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Attention deficit hyperactivity disorder ( ADHD) is a neurobehavioural disorder that, according to the NHS, affects about 3%-9% of British schoolchildren and young people. The prevalence is greater among boys. There are several types of ADHD: predominantly inattentive, predominantly hyperactive-impulsive, and a combination of the two. ADHD is usually diagnosed in childhood, although the condition can continue into adulthood.

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Some of the warning signs include failure to listen to instructions, inability to organise oneself and school work, fidgeting, talking too much, leaving projects, chores and homework unfinished, and having trouble paying attention to details.

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There is little compelling evidence that ADHD can arise purely from social or parenting factors. Most substantiated causes appear to fall in the realm of neurobiology and genetics. Causes include:

Environmental: studies have shown a possible correlation between the use of cigarettes and alcohol during pregnancy and ADHD in the offspring of that pregnancy. Another possible environmental cause is high levels of lead in the bodies of preschool children.

Genetics: attention disorders often run in families. Studies indicate that 25% of the close relatives of ADHD children also have ADHD, whereas the rate is about 5% in the general population.

Food additives and sugar: it has been suggested that refined sugar or food additives cause or exacerbate attention disorders. In 1982 the National Institutes of Health, a US government agency, found that diet restrictions helped about 5% of children with ADHD, mostly young children who had food allergies. A more recent study on the effect of sugar on children, using sugar one day and a sugar substitute on alternate days, without parents, staff or children knowing which substance was being used, showed no significant effects of the sugar on behaviour or learning.

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A professional with training in ADHD should make the diagnosis.

The symptoms of ADHD in children and adolescents are well defined. The NHS details the main symptoms of each behavioural problem below:

Inattentiveness

• a very short attention span
• being very easily distracted
• being unable to stick at tasks that are tedious, or time consuming
• being unable to listen to, or carry out, instructions
• being unable to concentrate
• constantly changing activity, or task

Hyperactivity

• being unable to sit still, especially in calm or quiet surroundings
• constantly fidgeting
• being unable to settle to tasks
• excessive physical movement

Impulsiveness

• being unable to wait for a turn
• acting without thinking
• breaking any set rules
• little or no sense of danger

If your child has ADHD, their symptoms will usually become noticeable at around the age of five.

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A significant number of children with ADHD referred to clinics have other behaviour disorders. The NHS details the main ones as:

Anxiety disorder, which causes them to worry much of the time.

Oppositional defiant disorder (ODD), negative and disruptive behaviour, particularly towards authority figures.

Conduct disorder, a tendency towards highly antisocial behaviour, such as stealing, fighting, vandalism and harming people and animals. If your child is behaving in this way, you should seek professional help as soon as possible.

Depression

Sleep problems

Epilepsy

Tourette’s syndrome, a condition of the central nervous system that causes involuntary movements and sounds.

Learning difficulties, such as dyslexia. Up to 35% of children with ADHD also have learning difficulties. However, it is important to remember that ADHD has no effect on intelligence.

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Exactly how ADHD contributes to social problems is not fully understood. Several studies have found that children with predominantly inattentive ADHD may be perceived as shy or withdrawn by their peers. Research indicates that aggressive behaviour in children with symptoms of impulsivity/hyperactivity may play a significant role in peer rejection. In addition, children with ADHD and other disorders appear to face greater difficulties in their relationships with peers.

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Children and adolescents with ADHD can have more frequent and severe injuries than their peers. They are significantly more likely to be injured as pedestrians or while riding a bicycle, to receive head injuries, to injure more than one part of the body, and to be hospitalised for accidental poisoning. Children with ADHD are more likely than other children to be admitted to an intensive care unit or to have an injury that results in disability.

Adolescents with ADHD are more likely to get involved in risky behaviour, such as drug use.

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The usual course of treatment may include medications such as methylphenidate a  stimulant that paradoxically decreases  impulsivity and hyperactivity and increases  attention. It is thought to work by adding extra stimulus, which prompts the natural calming-down mechanisms to kick in. Most experts agree that treatment for ADHD should address multiple aspects of the individual’s functioning and should not be limited to the use of medications alone.

Treatment should include structured classroom management, parent education (to address discipline and limit-setting), and tutoring and/or behavioural therapy for the child.