When you hear "ADHD," do you picture a child bursting with endless energy who can't sit still? While hyperactivity is one aspect, millions of children and adults experience attention deficit hyperactivity disorder (ADHD) in ways that look completely different.

According to data from the CDC, more than 11% of U.S. children have been diagnosed with ADHD, but that data doesn’t account for those who go undiagnosed because of a limited understanding of ADHD. Understanding how it shows up is the first step toward getting the right support.

We spoke with Dr. Howard Schub, a pediatric neurologist at JF&CS' Horwitz-Zusman Child & Family Center with more than 40 years of specialized experience in ADHD and neurological differences, to break down what parents and adults need to know.

"Everyone Learns Differently": Rethinking ADHD

"In the old days, people labeled ADHD as 'bad behavior, undisciplined, or daydreaming,'" says Dr. Schub. "I don’t see it as a deficit. I see it as everyone is learning differently. If a child struggles to pay attention and complete tasks, their self-esteem suffers. Our goal is to make learning easier and help people adapt to their unique strengths."

ADHD is an umbrella term encompassing three main types: Inattentive, Hyperactive/Impulsive, and Combined Type.

How Symptoms Evolve with Age

ADHD isn't static, it shifts as a child grows:

Preschool to Early Elementary (Ages 4–7): Feedback often centers on overt hyperactivity and impulsivity.

Older Children & Teens: Overt hyperactivity decreases, shifting toward internal and external distractibility.

• Internal distractibility: "Zoning out" or getting lost in thought rather than listening to a teacher.

• External distractibility: Being completely derailed by a bird outside the window during a quiet test.

What About Adults?

"Most adults with ADHD are very bright, accomplished, and well-functioning," notes Dr. Schub. "However, they may face persistent challenges with organization and meeting deadlines compared to their neurotypical peers."

Because ADHD has a strong genetic component, adult diagnoses often happen by accident. "Two-thirds of the adults I evaluate are parents of children I've treated," Dr. Schub explains. "They sit in the office during their child's assessment and say, 'that was me when I was younger.'"

Lesser-Recognized Signs of ADHD

While an accurate diagnosis requires a professional evaluation, Dr. Schub points out several common behaviors at home and school that may signal it's time for a closer look:

• School & Task Execution: Rushing through assignments, taking an excessively long time on simple work, or needing a parent physically present to finish homework.

• Daily Routines: Severe difficulty with morning routines or transitioning to bed at night.

• Behavioral & Social: Blurting out answers, trouble taking turns, fidgeting, or constantly moving in their seat.

• Focus: Deep daydreaming or difficulty keeping hands to themselves.

Note: Exhibiting two or more of these symptoms consistently across both home and school environments indicates a formal evaluation may be helpful.

A "One-Stop-Shop" Approach to Diagnosis and Care

Finding the right care plan shouldn't mean bouncing between different clinics.

"We take a multidisciplinary approach that is truly unique," says Dr. Schub. "Our team, includes skilled therapists, psychologists, and an executive function coach all working together under one roof. We spend 1.5 hours on initial evaluations and use objective measures like the QbTest to gather precise data on attention."

Treatment is always personalized: "We don't automatically medicate, because not everyone needs it. But when medication is helpful, we use precise trials to ensure every client gets the exact solution tailored to them."

Have questions or want to schedule an evaluation for you or your child? Contact us today.