Attention Deficit Hyperactivity Disorder (ADHD)
What is attention deficit hyperactivity disorder (ADHD)?
Attention deficit hyperactivity disorder (ADHD) is a common condition diagnosed in children who display symptoms of hyperactivity, inattention and/or impulsivity. Although its causes are not fully understood, factors including genetics and antenatal problems are thought to play a role.
Treatment for the condition will generally involve a team of professionals experienced in child development and ADHD specifically. It may encompass parent-training and the setting of stricter boundaries at home, as well as behavioral therapy and medication. With adequate support, children with ADHD can learn to manage their symptoms effectively.
Symptoms of attention deficit hyperactivity disorder (ADHD)
The symptoms of ADHD may first be recognised by a parent, teacher or caregiver. They can in some cases be difficult to distinguish from age-appropriate energeticness and/or misbehavior.
The core symptoms are persistent hyperactivity, inattention and/or impulsivity. These behaviors should be displayed in more than one setting – for example, at home and at school – and during more than one activity – for example, when doing schoolwork and when going to bed.
To be classed as ADHD, the symptoms must:
- First appear before the age of 12
- Occur in more than one setting
- Occur for at least six months
- Interfere with social, academic and/or occupational activities
- Be unrelated to any other condition or disorder that the child may have
- Hyperactive-impulsive subtype: Hyperactivity and impulsivity commonly occur together in young children with ADHD. This may mean that a child feels the need to move around constantly, talk a lot and may struggle with controlling their impulses.
- Inattention subtype: The main features of this subtype are difficulty paying attention and reduced cognitive ability. This may mean that a child is easily distracted, struggles to take in and follow instructions, and is forgetful. The symptoms of inattention will typically not become apparent until a child is eight or nine years old.
- Combined subtype: Children with this subtype will display features of both the hyperactive and inattention subtypes.
Hyperactivity in children with ADHD tends to fade after the age of eight or nine and may be difficult to detect to outside observers from then on. The adolescent, however, may still experience restlessness or find it difficult to settle down. Symptoms of impulsivity and inattention tend to persist throughout a person's life, although inattention may not be detectable until the age of eight or nine.
Causes of attention deficit hyperactivity disorder (ADHD)
The exact cause of ADHD is not fully understood by medical professionals, though a number of factors are believed to play a role.
- Brain function and structure: Research suggests that there are small differences in the brains of people with ADHD compared with the brains of people without the condition. The significance of this is not yet clear.
- Genetics: Research suggests that a child is more likely to develop ADHD if a close family member, such as a parent or sibling, also has the condition.
- Learning issues: While learning issues do not cause ADHD, children with conditions such as dyslexia, dyscalculia and dysgraphia are more likely to also experience ADHD.
- Antenatal problems: If a mother smokes, drinks alcohol or takes drugs during pregnancy, this may increase the likelihood of the child having ADHD.
- Birth problems: If a child is born with a low birth weight, is deprived of oxygen during birth or experiences any other kind of issue during birth, this may increase their chance of developing ADHD.
One or more of these factors may apply to a child with ADHD. Conversely, none of these factors may apply and there may be no clear cause of the condition.
Diagnosing attention deficit hyperactivity disorder (ADHD)
The diagnosis is usually made by a specialist pediatric doctor with experience in child development. There is no special test for ADHD; instead, a diagnosis will be based on the symptoms displayed and through an observation of the child’s interactions with their parents, siblings and, if possible, teachers and classmates.
Seeking a formal diagnosis is important because it enables families and teachers to coordinate plans for managing behavior and education.
Treatment for attention deficit hyperactivity disorder (ADHD)
The way in which a child with ADHD is treated will depend on the severity of the condition as well as the age of the child. Treatment should be coordinated by a team of professionals, including pediatricians, ADHD specialists and behavioral therapists.
The condition cannot be cured, but it can be effectively managed. The first stage of treatment will usually involve referral to a parent-training programme. The aim of this kind of training is to teach parents ways to manage behavioral problems, to understand the condition more thoroughly and to communicate more effectively with their child. These methods may also need to be taught to teachers and other caregivers, so activities can be tailored to suit the child’s attention span.
Other treatments include cognitive behavioral therapy (CBT), a method of psychological training that can help a child to understand why they act as they do and to come up with strategies to help manage their condition.
All children, including those with ADHD, are recommended to get at least 60 minutes of moderate to vigorous intensity activity per day. Regular physical activity is associated with improved cardiovascular health, mental wellbeing and cognitive performance.
Medication can also be prescribed to help treat ADHD in children over the age of six. Methylphenidate is the most commonly prescribed medication. It works by increasing the amount of dopamine released into the parts of the brain responsible for attention and self-control. A child may need to take medication for a number of years.
Medication is generally prescribed in severe cases of ADHD or in milder cases when other treatment options have not been effective. When used in children, ADHD medications are not thought to have an addictive potential. They can, however, cause side-effects.
Possible side-effects of methylphenidate include:
- A slight increase in blood pressure and heart rate
- Loss of appetite
- Sleeping problems
- Stomach aches
- Mood swings
Other names for attention deficit hyperactivity disorder (ADHD)
- Attention deficit hyperactivity disorder in children
- Hyperkinetic disorder
UpToDate. “Attention deficit hyperactivity disorder in children and adolescents: Clinical features and diagnosis.” February 27, 2018. Accessed July 11, 2018. ↩ ↩
NHS Choices. “Attention deficit hyperactivity disorder (ADHD).” May 30, 2018. Accessed July 11, 2018. ↩
NHS Choices. “Attention deficit hyperactivity disorder (ADHD) - Treatment.” May 30, 2018. Accessed July 17, 2018. ↩