Attention Deficit Hyperactivity Disorder (ADHD)

NB: Information presented here is only for educational purposes. While the information is accurate and up to date, it should NOT be used for self-diagnosis; only a trained psychiatrist is able to offer a mental illness diagnosis.

What is ADHD?

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common mental disorders affecting children. ADHD also affects many adults. Symptoms of ADHD include inattention (not being able to keep focus), hyperactivity (excess movement that is not fitting to the setting) and impulsivity (hasty acts that occur in the moment without thought).

Symptoms of ADHD

The symptoms of attention deficit hyperactivity disorder (ADHD) can be categorized into 2 types of behavioral problems: inattentiveness, and hyperactivity and impulsiveness.Most people with ADHD have problems that fall into both these categories, but this is not always the case.For example, some people with the condition may have problems with inattentiveness, but not with hyperactivity or impulsiveness.

 

Inattentiveness

The main signs of inattentiveness are:

  1.  having a short attention span and being easily distracted
  2.  making careless mistakes – for example, in schoolwork
  3.  appearing forgetful or losing things
  4.  being unable to stick to tasks that are tedious or time-consuming
  5.  appearing to be unable to listen to or carry out instructions
  6.  constantly changing activity or task
  7. having difficulty organizing tasks

Hyperactivity and impulsiveness

The main signs of hyperactivity and impulsiveness are:

  1.  being unable to sit still, especially in calm or quiet surroundings
  2.  constantly fidgeting
  3.  being unable to concentrate on tasks
  4.  excessive physical movement
  5.  excessive talking
  6.  being unable to wait their turn
  7.  acting without thinking
  8.  interrupting conversations
  9.  little or no sense of danger

 

Causes & Diagnosis of ADHD:

Causes

Scientists have not yet identified the specific causes of ADHD. There is evidence that genetics contribute to ADHD. For example, three out of four children with ADHD have a relative with the disorder. Other factors that may contribute to the development of ADHD include being born prematurely, brain injury and the mother smoking, using alcohol or having extreme stress during pregnancy.

Diagnosing ADHD in children

If you are concerned about your child, see your doctor. They can refer your child to a doctor who specializes in child and youth health (a pediatrician), a child psychologist or a child psychiatrist, who can assess your child.

There is no test for ADHD. A specialist can only diagnose ADHD after making a detailed assessment. They need to collect a range of information about the child –especially from parents or caregivers and the child's school. For ADHD to be diagnosed, the symptoms of ADHD must be obvious in most areas of the child’s life.

The assessment can include a history of the child’s behaviors, any trauma or illness they have experienced, and their relationships and family. 

Doctors and psychologists use a variety of tools, scales and criteria when diagnosing ADHD.

The above mentioned symptoms may suggest ADHD in children.

Diagnosing ADHD in Adults

It is not easy for a health care professional to diagnose ADHD in an adult. Sometimes, an adult will recognize the symptoms of ADHD in themselves when their child is diagnosed. Other times, they will seek professional help for themselves and find that their depression, anxiety, or other symptoms are related to ADHD.

In addition to symptoms of inattention and impulsiveness, adults with ADHD may have other problems, including:

  1.  Chronic lateness and forgetfulness
  2. Anxiety
  3. Poor organizational skills
  4. Low self-esteem
  5. Employment problems
  6. Short temper
  7. Hard time finishing a task
  8. Unthinking and immediate response; hard time controlling behavior
  9.  Restlessness

If these difficulties are not managed appropriately, they can cause emotional, social, occupational and academic problems in adults.

In order to be diagnosed with ADHD, an adult must have persistent, current symptoms that date to childhood. ADHD symptoms continue as problems into adulthood for up to half of children with ADHD. For an accurate diagnosis, the following are recommended:

  1.  A history of the adult's behavior as a child
  2.  An interview with the adult's life partner, parent, close friend, or other close associate
  3.  A thorough physical exam that may include neurological testing
  4.  Psychological testing

 

Treatment of ADHD

Types of treatment for ADHD include:

  1. Behavior therapy, including training for parents; and
  2. Medications

Treatment recommendations for ADHD

For children with ADHD younger than 6 years of age, professionals recommend parent training in behavior management as the first line of treatment, before medication is tried. For children 6 years of age and older, the recommendations include medication and behavior therapy together — parent training in behavior management for children up to age 12 and other types of behavior therapy and training for adolescents.  Schools can be part of the treatment as well. Other recommendations also include adding behavioral classroom intervention and school support. 

Good treatment plans will include close monitoring of whether and how much the treatment helps the child’s behavior, as well as making changes as needed along the way.

Medications

Medication can help children manage their ADHD symptoms in their everyday life and can help them control the behaviors that cause difficulties with family, friends, and at school.

Several different types of medications are approved to treat ADHD in children as young as 6 years of age:

  1. Stimulants are the best-known and most widely used ADHD medications. Between 70-80% of children with ADHD have fewer ADHD symptoms when taking these fast-acting medications.
  2.  Non-stimulants were approved for the treatment of ADHD in 2003. They do not work as quickly as stimulants, but their effect can last up to 24 hours.

Medications can affect children differently and can have side effects such as decreased appetite or sleep problems. One child may respond well to one medication, but not to another.

ADHD in Adults

ADHD lasts into adulthood for at least one-third of children with ADHD. Treatments for adults can include medication, psychotherapy, education or training, or a combination of treatments.

How can I help a child or adult with ADHD?

  1.   Create a routine. Try to follow the same schedule every day, from wake-up time to bedtime.
  2.  Get organized. Encourage your child to put school bags, clothing, and toys in the same place every day so that they will be less likely to lose them.
  3.  Manage distractions. Turn off the TV, limit noise, and provide a clean workspace when your child is doing homework. Some children with ADHD learn well if they are moving or listening to background music. Watch your child and see what works.
  4.  Limit choices. To help your child not feel overwhelmed or overstimulated, offer choices with only a few options. For example, have them choose between this outfit or that one, this meal or that one, or this toy or that one.
  5.  Be clear and specific when you talk with your child. Let your child know you are listening by describing what you heard them say. Use clear, brief directions when they need to do something.
  6.  Help your child plan. Break down complicated tasks into simpler, shorter steps. For long tasks, starting early and taking breaks may help limit stress.
  7.  Use goals and praise or other rewards. Use a chart to list goals and track positive behaviors, then let your child know they have done well by telling them or by rewarding their efforts in other ways. Be sure the goals are realistic—small steps are important!
  8.  Discipline effectively. Instead of scolding, yelling, or spanking, use effective directions, time-outs or removal of privileges as consequences for inappropriate behavior.
  9.  Create positive opportunities. Children with ADHD may find certain situations stressful. Finding out and encouraging what your child does well—whether it’s school, sports, art, music, or play—can help create positive experiences.
  10.  Provide a healthy lifestyle. Nutritious food, lots of physical activity, and sufficient sleep are important; they can help keep ADHD symptoms from getting worse.

 

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