ADHD is often missed — in both directions
ADHD (attention deficit disorder, sometimes called hyperactivity disorder) is one of the most misunderstood conditions in psychiatry. Some children are labelled "difficult" or "lazy" for years before anyone considers ADHD. Some adults spend a lifetime believing they're simply disorganised, forgetful, or not trying hard enough — never realising there's a name, and real help, for what they're experiencing. And in some cases, normal childhood energy or a normal adult's busy, distractible day gets over-medicalised without a proper assessment.
The goal of a psychiatric evaluation isn't to hand out a label quickly. It's to look carefully at the pattern — how long it's been present, how consistent it is across settings, and how much it's actually affecting daily life — before deciding what, if anything, needs to change.
Signs of ADHD, by age
ADHD looks different depending on age. Recognising the pattern that fits is the first step, not a diagnosis by itself.
Signs in children
Difficulty sitting still or staying in their seat at school, trouble following multi-step instructions, losing homework or belongings repeatedly, blurting out answers or interrupting, and a pattern of intense focus on preferred activities alongside near-total distraction elsewhere. Teachers often flag this before parents notice it fully at home.
Signs in teenagers
Chronic procrastination on schoolwork despite real intelligence, forgotten deadlines and misplaced materials, restlessness that shows more as fidgeting or talking than running around, and a growing gap between potential and actual academic performance that frustrates both the teen and their parents.
Signs in adults
Chronic disorganisation, difficulty finishing tasks even when motivated, losing track of time, restlessness felt as inner unease rather than visible hyperactivity, impulsive decisions, and a lifelong sense of working twice as hard just to keep pace with others. Many adults are diagnosed only after recognising the same pattern in their own child.
ધ્યાન ન લાગવું / ध्यान की कमी — a note on lay terms
Families in Surat often describe this pattern in everyday words rather than the clinical term — a child who is ekagrata nathi (can't concentrate), or "ધ્યાન નથી લાગતું" (attention doesn't stick), or in Hindi, "ध्यान की कमी" or बच्चा बहुत चंचल है (the child is very restless). These everyday descriptions are exactly the starting point a psychiatric assessment works from — you don't need the clinical vocabulary to begin the conversation.
Adult ADHD vs childhood ADHD — how assessment differs
| Area | Children | Adults |
|---|---|---|
| How it typically presents | Visible hyperactivity, disruption in class, missed instructions | Internal restlessness, chronic disorganisation, missed deadlines |
| Who usually raises the concern | Teachers or parents | Self-recognition, often after a child's diagnosis, or a partner/colleague noticing a pattern |
| Assessment sources | Parent and teacher input, developmental history, classroom observation reports | Detailed history since childhood, current functioning at work and home, self-report scales |
| Common co-occurring concerns | Learning difficulties, oppositional behaviour, anxiety | Anxiety, low self-esteem from years of being misunderstood, relationship or workplace strain |
| Treatment emphasis | Parent coaching, school accommodations, structured routines, medication where appropriate | Practical strategies, workplace accommodations, medication where appropriate, addressing accumulated self-esteem impact |
How assessment works with Dr. Heena
There is no single blood test or scan that confirms ADHD. Diagnosis is clinical, built from a detailed conversation about symptoms across different settings — home, school or work — and how long the pattern has genuinely been present. For a child, that usually means hearing from both parents and, where useful, a brief input from teachers. For an adult, it means an honest look back at childhood alongside a clear picture of current daily functioning.
Dr. Heena takes this seriously in both directions: she won't rush to a diagnosis where the picture doesn't fit, and she won't dismiss a genuine, long-standing pattern just because it wasn't caught earlier. The first conversation is unhurried, confidential, and free of judgment — for the child sitting quietly (or not so quietly) in the room, and for the adult who has spent years wondering what was "wrong" with them.
What treatment can include
Treatment is never assumed to be medication alone. Depending on age and severity, it may include behavioural strategies and routine-building, parent coaching for younger children, practical organisational strategies and workplace accommodations for adults, and — where clinically appropriate — medication, introduced with a clear explanation of what to expect and reviewed regularly rather than left on autopilot.
A quick self-check — not a diagnosis, a starting point
These questions don't diagnose anything on their own, but if several feel familiar — for you or your child — a proper assessment is worth having:
- Has this pattern been present consistently for six months or more, not just during a stressful period?
- Does it show up in more than one setting — home and school, or home and work?
- Is it noticeably affecting schoolwork, job performance, or relationships — not just an occasional off day?
- For a child: has a teacher independently raised something similar?
- For an adult: does this pattern trace back to childhood, even if no one named it then?
- Have simple fixes — more discipline, more willpower, more reminders — repeatedly failed to change it?
About Dr. Heena Khanna
Dr. Heena Khanna, MBBS, MD (Psychiatry)
Dr. Heena Khanna is a Consultant Psychiatrist practising at Mahavir Health Campus, Ring Rd, Athwa Gate, Surat. She holds an MBBS and an MD in Psychiatry, and is a member of the Indian Psychiatric Society and the Indian Medical Association. Her practice covers both child and adult psychiatry — including ADHD assessment, anxiety, depression, OCD, and stress-related conditions — using evidence-based approaches. No referral is required to book a first session, for yourself or your child.