The answer is more complicated than you think.

By Maggie O'Neill
Updated August 04, 2020
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Attention-deficit/hyperactivity disorder (ADHD) isn't necessarily an unheard of condition—in fact, it's one of the most common childhood disorders, and can often last through adolescence and into adulthood, according to the National Institute of Mental Health. Even many of the symptoms of ADHD—lack of attention, impulsivity, restlessness—are relatively well known as markers of the disorder.

Some things that aren't as well known, however, like what actually leads to an ADHD diagnosis—and what causes it in the first place. Are genetics at play, or do environmental conditions factor in—or is it a little of both? To find out, Health asked behavioral health specialists what's at the root of an ADHD diagnosis.

First, a quick reminder: What’s ADHD?

Attention-deficit/hyperactivity disorder (ADHD) is among the most common neurodevelopmental disorders diagnosed in children. (FYI: Neurodevelopmental disorders have to do with the way the brain grows and develops, per the Centers for Disease Control and Prevention.)

Children with ADHD often have a difficult time paying attention, and it can cause them to have a hard time controlling impulsive behaviors. This means they might act before considering the results of their actions. Additionally, ADHD can cause children to be overly active. Symptoms that might lead to a diagnosis during adulthood include having a hard time following instructions and not being able to finish tasks on time.

Is ADHD genetic?

The general consensus is: yes. “The thinking in the field is ADHD is genetic,” Michael Manos, PhD, head of the Center for Pediatric Behavioral Health at Cleveland Clinic, tells Health.

Lenard Adler, MD, director of NYU Langone’s adult ADHD program, agrees, adding that ADHD is a “highly heritable disorder.” Dr. Adler tells Health, “We think 80 percent of the transmission is familial.”

Dr. Adler adds that if a parent has ADHD, there’s a 20 to 25 percent chance their child will also have it. However, doctors don’t know exactly which gene causes the disorder, Dr. Adler says.

Can anything else cause ADHD, besides genes?

While doctors understand that ADHD runs in families, they aren’t positive what else could cause the condition. While there are a few theories, keep in mind that these haven't been set in stone as actual risk factors yet.

According to Dr. Adler, a few environmental factors have been associated with ADHD, like maternal abandonment and maternal smoking. Other possible risk factors include brain injury, low birth weight, and premature delivery, according to the Centers for Disease Control and Prevention (CDC). The CDC also warns that alcohol use, in addition to tobacco use, during pregnancy can increase the chances of your child having ADHD.

A number of other risk factors have been associated with ADHD. These include eating an excessive amount of sugar, watching television too often, poverty, “family chaos,” and certain parenting habits, the CDC notes. However, it explains that while these factors might make a child’s ADHD worse, “the evidence is not strong enough to conclude that they are the main causes of ADHD.”

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