What is ADHD and how can you spot the signs in your child? We ask two experts
ADHD is the most common behavioural disorder in children yet it isn't widely understood. Look out for inattentiveness, hyperactivity and impulsiveness both at home and in the classroom, as experts tell Liz Connor
IT'S normal for children to get distracted, forget their homework, get fidgety, or tune out from time to time. But how do you know when inattention and hyperactivity is a sign that something more is going on?
Attention Defecit Hyperactive Disorder (ADHD) is the most common behavioural disorder in children, yet plenty of us are still in the dark about what it really is.
About 5 per cent of children worldwide are diagnosed with ADHD, and if left untreated, the disorder can cause significant mental health problems, issues with work or education, and unnecessary distress and loneliness.
ADHD is something lots of parents worry about, but plenty of successful people with the disorder have gone on to achieve great things – but early diagnosis, say experts, is key to managing it.
What is ADHD?
ADHD is a behavioural disorder characterised by a group of symptoms: inattentiveness, hyperactivity and impulsiveness.
Signs of the disorder tend to be noticed at an early age – usually between six and 12 years – and may become more noticeable when a child's circumstances change, such as starting a new school.
It's believed that ADHD always begins in childhood, so it's likely that if a person is diagnosed later in life, they will have had their symptoms for a long time.
What causes ADHD?
"The exact cause of ADHD isn't known," says Dr Hayley Van Zwanenberg, a child and adolescent psychiatrist from the Priory Group (priorygroup.com), "but it has a large hereditary component."
She explains that a big clue lies in your genes – ADHD often runs in families, and a child who is displaying the symptoms may well have a parent or sibling with ADHD too.
It's primarily a neurodevelopmental disorder, which means certain aspects of brain development are slightly altered in those with ADHD. "There is evidence that some areas of the brain involved in attention and concentration may be less active, or even slightly smaller in children with ADHD than those without," explains Dr Van Zwanenberg.
Further factors scientists believe may increase the risk of ADHD are being born before the 37th week of pregnancy or being a very low birth weight, having epilepsy, or having a brain injury before or following birth.
Am I to blame?
One of the biggest myths about ADHD is that it's a result of 'bad parenting'. "This is simply not the case," says Dr Maite Ferrin, a consultant child psychiatrist from Re:Cognition Health (recognitionhealth.com). "Scientific evidence shows that ADHD is a highly heritable condition, mostly a combination of certain susceptibility genes and environmental risks factors during pregnancy and early childhood."
What are the symptoms to look out for?
The core symptoms are general difficulty in regulating attention, controlling impulses and hyperactivity – but these issues can present themselves in childhood in a number of different ways.
You may find that your child finds it difficult to focus at school and will frequently get bored, move on to new tasks before completing existing ones, or appear like they're not listening.
Sitting still can often be a challenge for children with ADHD, and they may talk excessively, interrupt frequently, or have trouble waiting patiently for their turn. You may also find they struggle to organise themselves, often lose things or forget what they're supposed to be doing. Experiencing these symptoms can, understandably, be frustrating for a child, leading to feelings of upset, anger or irritability.
How is a diagnosis made?
Many children go through stages of restlessness, but if you're concerned, it's worth speaking to your child's teacher to find out whether behavioural issues are also presenting themselves at school.
To be diagnosed with ADHD, your child must have been displaying symptoms since before age 12, and continuously for at least six months. They must also be displaying six or more specific symptoms of inattention or hyperactivity on a regular basis and in at least two settings – such as at home and at school.
It should also be obvious that symptoms can't be chalked up to a developmental disorder or difficult phase. Usually, a diagnosis is made by a child and adolescent psychiatrist or a specially trained paediatrician. The first step should be visiting a GP who can refer you to one of these specialists, either via the NHS or privately.
How can it be treated?
"The first thing to know is that ADHD cannot be cured," says Dr Van Zwanenberg. "Often, symptoms change or reduce as time goes on and both medical and psychological treatments can help your child to control their symptoms.
"The NHS estimates that around one third of children seem to grow out of their disorder during adolescence, but others find their ADHD persists into adult life," she continues. "At times, just giving some strategies to schools and parents to help the young person is enough to make a difference."
ADHD can be treated using medication or therapy, but the NHS recommends that a combination of both is often best. Talking therapies like CBT, psychoeducation and social skills training are particularly useful for helping young people to understand how to alter some of the behaviours related to ADHD.
If you decide to go down the medication route, there are five types licensed for the treatment of ADHD: methylphenidate, dexamfetamine, lisdexamfetamine, atomoxetine and guanfacine. Some need to be taken every day, while some can be taken just on school days.
Much like anti-depressants for mental health issues, medication for ADHD is not a 'cure'. Instead, some young people find taking medication can help to put them back on a level playing field with their peers and allow them to reach their potential in school.
Providing a healthy, balanced diet for your child is important, and some people may notice a link between things like sugar, food colouring, additives and caffeine and worsening ADHD symptoms. Eating sugary sweets or drinking fizzy drinks, for instance, is often blamed for aggravating hyperactivity.
Dr Van Zwanenberg notes that it's always worth speaking to your GP about the options available, so you can discuss the best course of treatment for your child. "If you're concerned about ADHD, it is sensible to have an assessment and receive a diagnosis if it is present," she says, "as understanding and treating it can reduce the likelihood of other difficulties arising as time goes on."