What is ADHD?
Attention deficit hyperactivity disorder is a genetically determined condition that affects those parts of the brain that control attention, impulses and concentration. It is thought to affect 3 to 7% of school age children. The best description for ADHD is that a child who suffers from this condition shows disruptive behaviors which cannot be explained by any other psychiatric condition and are not in keeping with those of the same-aged people with similar intelligence and development. These behaviors are usually first noticed in early childhood, and they are more extreme than simple “misbehaving”. Children with ADHD have difficulty focusing their attention to complete a specific task. Additionally they can be hyperactive and impulsive and can suffer from mood swings and “social clumsiness”.
When does ADHD develop?
ADHD develops in childhood and is most commonly noticed at the age of 5. Research suggests that 80% of children diagnosed with ADHD continue to experience symptoms during adolescence and 67% continue to have symptoms into adulthood.
What are the symptoms?
ADHD covers a broad range of symptoms. But there are three common themes.
Attention difficulties
Poor concentration and poor working memory. They will often be very forgetful, easily distracted and are usually disorganized. They have difficulty settling down and appear to get bored very easily.
Hyperactivity
Overactive and restless behaviour, including fidgeting or moving about. They may also be noisy and talkative.
Impulsiveness
Acting before thinking, often interrupting conversations, talking out of turn and intruding on others. They will have difficulty waiting or taking their turn in group situations.
Does every person with ADHD have the same symptoms?
The symptoms of ADHD (impulsivity, hyperactivity and inattention) are not seen to the same degree in all people diagnosed with this condition.
As a result, clinicians recognize three types of people with ADHD: –
The mostly (predominantly) hyperactive-impulsive type.
The mostly (predominantly) inattentive type.
The combined type (which make up the majority of ADHD cases.)
Is there a different effect on boys and girls?
ADHD is more commonly diagnosed in boys than girls. This may be because boys with ADHD tend to be more hyperactive and disruptive. Girls can have ADHD but many have predominantly inattentive type and can often appear to be in a world of their own. Their symptoms may not be noticed because they don’t disrupt the class; however, their problems can lead to academic and social failure.
What causes ADHD?
ADHD has multiple causes. However the evidence so far shows that it is not caused by poor parenting, rather, it is caused by a complicated combination of factors. These factors include changes in those parts of the brain which control impulses and concentration (neurobiological factors) and genetic, inherited and environmental factors. Other research has suggested that in a small percentage of cases, ADHD can be due to injury (during development) to specific regions of the brain. For example, use of alcohol or tobacco during pregnancy, premature delivery with associated minor brain bleeding or accidental head injury after birth, could all cause ADHD-like symptoms. ADHD is not associated with purely social factors such as poor parenting (child management), family stress, divorce, excessive TV viewing or video game playing, or diet, although some of these factors can exacerbate a pre-existing condition.
Is ADHD genetic?
ADHD has a significant genetic component: most differences in severity of symptoms are due to genetic factors. For example, if a family has one ADHD child, there is a 30-40% chance that another brother/sister will also have the condition and a 45% chance (or greater) that at least one parent has the condition1. If the child with ADHD has an identical twin, the likelihood that the twin will also have the disorder is about 90%.
Is it definitely ADHD?
It’s easy to confuse ADHD with normal child development and other conditions. As there isn’t simple test for the condition, the child neurologist will have taken considerable care before diagnosing your child with ADHD.
With ADHD, children may also have other problems such as dyslexia, dyspraxia, Asperger’s syndrome and compulsive or defiant behaviour.
What treatments are typically recommended for ADHD?
There are typically four steps in the management of ADHD: –
Proper diagnostic evaluation by a Paediatric Neurologist or an experienced developmental Paediatrician
Information provided for parents and teachers.
Discussions between healthcare professional and parents and teachers on behavioural therapy and educational support (such as special educational services).
Medication – atomoxetine and methylphenidate.
Most experts agree that the most effective way to treat ADHD is with several complimentary approaches. An effective treatment plan will involve a combination of treatments such as psychiatry, psychology, appropriate educational interventions, behavioural therapy and medication. Depending on the needs of the individual child, a combination of medical, teaching and behavioural support can help the child to reach his/her full potential and live as normal a life as possible, having meaningful relationships and reducing family stress.
What shall I do if I think my child or somebody I know has ADHD?
There is no specific test for ADHD but it is important that a Paediatric neurologist makes a diagnostic evaluation. If you suspect that your child or a child you know has ADHD you may wish to alert their parent or teacher, so that s/he can be referred early and so that the condition can be identified. This will enable treatment (whether behavioural, psychological or medication) to be started, to help the child to achieve their full potential.
Who can diagnose ADHD?
ADHD is diagnosed usually by a child neurologist or a child psychiatrist or pediatrician. However a team of people may be involved in the steps to diagnosis and decisions regarding therapy.
These people can include: –
Pediatric neurologist
Child psychiatrist
Child psychologist
Pediatrician
Specialists in speech and language, auditory processing, occupational therapy etc
Teacher
How do children with ADHD develop?
Children with ADHD can be intelligent and creative. Many overcome their disability and lead successful lives. The problems may ease with time, but ADHD can last into adulthood. Coming to terms with and understanding ADHD often make it easier to deal with.
Myths and Facts about ADHD
Myth:
Children naturally outgrow ADHD.
Fact:
In some children, the overactive behavior of ADHD decreases during the teen years. But inattention often becomes more challenging during early high school years when students must organize homework assignments and complete complex projects. Some children do not experience any symptoms of ADHD in adulthood, while some experience fewer symptoms. Others have no change in their symptoms from childhood to adulthood.
Myth:
ADHD is caused by too much white sugar, preservatives, and other artificial food additives. Removing these things from a child’s diet can cure the disorder.
Fact:
Studies have shown that very few children with ADHD are helped by special diets. Most of the children who do respond to diets are very young or have food allergies. Sugar and food additives have been ruled out as causes for ADHD.
Myth:
Poor parenting is responsible for ADHD behaviors in children.
Fact:
ADHD is a physical disorder caused by differences in how the child’s brain works. Anxiety-producing factors, such as family conflicts or disruptions, can aggravate the disorder, but they do not cause it.
Common Myths about ADHD Stimulant Medications
Myth:
Children treated with stimulant medications will become addicted or will be more likely to abuse other drugs.
Fact:
Stimulant medications are not addictive when used as directed. Studies have shown adequate treatment of ADHD may reduce the risk of substance abuse.
Myth:
Children must be taken off stimulant medications by the time they become teenagers.
Fact:
About 80% of children who need medications will need them as teenagers.
Myth:
Stimulant medications stunt growth.
Fact:
While stimulant medications may cause an initial, mild slowing of growth, this effect is temporary. Children treated with ADHD stimulant medications ultimately reach their normal height.
Myth:
Children build up a tolerance to stimulant medication. They end up needing more and more of it.
Fact:
While your child’s medication may need to be adjusted occasionally, there’s no evidence that children become tolerant to medication or require more of it to be effective.
“Every Child deserves the chance to make the most of the school day”
Useful Links:
http://en.wikipedia.org/wiki/Attention_deficit_hyperactivity_disorder
http://www.nhs.uk/Conditions/Attention-deficit-hyperactivity-disorder/Pages/Introduction.aspx