Does having ADHD mean that something is fundamentally wrong with my child’s brain?

ADHD is a biological, brain-based problem, but that’s not the same as saying that something is wrong with your child’s brain. There’s a big difference between damage and dysfunction. Damage causes problems with the “hardware” or the basic brain structures. That’s not what happens in ADHD. Although research data show that some brain structures, particularly the caudate, the corpus callosum (which allows the two hemispheres to “talk” to each other), and the cerebellum may be smaller in children with ADHD, but there is no indication that damage per se is present. In ADHD, the primary problem is with the “software”: the wiring or the connections in the brain. The problem with the connections most likely can be traced to atypical amounts of specific neurotransmitters, either individually or in relation to one another.

One recent imaging study showed that children with ADHD have relative cortical thinning in regions important for attention. Children with persistent ADHD had “fixed” thinning of areas of the frontal cortex, which may compromise the maturation of attentional systems. On the other hand, cortical thickness normalized in children who “outgrow” their ADHD.