ADHD, Hyperactive/Impulsive Type: Symptoms, Screening & Treatment

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Some children can’t “sit still”; they jump from one chair to another and interrupt before instructions are ended. But as they grow up, their outward activities lessen, but this restlessness functions from inside in ways like interrupting conversations, making instant choices without checking consequences, and more.
These behaviors and urges deeply disturb home, school, or work, and what you’re experiencing may be the hyperactive/impulsive presentation of ADHD.
In this read, we’ll help you understand the ADHD hyperactivity/impulsivity type (in children, teens, and adults) and how clinicians test and diagnose it with evidence-based ADHD treatment options that help control restlessness and impulsivity.

What “Hyperactive/Impulsive” Means

The hyperactivity/impulsivity of ADHD appears when a person shows constant movement, like fidgeting, with impulsive symptoms like interrupting, acting before thinking, and more.
As a person grows, the obvious movement like running/climbing usually fades, but symptoms like restlessness, interrupting, and quick decision-making often persist.

Hyperactive vs. Inattentive ADHD

The table below shows the main differences between the ADHD hyperactive/impulsive type and the ADHD inattentive type.
Feature Hyperactive/Impulsive (HI) Inattentive (I)
Core pattern Extra movement and talking with low impulse control Distractibility and low sustained attention
Common in children Leaves seat, runs/climbs, interrupts Loses things, careless mistakes
Common in adults Restless in meetings, talks over others, quick decisions Disorganized, misses details/deadlines
When it’s noticed Early childhood (behaviors are visible) Later (quieter, less disruptive)
Can it shift over time? Outward hyperactivity often decreases with age Yes, mix can change; some develop ADHD combined type features

Symptoms, Hyperactive/Impulsive ADHD

There is not a single test that can solely diagnose hyperactive-impulsive ADHD in your child. A mental health provider will rule out any other things or related disorders that can cause hyperactivity and impulsivity. The exhibited behavior might be normal for your child’s age, or it could be a reaction to emotional issues or stress.

Keep in mind that for ADHD, symptoms should be extreme and occur for at least 6 months. Plus, hyperactivity doesn’t always mean physical symptoms; it can be in the form of mental hyperactivity, such as impulsive speech/decisions or racing thoughts.

Symptoms Ladder

Children (preschool/early school)

  • Frequently leaves the seat
  • Runs/climbs excessively (e.g., on furniture)
  • Hard to sit for meals or stories
  • Fidgets/squirms
  • Talks a lot
  • Grabs or interrupts
  • Trouble waiting turn

Middle childhood (later primary → preteen)

  • Often talking/interrupting
  • “butts into” games or conversations
  • Cannot sit still at mealtimes
  • Fidgets even during TV/quiet tasks
  • Disruptive noise-making
  • Grabs objects
  • Chores left incomplete

Adolescence

  • Restless and fidgety during quiet activities/classes
  • Interrupts and annoys others
  • Gets into trouble more frequently
  • Hyperactive signs may lessen, but restlessness persists
Adults
  • Ongoing restlessness
  • Difficulty remaining seated in meetings or events
  • Interrupts in conversations/meetings
  • Acts quickly without full consideration
  • Talks excessively
  • Rackless driving

Symptoms in Women

ADHD in women is more inattentive (emotional dysregulation and internal restlessness) than hyperactive. This is one of the reasons it is often overlooked in women.
ADHD, Hyperactive/Impulsive Type: Symptoms, Screening & Treatment

What Causes Hyperactive-Impulsive ADHD?

The hyperactive-impulsive ADHD does not have a separate cause from its other types. As ADHD is a neurodevelopmental condition, it is strongly related to genetic contribution, with additional factors like early-life risk factors. There is not a single test that identifies the cause of ADHD.

What the Best Evidence Shows

  • Genetics has a major role. If your parents or siblings have ADHD, you are at greater risk. Studies show that about 74% of the overall risk is due to genetics.
  • A 2025 review of 55 studies (4.0 million people) found that smoking during pregnancy raises the risk of ADHD in children by 1.5×.
  • Being born very preterm (before 32 weeks of pregnancy) or with very low birth weight also increases the risk of ADHD.
  • Studies observed that lead (heavy metal) exposure significantly enhances the risk of ADHD.
  • Significant head injury and alcohol use during pregnancy might be additional risk factors for ADHD, but they do not directly guarantee ADHD. During evaluation, clinicians screen for these signs and risks.

Testing & Diagnosis of ADHD, Hyperactive/Impulsive Type

There isn’t a lab test, brain scan, or any kind of computerized task or quiz that can single-handedly diagnose ADHD. It can only be diagnosed by clinicians after a multi-step evaluation.
They begin with a medical history, followed by collateral reports (information from family, teachers, and others), and then proceed to standardized rating scales, as per AAP guidance.

DSM-5 Criteria

Children up to 16 should show 6 or more symptoms of inattention or hyperactivity/impulsivity. For those aged 17 and older, there should be 5  or more symptoms.
  • Symptoms should start before the age of 12.
  • They should be present in more than one setting (e.g., home, school/work, with friends/relatives).
  • The symptoms should clearly interfere with or reduce the quality of social, school, or work functioning.
  • There should be no other medical condition responsible for the symptoms.

ADHD Hyperactive “Tests”—What They Can & Can’t Do

Tool What It Does What It Doesn’t Do
Rating scales (Vanderbilt, Conners, SNAP-IV) Measure ADHD symptoms like inattention and hyperactivity through teacher, parent, or self-reports. Help with clinical assessment, and do not diagnose ADHD by themselves.
Adult Screener (ASRS v1.1, 6-item) Screens adults for ADHD traits based on everyday attention and impulse patterns. It cannot confirm ADHD, nor can it rule out other conditions on its own.
Structured diagnostic interview (e.g., DIVA-5) Clinician-led interview confirming ADHD using real-life examples from childhood and adulthood. Does not replace the clinician’s judgment about other similar medical conditions.
Neuropsychological testing Assesses focus, memory, and executive function to understand how ADHD impacts thinking and behavior. Not required for diagnosis, and can’t diagnose ADHD all by itself.
Labs/brain imaging Help rule out medical or neurological conditions that may mimic ADHD symptoms. Used only to rule out other conditions, not to diagnose ADHD.
ADHD, Hyperactive/Impulsive Type

ADHD Hyperactive Type in ICD-10 (F90.1)

F90.1 is the ICD-10-CM diagnosis code for ADHD, hyperactive/impulsive type, as per DSM-5 criteria.

Closely related ADHD codes (for orientation):

  • F90.0 – Predominantly inattentive type
  • F90.2 – Combined type
  • F90.9 – Unspecified ADHD

Treatment Options for Hyperactivity/Impulsivity Type

Diagnosing what type of ADHD is important for treatment. Every child’s treatment plan can be different. The mental health professionals of AZZ deliver all options, combining therapy, medication, and lifestyle changes so that your child can effectively manage symptoms.

Medications - Children and Teens (age 5+)

Selection and dosage follow the clinician’s judgment of your mental health provider.

Stimulants

Don’t get confused by the name because here, stimulants work to calm someone with ADHD.
  • Methylphenidate (IR/ER)
  • Dexmethylphenidate
  • Lisdexamfetamine
  • Dexamfetamine
  • Mixed amphetamine salts (e.g., Adderall IR/ER)
(This is not clinical advice; consult your provider before making any medication-related decision.)

Non-stimulants

When a stimulant isn’t suitable (due to side-effect concerns, medical contraindications, and more), non-stimulants are used. Some people prefer non-controlled substances due to a history of misuse risk.
  • Atomoxetine
  • Guanfacine ER
  • Clonidine ER
(This is not clinical advice; consult your provider before making any medication-related decision.)

Medications - Adults

Stimulants

  • Lisdexamfetamine
  • Methylphenidate (IR/ER)
  • Dexamfetamine
  • Mixed amphetamine salts (e.g., Adderall IR/ER)
Non-stimulants
  • Atomoxetine
  • Viloxazine ER (Qelbree)
  • Guanfacine ER
(This is not clinical advice; consult your provider before making any medication-related decision.)

Skills (For Children and Teens)

As a parent, pick the routine you want to fix first, like homework time or bedtime. Set one clear rule and praise the moment your child follows it. Use a small and predictable reward for effort and completion of tasks, and keep brief and consistent consequences when the rule isn’t followed. Keep the routine the same each day so your child knows what to expect. Over time, they will learn how to control their actions.

Cognitive-Behavioral Therapy for Adults

CBT is the gold standard of talk therapies. It teaches you ways to change your negative thoughts and behavior into positive ones.

A trained therapist teaches practical skills to plan the week and help break tasks into steps. You do one thing for about 25 minutes, then take a short break, and learn to pause for a few seconds before speaking or acting. It changes negative thoughts into positive ones and helps delay impulsive actions.

Driving & Safety

People with ADHD are at higher risk of car crashes, mainly due to inattention and impulsive actions. Make this part of care:
  • Includes driving hours or other safety-critical tasks.
  • Make sure you use a seatbelt and don’t use your phone.
  • For jobs with machinery or heights, have written checklists and schedule breaks on your side.
  • After a near miss or any unfortunate collision, review what the symptoms were and change your current plan according to them.

Why Choose AZZ Medical Associates

The board-certified psychiatrists and psychologists of AZZ Medical Associates understand that hyperactivity and impulsivity affect how you live and function in life. That is why we build a treatment plan that is actually around your symptoms.

Patients across New Jersey trust us because:

  • Accept all insurance
  • Same-day appointments
  • Walk-in appointments
  • HIPAA-compliant telepsychiatry
  • Board-certified psychiatrists
  • 21+ convenient locations in NJ
  • Behavioral therapy for children
  • Cognitive-behavioral therapy for adults
  • Personalized treatment plans

Takeaways

Hyperactive/impulsive ADHD might make you feel like you can never control impulsive thoughts/actions or restlessness. Treatment is possible, and early diagnosis is key because it helps your clinician understand how your symptoms are evolving, which helps them create the best treatment plan.
The able mental health professionals of AZZ Medical Associates make it easier for you to manage ADHD. Our online psychiatrists, psychologists, and therapists are experts in recognizing what type of ADHD you’re struggling with. As we understand your symptoms and the type you have, we create a treatment plan accordingly.

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David M Bresch, MD

Psychiatrist

Dr. David Bresch has expertise in neuropsychiatry and sleep medicine. His research includes work in autism, neurology/neuroscience, insomnia in prison, and neuropsychopharmacology. He is a member of the American Psychiatric Association and also certified by the United Council for Neurologic Subspecialties and the American Board of Sleep Medicine.

Abdulrahman Virk

Senior Content Editor

Abdulrahman Virk is a medical writer and editor with 7+ years of experience creating evidence-based healthcare content. He has collaborated with international Medical organizations, including GE Health, Teladoc Health, and more. Producing clear, accurate, and patient-focused materials.