ADHD: Beyond Bad Behaviour

ADHD is more than just ‘bad behaviour’, although confusion over symptoms of the disorder means that it often goes undetected. The following advice will help you spot the telltale signs and get treatment for your son or daughter.

Attention deficit hyperactivity disorder (ADHD) is the most common behavioural disorder in the UK, and estimates suggest that it affects between two and five percent of children and young people. While there is no cure for ADHD, you can help your child manage the symptoms with appropriate educational support, advice and in some cases, medication.

How can I identify the telltale signs of ADHD?

ADHD is often hard to detect, which is why your doctor will ask you to pay close attention to your child’s behaviour for approximately 10 weeks during the early stages of diagnosis. During this ‘watchful stage’ you will observe whether or not the symptoms improve, stay the same or worsen.  If there is no improvement then the GP will suggest going to a specialist for a formal assessment.  ‘The key to diagnosis is identifying that the child is showing enough significant differences from their peers,’ says Val Harpin, an NHS Consultant Paediatrician. ‘The difficulty is the jigsaw of putting the pieces together. Specialists have to consider factors such as genetics, social circumstances and birth information, putting this together with the actual symptoms displayed. It is a complex process, but where it is done properly, a diagnosis can become clear.’ 

What are the symptoms of ADHD?

ADHD can be separated into two distinct subtypes, depending on  the symptoms displayed:

•  ADHD inattentive short attention span, making careless mistakes, being forgetful or losing things, inability to concentrate or persevere with tasks deemed tedious or time consuming, inability to listen to or carry out instructions, constantly changing activity or task, difficulty organising tasks or struggling to settle.

• ADHD hyperactive and impulsive Inability to sit still, constantly fidgeting, excessive physical movement and talking, acting without thinking, interrupting conversations or having little or no sense of danger.

Most people with ADHD fall into both categories, however this is not always the case. For example, people only displaying signs of ADHD inattentive are known to have a form of ADHD known as attention deficit disorder (ADD), which can be harder to diagnose.

What is the cause?

The cause of ADHD combines hereditary and environmental factors and it is recognised that a child is four or five times more likely to suffer from the condition if the parents are also diagnosed. ‘ADHD is a very genetic condition,’ says Harpin. ‘It’s not a straightforward genetic condition such as eye colour—but it does run in families and there are many genes involved.’ Environmental risk factors for the disorder range from smoking, drug and alcohol abuse during pregnancy, to excessive exposure to television and being born prematurely.

What treatment is available?

The most common treatments for ADHD are medications such as methylphenidate, dexamfetamine and atomoxetine. These don’t provide a cure, however they do reduce your child’s difficulties by providing relief from symptoms. They help sufferers to calm down, manage their emotions more easily, minimise aggression and hyperactivity and improve their performance in school. Another popular treatment, effective if provided alongside medication, is therapy. Therapies including psychoeducation and cognitive behavioural therapy (CBT) have proved useful in treating symptoms related to ADHD, such as anxiety. Some parents find that a healthy diet and regular exercise helps improve their child’s symptoms, although this is not supported by medical evidence. Foods containing sugar and caffeine are likely to aggravate hyperactivity and intolerance to wheat or dairy products could also enhance symptoms. Family support is also a crucial factor for successful treatment. Parent training and educational programmes can help you understand the condition and learn how to help your child cope with ADHD. 

Dr Chris’s Recommended Medications for ADHD

Methylphenidate

A stimulant that increases the activity in the parts of the brain that control attention and behaviour. Prescribed to children (age six or older) and teenagers with ADHD.

Dexamfetamine

Similar to Methylphenidate, Dexamfetanine stimulates the areas of the brain that control attention and behaviour. Prescribed to children (age three or older) and teenagers with ADHD.

Lisadexamfetamine

Similar to Dexafetamine, Lisadexafetamine is a stimulant and affects the same parts of the brain. Prescribed to children (age six or older) and teenagers if treatment with Methylphenidate doesn’t help.

Atomextine

This is a Selective Noradrenaline Uptake Inhibitor (SNRI). It increases noradrenaline in the brain, which is the chemical that transfers messages back and forth between brain cells. The increase can control concentration and impulses. Prescribed to children (age six or older) and teenagers, as well as adults who are continuing with ADHD treatment.

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