A.D.H.D. Contributed by: Dr Sunil Pulpaka. Speciality Registrar Child and Adolescent Psychiatrist.

What is A.D.H.D.?

ADHD is a behavioural disorder which often becomes obvious in early child hood. The behaviours are due to underlying problems of poor attention, hyperactivity and impulsivity.

Many children, especially under-fives, are inattentive and restless. This does not necessarily mean they are suffering from ADHD. The inattention or hyperactivity becomes a problem when they are exaggerated, compared with other children of the same age, and when they affect the child, their school, social and family life.

Fast Facts!

It is reported 2-5% of school age children suffer from ADHD. Boys are more commonly affected than girls, although girls can have it too.

• 1/3 of children continue to have symptoms when they are adults.

• 1/3 can grow out of their condition and do not require any treatment and they can cope and manage by adapting their careers and home life (such as taking jobs that allow them to burn off energy).

• 1/3 can have problems even as adults, requiring ongoing treatment.

What causes it?

We do not know exactly what causes ADHD. Some evidence suggests:

• Genetics – that children with parents who have these features are also more likely to experience them.
• Children who suffer an early traumatic event.

There is no evidence that poor parenting directly causes ADHD. Parents have an important role in supporting a young person however to find better ways to cope through their parenting skills.

What are the symptoms?

ADHD can present differently depending on the age of a young person, and also can present differently in different environments.

Attention problems: These children can appear forgetful, distracted, not seeming to listen, disorganised, takes ages to start doing things and rarely finish it.

Hyperactivity: These children seem restless, fidgety, and full of energy, always ‘on the go’, they seem loud, noisy and disturb others.

Impulsivity: These children do things without thinking. They have difficulty waiting their turn in a queue, games and frequently butt into conversations.

How is it diagnosed?

There is no single, simple, definite test for ADHD. Making a diagnosis requires a specialist assessment, usually done by a child psychiatrist or specialist paediatrician. The diagnosis is made by recognising patterns of behaviour, observing the child, obtaining reports of their behaviour at home and at school. Sometimes a computerised test may be done to aid the diagnosis. Some children also need specialised tests by clinical or educational psychologist.

How is it treated?

Firstly it is very important for the family, teachers, and professionals to understand the child’s condition and how it affects them. Teachers and parents may need to use behavioural management strategies like reward charts. Parents/family may find parent training programmes helpful, especially in managing the defiant behaviours which may arise from their hyperactivity.

At school, children may need specific educational support and plans to help with their daily work in classroom and also homework. They may also need help to build their confidence, develop their social skills. To ensure this is achieved good communication between school, family and other professionals is very important.

Medications can play an important role in managing moderate to severe ADHD. Medications can help to reduce hyperactivity and improve concentration. The improved concentration gives the child the opportunity and time to learn and practise new skills. Children often say that medication helps them to get on with people, to think more clearly, to understand things better and to feel more in control of themselves. Not all children with ADHD will need medication

Case Study

John is an 11 year old who always got into trouble at school and outside. The teacher used to tell him off for not sitting still; He used to walk around and is always wanting to get up from seat. He was easily distracted and found difficult to concentrate and finish his work unlike his peers which affected his self esteem.

Family reported John always had lot of energy, couldn’t take him any where when he was younger as he was noisy, always on the go, wouldn’t follow instructions. They wondered if he has issues with short term memory and always seemed to be getting into trouble most of the time. The noticed that even when he was trying to concentrate on things he enjoyed – such as playing his computer games, he really struggled to stick on task!

John was also described as a very impulsive boy, who would make decisions without really thinking them through – meaning his parents had to keep an extra eye on him as he might place himself in danger without realising it. They also found that whilst he could behave badly at times, he often had not thought through the consequences of his actions first.

Want to know more?

For parents/professionals

ADD/ADHD Behaviour change resource Kit: Ready-to-Use Strategies & Activities for Helping Children with Attention Deficit Disorder, Grad A Flick, Paperback, 1998,Jossey Bass Publishers, Wiley Print.

ADHD Handbook – For Parents and Professionals. Dr Alison Munden and Dr Jon Arcelis. Jessica Kingsley Publishers.1999

For children

Young Minds -Parents’ helpline: 0800 018 2138: for any adult concerned about the emotions and behaviour of a child or young person.

Everything a child needs to know about ADHD (2006), Dr C R Yemula, ADDISS publications, 2007, second edition. For children aged 6-12 years

Putting on the Brakes: Young People’s Guide to Understanding Attention Deficit Hyperactivity Disorder.
For ages 8 – 12 .

Author: Patricia O. Quinn, Judith M. Stern.

If you are worried about yourself or a friend/family member, then you should encourage them to go and see their GP.