Attention Deficit Hyperactivity Disorder - Overview

ADHD is a common behavioural disorder of childhood which often goes undiagnosed and carried into adulthood. Children with ADHD are characteristically impulsive, hyperactive and lack attention. This is to a degree that it interferes with their daily lives. However, this is not something that can't be treated with medications and therapy.

What is ADHD?

ADHD is a common neurodevelopmental disorder typically affecting children. Symptoms may vary, but persistent inattentiveness, hyperactivity and impulsiveness are most common. Nearly 20% of children have some form of ADHD with varying ranges.

ADHD Types

ADHD can be classified into 3 main types:

Primarily Inattentive Presentation

Children present with difficulty in paying attention for longer periods. They have trouble organising tasks and completing them without getting distracted.

Primarily Hyperactive-Impulsive Presentation

Children present with the inability to sit still and have the constant urge to move around. They always feel restless and impulsive, but attention is usually absent.

Combined Presentation

This type of presentation includes both inattentive and hyperactive-impulsive symptoms. It is the most common type of ADHD present in children.

ADHD in Adults

Adult ADHD disorder is a result of undiagnosed ADHD as a child. ADHD in an adult is more challenging as it interferes with normal day-to-day tasks. Adults struggle to focus, organise their tasks or control impulses. This affects their relationships with people at home or work. Decreased functionality usually results in decreased self-worth and quality of life.

Causes of ADHD

What causes ADHD is still a topic of research, as the exact reason is unknown. However, according to research, various factors influence its development.

Genetic Factors

ADHD usually runs in the family. Interestingly, adults get diagnosed with ADHD after they find out their children have it, too. Genes for regulating dopamine (responsible for its development) are often affected. They cause changes in the brain areas for attention and impulse control, leading to ADHD through generations.

Environmental Influences

Toxin exposure (smoking and alcohol) of a child during pregnancy is one of the factors causing ADHD. Preterm babies or underweight babies are more at risk of developing ADHD disorder than normal ones. Family environment and socioeconomic status also play a role in children developing ADHD.

Symptoms of ADHD

Symptoms of Attention Deficit Hyperactivity Disorder differ from patient to patient. The most common ones are discussed below.

Hyperactivity

Children with ADHD are persistently hyperactive. This is a common trait in children, but it can also be a hyperactivity disorder if it interferes with their daily tasks.

Description and Impact

Children are excessively restless, fidgety, and have trouble staying in one place when expected. They may have trouble engaging in quiet activities, talk too much and are seen constantly moving around.

Hyperactivity disorder results in children having difficulty sitting through class. They cannot get along with people, whether at home or school. This impacts their social interactions and ability to make friends.

Managing Hyperactivity

Hyperactivity can be managed by setting routines for the children. Engaging them in regular physical exercises helps take the edge off their restlessness. Reducing distractions also helps them maintain their attention. While medications are available, hyperactivity in children can be managed at home. A friendly and supportive school environment also helps the children.

Inattention

Another characteristic trait of ADHD in children is a lack of attention. Parents often complain of their children daydreaming or zoning out where attention is required. 

Signs and Consequences

Signs of ADHD include frequent distraction, forgetfulness and dislike for sustained mental tasks. Children look disinterested in tasks and underachieve at school. This leads to an inability to make friends and poor self-esteem. Moreover, they find it tough to manage simple daily tasks.

Coping Strategies

To cope with the lack of attention in children, there are various strategies parents can try at home or school. They can use tools such as planners or reminders to stay organised. Splitting a task into smaller parts and creating a routine has been seen to help. Reducing distractions, setting achievable goals, and meditation have helped improve children's attention span.

Impulsivity

Impulsive actions mean the child does careless things without thinking much about the consequences. This is also one of the major signs of ADHD.

Behavioural Traits

Children with ADHD often talk out a turn or interrupt other people's conversations or games persistently. They usually blurt out answers before a question has been completed. Lack of impulse control can make them indulge in risky situations without thinking much.

Interventions

Adopting structured routines, establishing clear expectations and teaching relaxing techniques can improve their impulsiveness. Usually, with the help of parents and teachers, this can be managed effectively at home. But in extreme cases, therapies such as Cognitive-Behavioral Therapy (CBT) or medications can be used.

ADHD Diagnosis

Certain criteria need to be met to diagnose ADHD disorder. The diagnosis will decide how to manage it.

Diagnostic Criteria

Doctors most commonly use the DSM-5 criteria for ADHD diagnosis. The guidelines given by this criteria are as follows:

• The child should have persistent symptoms of hyperactivity, inattention and impulsivity.
• The symptoms must start presenting before the age of 12.
• The symptoms should last at least 6 months.
• Symptoms should significantly affect social and academic functioning.
• Symptoms should appear in multiple settings, such as at home or school.
• A more detailed assessment should rule out other causes of such behaviour.

Process and Tools

Doctors use various tools to diagnose a child with ADHD. Combined assessment by a psychiatrist, a paediatrician and a psychologist is important. The process to diagnose ADHD is as follows:

• Detailed clinical interviews of the child along with his parents.
• Observe the behaviour of the child in different settings like home or school.
• Have the parents or teachers fill out specific questionnaires (ADHD Rating Scale or Vanderbilt Assessment Scale) to help with diagnosis.
• Review medical and family history and carry out physical examinations to rule out other causes.
• Use cognitive tests to test attention span, memory or impulsivity to classify the type of ADHD.

Differential Diagnosis

Symptoms of ADHD can coincide with other disorders as well. Hence, a detailed examination must rule out other causes before diagnosing.

Psychiatric Conditions

• Anxiety disorders
• Conduct disorders
• Oppositional defiant disorder
• Learning disabilities such as dyslexia
• Autism Spectrum Disorder

Medical Conditions

• Thyroid disorders can cause restlessness
• Sleep disorders like insomnia can cause fatigue
• Some seizure disorders can present as ADHD symptoms

ADHD in Children

ADHD presents differently in children than it does in adults. Moreover, if parents provide timely diagnosis and support, their quality of life can improve.

Developmental Impact

ADHD impacts learning capabilities in children as well as their relationships with others. They fail to develop a sound sense of reason due to their impulsivity. This affects their ability to develop meaningful relationships with other people throughout childhood and well into adulthood.

Academic Challenges

Children often fall behind in school due to their short attention spans. They fail to organise tasks and are unable to manage their time. Children face problems in task completion and obeying commands. As a result, they do poorly in academics and have trouble keeping up.

Social and Emotional Aspects

Due to their impulsiveness, children have strained relations with friends at school and home. Due to this, children may get isolated and develop low self-esteem. This hurts the emotional health of the child. They retreat within themselves and push people away.

Parenting Strategies

Parents and teachers must step up to help the children deal with the symptoms. They can help by positive reinforcement to uplift their self-esteem. Set up routines and clear expectations which enable the child to function properly.

Communicate with teachers and doctors to determine what works best for your child. The support of parents and educators is extremely important in managing ADHD.

Supportive Techniques

ADHD is manageable with interventions which help with the functionality of the child. Visual aids and reminders can help with forgetfulness. Frequent breaks and smaller tasks can help with hyperactivity.

Therapies can develop better decision-making abilities in children. It is important to encourage physical activities and maintain a peaceful environment. All that, along with open communication, can help manage symptoms and develop positive behaviour.

ADHD Treatment Options

ADHD treatment consists of behavioural therapy and medications.

Medications

Doctors consider children's unique requirements and their response to treatment. They help reduce bouts of hyperactivity and impulsiveness. They also help improve children's attention span if conventional methods are not working.

Types and Effects

There are 2 main types of medications commonly prescribed for ADHD. They are:

Stimulants (Methylphenidate, Amphetamine derivatives)

These boost the activity of neurotransmitters like dopamine and norepinephrine. They enhance concentration and decrease hyperactivity.

Non-stimulants (Atomoxetine, Guanfacine)

They regulate the effect of neurotransmitters. These help improve attention and impulse control.

Side-Effects

Medications used for the treatment of ADHD don't come without side effects. Some common possible side effects include:

• Weight loss
• Mood swings or irritability
• Fatigue
• Lightheadedness
• Upset stomach

Behavioural Therapies

Aside from medications, ADHD in children can be managed by behavioural therapies. 

Cognitive Behavioral Therapy (CBT)

For ADHD, CBT involves identifying and changing negative thoughts and behaviours. It equips children with coping skills, organisation techniques and problem-solving strategies. This helps boost their concentration and practice restraint. In addition to managing ADHD symptoms effectively, CBT assists children and adults in enhancing their overall functioning.

Consult an Attention Deficit Hyperactivity Disorder expert now.

If you think that you or your child may be suffering from ADHD, then consult an Attention Deficit Hyperactivity Disorder expert now.