ADHD: What is it?

Attention deficit hyperactivity disorder (ADHD) is a condition that affects a child’s ability to focus and pay attention. Children with ADHD are fidgety and easily distracted. This makes it difficult to concentrate on anything they have been given to do at home or at school. The NHS estimates it affects 3 to 9% of schoolchildren and young people.

ADHD symptoms: Inattention

The main symptom of ADHD is the inability to pay attention. Children may have trouble listening to a person who is speaking, following directions, finishing tasks or keeping track of personal items. They may daydream often and make careless mistakes. Children with ADHD tend to avoid activities that require sustained concentration or that might be boring.

ADHD symptoms: Hyperactivity

Another symptom of ADHD is the inability to sit still. Children may run and climb on things constantly, even when indoors. When they are seated, they tend to squirm, fidget or bounce. Some children with ADHD talk excessively and find it difficult to play quietly.

ADHD symptoms: Impulsiveness

A third symptom is impulsiveness – not waiting for their turn, interrupting others or blurting out answers before the teacher finishes a question. This aspect of ADHD makes it difficult for children to wait for their turn or think before they act.

ADHD's impact on daily life

Without treatment, ADHD can affect a child's development socially and academically. The inability to focus often leads to poor performance at school. Children who interrupt or won't wait for their turn may have trouble making and keeping friends. These setbacks can lead to low self-esteem and risky behaviour. ADHD also increases the risk of childhood depression and anxiety disorders.

Causes of ADHD

Children with ADHD have less activity in areas of the brain that control attention. They may also have imbalances in brain chemicals called neurotransmitters. It's unclear what causes these irregularities, but ADHD runs in families, so many experts believe genetics play a role.

Diagnosing ADHD

There are no laboratory tests to detect ADHD. Instead, doctors rely on the patient's response to questions and tests, the family's description of behaviour problems and a school assessment. With ADHD, a child must display some combination of inattention, hyperactivity and impulsiveness for at least six months to a degree that is abnormal and inconsistent with his or her age. Some of the symptoms need to have appeared before the age of seven.

Types of ADHD

There are three forms of ADHD. Combined type is the most common and applies to children who display inattention, hyperactivity and impulsiveness. In the hyperactive/impulsive type, children are fidgety and can’t control their impulses. Children with the inattentive type, formerly called attention deficit disorder, have trouble focusing. But they are not overly active and usually don’t disrupt the classroom.

Medication for ADHD

Stimulant medication can help increase a child’s attention span while controlling hyperactivity and impulsive behaviour. Studies suggest these drugs work in 70 to 80% of patients, although they have some troubling side effects. Non-stimulant medications are also options for some children. A GP would refer a child to a specialist for a diagnosis and to prescribe any medication.

Counselling for ADHD

Counselling can help a child with ADHD learn to handle frustrations and build self-esteem. It can also provide parents with supportive strategies. A specific type of therapy, called social skills training, can help children improve at taking turns and sharing. Studies show that long-term treatment with a combination of drugs and behavioural therapy is more effective than medication alone.

Special education for ADHD

Most children with ADHD go to the same schools and classrooms as children without the disorder. Any special requirements they have will be arranged and monitored by the school’s Special Educational Needs Co-ordinator (SENCO), a teacher who is specially trained to deal with children with learning disabilities or behavioural disorders.

The role of routine

Parents can give children more structure at home by setting out clear routines. Sticking up a plan for the day will remind your child of what he or she is supposed to be doing at any given time. This can help a child with ADHD stay focused. The schedule should include specific times for waking up, eating, playing, homework, chores, activities and bedtime.

ADHD diets

Studies on ADHD diets have produced mixed results, but some health experts believe food that is good for the brain could reduce symptoms of ADHD. High-protein food, including eggs, meat, beans and nuts, may improve concentration. It may also be helpful to replace simple carbohydrates, like sweets and white bread, with complex carbohydrates, like pears and wholemeal bread. Talk to your GP or specialist before making any dramatic changes to your child’s diet.

ADHD and junk food

While many children bounce off the walls after eating junk food, there is no evidence that sugar is a cause of ADHD. The role of food additives is less certain. Some parents believe preservatives and food colourings worsen their child’s symptoms and the American Academy of Pediatrics says it’s reasonable to avoid these substances. The UK advice is to avoid giving products containing certain colourings (E numbers) to children with ADHD as it can make their behaviour worse.

ADHD and television

The link between television and ADHD is unclear, but the American Academy of Paediatrics suggests limiting young children's exposure. The group discourages TV viewing for children under the age of two and recommends no more than two hours a day for older children. To help your child develop attention skills, encourage activities like games, blocks, puzzles and reading.

Preventing ADHD

There is no certain way to prevent ADHD in children, but there are steps you can take to reduce the risk. You can increase your chance of your child not having ADHD by staying healthy during pregnancy. Start by avoiding alcohol, drugs and tobacco during pregnancy. Children whose mothers smoked during pregnancy are twice as likely to develop ADHD.

Outlook for children with ADHD

With treatment, a large majority of children with ADHD improve. They should continue to undergo regular follow-ups since many children grow out of the disorder as they get older. More than half of patients continue experiencing symptoms once they reach adulthood.

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