Most of the ADHD kids that are seen in a private practice setting are hyperactive kids simply because they get into the most trouble. Their parents are usually pulling their hair out and saying, "We've got to get this child some help." The sad truth is that if a parent is going to spend money to get treatment for his kid, that kid's usually got to get into trouble first. So that's why hyperactive kids are seen the most in treatment.

Remember, though, not all of the kids with Attention Deficit Hyperactivity Disorder are hyperactive. Perhaps as many as two out of three are, but perhaps as few as only 50%. So, that means that as many as 35% to 50% of kids with ADHD are not hyperactive.

So, what is hyperactivity? If you have a child who is hyperactive, you need no explanation. He's the one running across the ceiling. But for the rest of you, this is what hyperactivity in children and teens looks like. These are kids that act as if they are driven by a motor. They "go." You wind them up in the morning and they "go" until they're finally exhausted, and then they go to sleep, maybe. Some of these sleep pretty well during the night, and some of them hardly need sleep at all. Three hours of sleep and they're up and ready to go.

One definition of hyperactivity is "high levels of non-goal directed motor activity." A child with high levels of motor activity that is always directed at a goal may not be clinically hyperactive. He may be a future professional athlete or rocket scientist. It's the kid who bounces from one activity to another, in a manner inappropriate for their age, which is our concern.

Hyperactivity is often thought of as the child being "over aroused." There is a part of your brain that is constantly scanning the environment to see if there are any changes in that environment. If anything has changed, then that part of the brain asks the question, "Is this new thing in the environment good or bad? Is it something good to eat, or is it going to eat me? How should I feel about this new thing? Should I like it, or be afraid or it?" In many ADHD kids who are hyperactive this part of the brain is overly sensitive, and the kids are seen as being easily startled or scared, overreacting to things, touching everything around them, and being very edgy.

They never seem to be able to just relax. Some of these kids also have a very quick temper, a short fuse. They are sometimes explosive. They often lose friends because of their intensity and temper, and they often seem to run over people like a tornado.

But as we have said, a lot of ADHD kids are not hyperactive. And the kids who are not hyperactive tend to be girls, and they tend to sit in the back of the classroom and just quietly get C's and D's when everyone knows they should be getting A's and B's. These kids with ADHD without hyperactivity are the one's being labeled as "lazy" and at the parent conferences the parents are told, "He or she could do better if they'd just try harder."

You can learn more about the different types of ADHD. There are at least five different types of ADHD, and there are specific treatment strategies that should be used for each type. Impulsive children need a different strategy than children who are not impulsive, and hyperactive children need a different strategy than children who are not hyperactive. So be sure to visit the ADHD Information Library's section on the Different Types of ADHD.

Douglas Cowan, Psy.D., is a family therapist who has been working with ADHD children and their families since 1986. He is the clinical director of the ADHD Information Library's family of seven web sites, including http://www.newideas.net, helping over 350,000 parents and teachers learn more about ADHD each year. Dr. Cowan also serves on the Medical Advisory Board of VAXA International of Tampa, FL., is President of the Board of Directors for KAXL 88.3 FM in central California, and is President of NewIdeas.net Incorporated.