Attention-deficit hyperactivity disorder (ADHD) in children

Childhood ADHD - attention-deficit hyperactivity disorder - is diagnosed after a child has shown six or more specific symptoms of inattentiveness or six or more specific symptoms of  hyperactivity and impulsiveness on a regular basis for more than six months, in more than two settings, and these symptoms began before the age of seven years old and make life considerably more difficult and are not part of a development disorder. There is no single test for ADHD.

A specialist doctor can diagnose ADHD with the help of standard guidelines. The diagnosis of ADHD involves the gathering of information from several sources, including school, carers and parents. The doctor will consider how a child's behaviour compares with that of other children the same age.

ADHD symptoms

The symptoms of ADHD include inattention, hyperactivity, and impulsiveness that are inappropriate for age.

There are three main types of ADHD:

• Combined ADHD, this is the most common type of ADHD and includes all of the symptoms
• Inattentive ADHD, this is marked by impaired attention and concentration
• Hyperactive-impulsive ADHD, this is marked by hyperactivity without inattentiveness

For a formal diagnosis of ADHD, some symptoms that cause impairment must be present before the age of seven and some impairment from the symptoms must be present in more than one setting (such as home and school or home and work).

Symptoms of childhood ADHD

Children with ADHD show signs of inattentiveness, hyperactivity, and impulsiveness in specific ways. These children:

• Are in constant motion
• Squirm and fidget
• Do not seem to listen
• Have difficulty playing quietly
• Often talk excessively
• Interrupt or intrude on others
• Are easily distracted
• Do not finish tasks

Some behaviours can appear to be ADHD-related, but are not. Some causes of ADHD-like behaviour are:

• A sudden life change (such as divorce, a death in the family, or moving)
• Undetected seizures
• Medical disorders affecting brain function
• Anxiety
• Depression

How is ADHD diagnosed?

If there are concerns about a possible diagnosis of ADHD, your child’s GP or teacher can refer him or her to a specialist team for assessment. There are strict criteria that need to be fulfilled before a diagnosis of ADHD can be made. The National Institute of Health and Clinical Excellence (NICE) has published guidelines on diagnosis and treatment of ADHD for the NHS.

It is very difficult to diagnose ADHD in children younger than five years of age. That's because many pre-school children have some ADHD symptoms in various situations. In addition, children change very rapidly during the pre-school years. It is also difficult to diagnose ADHD once a child becomes a teenager.

The process of diagnosing ADHD requires several steps and involves gathering a lot of information from multiple sources. You, your child, your child's school, and other carers should be involved in assessing your child's behaviour.

Diagnosis should only be made by a specialist psychiatrist, paediatrician or other healthcare professional with training and expertise in the diagnosis of ADHD. The specialist will probably ask questions about the child’s medical history and do a clinical examination. They will ask what symptoms a child is showing, how long the symptoms have occurred, and how the behaviour affects a child and his or her family.