Medical Encyclopaedia
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Diabetes
ADHD (Attention Deficit Hyperactivity Disorder)
Introduction:
It is estimated that around five per cent of school children in the UK have the behavioural problem Attention Deficit Hyperactivity Disorder (ADHD). As it is so widespread, most children will come into contact with others who have ADHD, even if they do not have it themselves.
Parents of children with ADHD will naturally be worried because the condition affects all areas of a child’s life. It can lead to poor achievement at school, problems with discipline and difficulties in getting on with other children, but there is help available.
The main types of behaviour displayed by children with ADHD are:
- Inattentiveness – inability to concentrate or listen
- Hyperactivity – overactive disruptive behaviour
- Impulsiveness – acting without thinking and taking dangerous risks
In other words ADHD results in children with a short attention span who are restless (constantly fidgeting) and easily distracted.
Many people might think these characteristics are natural behaviour for children. While they can be typical of many pre-school children, those with ADHD display extreme forms and continue the behaviour as they get older.
The condition affects more boys than girls, but some experts think this is because disruptive behaviour is looked for in boys. In girls, ADHD is more likely to make them inattentive in a different way, so they are never diagnosed because they are not as disruptive
Symptoms
Symptoms start at an early age and become more obvious when starting school as other children without ADHD tend to behave in a less distracted and antisocial way as they mature.
Children with ADHD tend also to have additional problems such as poor sleeping patterns and sometimes learning difficulties – around 35 per cent of ADHD children have dyslexia.
The commonest type of ADHD is ‘combined ADHD’, in which the children display
a combination of inattentiveness, hyperactivity and impulsiveness.
However, some children with ADHD are described as ‘mainly inattentive’ and
others may be ‘mainly hyperactive-compulsive’. Others have ADD which means they
are inattentive but not hyperactive or impulsive.
There is no simple test for ADHD and a GP or school will refer a child for a full diagnosis by a specialist (psychiatrist, paediatrican and clinical psychologist) who looks for a specific set of at least six or more symptoms of inattentiveness, hyperactivity and/or impulsiveness behaviours.
Symptoms of ADHD in children and adolescents
The main symptoms of each behavioural pattern are shown below. To be diagnosed by a specialist, a child has to have displayed the symptoms continuously for at least six months, and before the age of seven, and in different settings which means both at home and at school.
It must be demonstrated that their lives are being made difficult at school by the condition and that it is not just a passing phase, or due to another condition.
Inattentiveness:
- A very short attention span
- Being very easily distracted
- Being unable to stick at tasks that are tedious, or time consuming
- Being unable to listen to, or carry out, instructions
- Being unable to concentrate
- Constantly changing activity, or task
Hyperactivity
- Being unable to sit still, especially in calm or quiet surroundings
- Constantly fidgeting
- Being unable to settle to tasks
- Excessive physical movement
Impulsiveness
- Being unable to wait for a turn
- Acting without thinking
- Breaking any set rules
- Little or no sense of danger
As well as having the above behaviour, some children with ADHD are also more anxious and nervous than other children, which can give them physical symptoms of getting ‘hot and bothered’, being dizzy or having a racing heart.
Other disorders associated with ADHD have also been defined:
‘Oppositional Defiant Disorder’, where the child is negative and disruptive, particularly to figures of authority, such as teachers
‘Conduct Disorder’, defined as a tendency toward antisocial behaviour, such as stealing, fighting, vandalism and injuring people and animals
What causes ADHD?
The exact cause or causes of ADHD is not known, but parenting techniques or family problems are not thought to be a cause. ADHD tends to run in families, so it may be genetic.
Clinical studies of children with ADHD have shown less activity in the part of the brain that controls decision making, activity and attention.
Another theory is that brain neurotransmitters (chemicals that carry messages in the brain) do not work properly in children with ADHD. And studies on excessive television exposure have linked several hours daily viewing between the age of one and three to ADHD and attention problems.
Is there a cure for ADHD?
There is no cure for ADHD, and children do not usually grow out of it, so the condition continues through adolescence into adult life. However there are ways of managing the condition. Psychological (talking therapies) and educational and social therapies are helpful.
For example, talking therapies may help reduce associated anxiety and stress, and also help children’s understanding of issues thrown up by behaviour. Social skills training helps children see how their behaviour affects others. Parenting skills training can assist parents to help their children.
Drug therapy
Medication is also used to manage the condition in some children. The drugs
used (Ritalin ®) for hyperactive children are prescription only. They are
designed to make the child feel calmer and less impulsive for a short period,
so they can concentrate and learn better.
Medication is not a cure, however, and they can cause side effects and make
sleep problems worse.
Diet
Some parents think diet, particularly food containing certain chemical
additives and preservatives, worsen hyperactivity in their children.
Avoiding so-called ‘junk food’ that contains lots of fats, sugars and
additives, along with over-stimulating fizzy drinks containing sugar,
sweeteners or caffeine may be beneficial.
Although food intolerance or allergy is not a cause of ADHD, some studies show
children with the condition react to common allergens such as milk, wheat and
nuts.
References:This article has been written for PruHealth by Dr Foster Research. All Dr Foster Research (DFR) health content is provided for general information only, and should not be treated as a substitute for the medical advice of your own doctor or any other health care professional.
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