ADHD is also known as attention deficit disorder (ADD) and hyperkinetic disorder. It is a fairly common condition that mainly affects a child’s behaviour. There may also be problems with the child’s intellectual, social and psychological development as a result of the behaviour.
The symptoms of ADHD fall into three main areas: hyperactivity,impulsivity, inattention.
There are three subtypes of ADHD:
Hyperactive-impulsive subtype. Some features of this type of ADHD are that a child may:
- Fidget a lot.
- Run around in inappropriate situations.
- Have difficulty playing quietly.
- Talk excessively.
- Interrupt others.
- Have trouble waiting their turn in games, in conversations and also in queues.
Inattention subtype. In this subtype, a child may:
- Have trouble concentrating and paying attention.
- Make careless mistakes and not listen to, or follow through on, instructions.
- Be easily distracted.
- Be forgetful in daily activities and lose essential items such as school books or toys.
- Have trouble organising activities.
Combined subtype. If a child has this subtype, they have features of both of the other subtypes.
The cause of ADHD is not known. It is thought that there may be subtle changes in parts of the brain which control impulses and concentration. Various factors are thought to increase the risk of a child developing ADHD. These include:
- Genetics. Some studies have shown that certain genes are related to ADHD. A child may therefore be more likely to have ADHD if there is another family member such as mother, father, brother or sister with ADHD.
- Antenatal problems. If a mother drinks alcohol, smokes or takes heroin while she is pregnant, this may increase the risk of her child developing ADHD.
- Obstetric problems. Difficult labour causing lack of oxygen to the brain. Babies with very low birth weight have an increased risk of developing ADHD.
- Severe deprivation. If a child is severely neglected early in life, this may increase their risk of developing ADHD.
There is no simple test to diagnose ADHD.For a doctor to make a firm diagnosis of ADHD, there are strict criteria that need to be fulfilled. For example, the symptoms of inattention and/or hyperactivity and impulsivity need to be present for at least six months.
pre-school children or for older children with mild-to-moderate ADHD, the first step is usually (parent or guardian) to be referred to a parent-training programme. Sometimes child will also be referred for a group treatment programme aimed at improving behaviour. The parent programme may include such things as:
- Learning skills to manage and reduce problem behaviour.
- Learning more effective ways to communicate with your child.
- Helping you to understand your child’s emotions and behaviours.
Your child’s school teacher may be invited to be involved in the treatment process. They may be able to use certain techniques in the classroom to help your child learn and function better. Family therapy may also be helpful.
In more severe ADHD, or where the above treatments have not succeeded, medication is usually recommended.
There are three main medications for the treatment of ADHD .Methylphenidate
( Ritalin) is the most commonly used medicine.
Atomoxatine and dexafenatamine are other medicines that may also be used. Medicines are not usually given to children aged under 6 years. Treatment with medicines is done under the supervision of a specialist in childhood behavioural disorders.
Dietary changes for the treatment of ADHD have been widely used for many years. They take the form of:
- Supplements with substances thought to be lacking. For example, supplements of fatty acids such as omega 3 and omega 6; and/or
- Cutting out foods thought to be harmful. For example, cutting out foods containing artificial colouring and other additives.
A guideline on ADHD was published by NICE in 2008. The guideline came to the conclusion that there is no good evidence that dietary changes can help children with ADHD.