Attention Deficit Hyperactivity Disorder (ADHD, ADD)

Attention deficiency hyperactivity disorder (ADHD) is a behavioural disorder which is characterised by symptoms including inattentiveness, restlessness and impulsiveness. Attention deficiency hyperactivity disorder is the most common child-onset behavioural disorder in the UK and it is estimated that between 3% and 9% of schoolchildren are affected by the disorder. In most cases, symptoms develop during early childhood and tend to get worse when children go through changes or upheavals, such as starting school or moving home. ADHD affects the way children behave, think and act and it is often associated with learning difficulties and delayed development.

What causes ADHD?

The exact cause of ADHD is largely unknown. It is difficult to pinpoint single causes and most experts believe a combination of factors contribute to an increased risk of developing ADHD. These factors include:

• Genetic factors: there is evidence to suggest that ADHD runs in families and a child is up to five times more likely to have ADHD if they have a sibling or parent with the disorder.
• Environmental factors: exposure to alcohol, drugs and smoking during pregnancy can increase the risk of a child developing ADHD.
• Neurological factors: research in this area is ongoing but examination of the brain has determined that brain function is different in people with ADHD. There is also evidence to suggest that the neurotransmitters (chemicals that are responsible for sending messages in the brain) do not work properly in people with ADHD.

Other risk factors include:

• Gender: boys are more likely to be diagnosed with ADHD.
• Low birth weight.
• Food allergies and diet.
• Exposure to prolonged episodes of watching television on a regular basis.
• Brain damage during the early years.

Symptoms of ADHD

Symptoms of ADHD are usually classified into two groups; those associated with inattentiveness and those associated with hyperactivity and being impulsive. Most children display symptoms associated with one of three types of ADHD, which include:

• ADHD: predominantly inattentive.
• ADHD predominantly hyperactive and impulsive.
• Combined ADHD.

Children with ADHD usually have problems and difficulties with the following tasks:

• Sitting still for set periods of time.
• Concentrating.
• Waiting their turn.
• Being distracted easily.
• Making simple mistakes.
• Losing interest quickly.
• Difficulty listening.
• Problems sticking with tasks, especially if they take a long time.
• Organising.
• Remembering things.
• Wriggling and fidgeting.
• Talking constantly.
• Interrupting other people.
• Breaking rules.
• Acting without thinking about the consequences.

ADHD is often associated with other behavioural disorders and conditions, which may include:

• Conduct disorder.
• Anxiety disorder.
• Oppositional defiant disorder.
• Depression.
• Tourette’s syndrome.
• Learning difficulties.

How is ADHD diagnosed?

In most cases, the symptoms of ADHD develop before the age of 7 years old, with most children being diagnosed with the condition between the ages of 3 and 7. If you think your child may have ADHD, arrange to see your GP who will ask questions about your child’s symptoms, family and medical history. Your GP may ask when the symptoms started; if there appear to be triggers or things that make symptoms worse and where the symptoms appear (some children develop symptoms when they are at school or other peoples’ houses, for example). Your GP may also ask if the child has undergone any recent traumatic events or changes in their life, such as a divorce or moving school.

If your GP suspects that your child has attention deficiency hyperactivity disorder, they will refer the child for tests. They may also refer your child to a specialist psychiatrist or paediatrician, who will carry out tests to diagnose or rule out ADHD. Tests include:

• A physical examination.
• Concentration and problem solving tests.
• Interviews.
• Reports from teachers and parents.

In order for a diagnosis to be made the following criteria must be satisfied:

• Symptoms have been apparent for at least 6 months.
• Symptoms appear in at least 2 different settings (including school and home, for example).
• Symptoms are interfering with the child’s daily life.
• Symptoms developed before the age of 7.
• Symptoms are not associated with another developmental disorder or a particularly difficult phase in the child’s life.

It is more difficult to diagnose attention deficiency hyperactivity disorder in adults, as there is not a specific list of symptoms. If a GP suspects an adult patient has ADHD they will refer them to a specialist for further tests.

Treating ADHD

There is currently no cure for ADHD but there are treatments that can help to ease symptoms and make life easier for people with the condition. ADHD is usually treated with medication and therapy, and most experts agree that a combination of treatments is most effective.

Medication: three types of medication are used for ADHD, which are called atomoxetine, dexamfetamine and methylphenidate. The type of medication will depend on the age of the patient. Medicine helps children to concentrate better, learn and develop skills and act less impulsively; however, medication is not a long-term cure for ADHD.

Therapy: various therapies are used to treat patients with ADHD and they can also be very beneficial for treating associated disorders. Examples of therapies include:

• Counselling.
• Psychotherapy.
• Behavioural therapy.
• Cognitive behavioural therapy.

There are also programmes available for parents of children with ADHD, in order to help them understand the condition better and learn ways to handle symptoms and help their children.

There are also other things you can try to ease symptoms, such as cutting out certain foods. However, you should always seek medical advice before altering your child’s diet, but some parents find that reducing their child’s intake of sugary foods and foods containing caffeine help to reduce symptoms, especially in children who display symptoms associated with hyperactivity. Regular exercise has been found to be beneficial in children with ADHD. Exercise also helps to reduce the risk of physiological and psychological problems and is a great way for children to have fun, learn important life skills, such as team work and playing by the rules, and meet new friends.