, role in the major causes of ADHD. Family influences are not a major factor in the formation of ADHD, but play an important role in determining the consequences of ADHD and its associated problems. Lack of understanding on the part of parents or teachers, and abusive and degrading practices all have a serious impact on children’s behavioral and emotional development, and can even lead to antisocial behavior. Fourth, the diagnosis of ADHD mainly rely on clinical diagnosis, the need to do relevant psychological tests to assist in the diagnosis, our country based on CCM-3 on the diagnostic criteria for the diagnosis of ADHD, according to the international ICD-10 or DSM-V to diagnose. It is mainly categorized into attention-deficit-predominant type (commonly known as immobile ADHD); hyperactive-impulsive-predominant type and mixed type, with mixed type being the most common. Lay people generally think that only hyperactive children have ADHD, referring to the latter two types. V. TREATMENT First of all, it must be recognized that ADHD is a chronic disease and treatment requires the participation of doctors, parents, children and teachers. An appropriate treatment goal should be defined, that is, to maximize the improvement of the child’s social functioning: to improve relationships with parents, teachers, and peers; to reduce disruptive behaviors; to improve academic performance; to increase independence in self-care or homework; to improve self-esteem; and to increase safety in life. A combination of medication and psychosocial interventions is mostly used: medication targets the core biological symptoms of the disease (inattention, hyperactivity, impulsivity); psychosocial interventions promote the establishment of children’s pro-social behaviors, mainly through changes in the natural and social environment. Medications are the most effective first line of treatment for ADHD symptoms. Studies have shown that excitatory medication alone is more effective in improving symptoms than behavioral therapy alone; combining behavioral therapy with medication does not have much effect on core ADHD symptoms, but is moderately effective in improving non-ADHD symptoms and social functioning. Commonly used psychostimulant medications are Ritalin (short-acting methylphenidate), and methylphenidate hydrochloride extended-release (Focus, long-acting methylphenidate). In general, the use of long-acting preparations is preferred to short-acting preparations with multiple doses, and long-acting preparations can increase adherence to treatment and reduce the need to go through the change state of beginning and ending administration of medication during the day. Tomoxetine (Zesta), which has begun to be used in China in recent years, also has good efficacy in ADHD. Psycho-behavioral interventions: The main focus is on improving the child’s behavioral problems and the family’s attitudes and life strategies (e.g., self-concept, interpersonal skills, school problems, family’s evaluation of the child). Parent management training, educational interventions, family counseling, and individual counseling are used to change the natural and social environments to promote the establishment of pro-social behaviors and improve social functioning in children.