ADHD - Attention Deficit Hyperactivity Disorder
ADHD – Attention Deficit Hyperactivity Disorder
ADHD (previously known as Attention Deficit Disorder or ADD) is a term that is is used to describe a neurodevelopmental disorder with a recognized and persistent pattern of behaviour. ADHD begins at birth and in most cases persists to some degree throughout the lifespan.
When people think of ADHD they tend to think of overactive, noisy boys who are disruptive in class and won’t sit still. In reality, ADHD affects both sexes and all age groups. Also, hyperactivity is only one part of ADHD and may not be relevant at all for some children. When present, the hyperactivity often burns out by adulthood.
Diagnosis for ADHD
A diagnosis of ADHD can be controversial, and some health professionals have been concerned that it has been over diagnosed in recent years. Other problems, such as a traumatic family environment, brain injury or disability, can sometimes cause children to behave in ways that seem like ADHD. A common presentation would be someone who has difficulty maintaining attention, is easily distracted and forgetful, may be somewhat restless and fidgety, is likely to act without thinking, and needs direction to stay on task and get things done. Some people may have occasional outbursts of intense emotion that are short-lived and usually triggered by frustration.
The diagnosis is usually made by a specialist paediatrician or child psychiatrist after referral from a doctor.
- To make a diagnosis of ADHD, a specialist will need to be sure the ADHD symptoms:
- began before the age of 7 and have persisted for 6 months or more
- are present in more than one setting
- have caused significant impairment, at school, home or socially
- are unusual for the child’s age and developmental level
- are not better explained by another mental or physical condition, family circumstances or stress.
ADHD Symptoms and Assessment
Attentoin deficit hyperactivity disorder can manifest with or without hyperactivity or Behavioural Disorders. Most children with ADHD can be well behaved and polite and are beautiful children of normal intelligence and many have above average intelligence. However, they can often be overly inattentive and be easily distracted, they can be fidgety and may tend to make impulsive mistakes. The media often concentrates on presenting mostly the hyperactive children with associated behaviour disorders as representative of ADHD. Consequently, parents with the more inattentive subtype are understandably unwilling to accept that their child may have ADHD.
Treatment for ADHD and Costs
There are several different options for the treatment of attention deficit hyperactivity disorder (ADHD), depending on the specific needs of each child and family.
Treatment may involve different health professionals, including a doctor, psychiatrist, paediatrician, psychologist or family therapist. Parents – and possibly schoolteachers too – need to be actively involved in the treatment plan.
Treatment may include:
- psychological treatments
- positive parenting strategies
- school support
- an education plan for the classroom.
Psychological treatments, such as behaviour therapy, may help a child develop strategies and skills for learning and behaviour.
Depending on your personal circumstances the cost will vary. In a public system the cost of each assessment may be covered but you will need to ask if there are any extra expenses. If you have a diagnostic assessment in the private system you will need to ask the clinic or doctor’s practice about the cost of all the assessments and how much is covered by Medicare. If you have private health insurance contact them to find out how much you will be able to claim.
What causes ADHD?
The exact causes of ADHD are not known, and there is no single cause.
Studies have shown that ADHD symptoms are related to biological features in the brain. It is thought that genetic and environmental factors can interact to cause changes in brain development and function.
- Neurophysiology: It includes differences in brain anatomy, electrical activity and metabolism.
- Genetics: Research shows that ADHD often runs in families. Researchers are currently working on identifying which genes are involved.
- Drug use during pregnancy: Research has linked ADHD to smoking, alcohol and cocaine use during pregnancy.
- Lead: Some studies have shown that pre-schoolers who were exposed to lead (in certain types of paint or plumbing) had a higher risk of developing ADHD.
- Brain injury: Some children with brain injuries show behaviour that resembles ADHD; however, most children with ADHD have no history of brain injury.
Poor sleep during the night can cause trouble concentrating the following day. It is thought that one third of children with ADHD might have sleep apnoea, but it’s not clear whether sleep apnoea is a cause of ADHD.
Parents and ADHD
People with attention deficit hyperactivity disorder are frequently labelled as being lazy, which is unfair and unhelpful. In reality, people with ADHD often have to work twice as hard just to stay on track. Simple tasks that can seem easy to others can feel like a mountain to someone with ADHD. People with ADHD can become mentally tired from constantly trying so hard. But when they are really interested in a task they will hyper focus and can excel. People with ADHD are often creative thinkers with a lot of energy.
Parents are also often blamed for their child’s ADHD. They are accused of not providing appropriate discipline. While some of the parents themselves may also have ADHD (often without knowing it) and may not always be consistent with their parenting skills, the reality is that children with ADHD are harder to parent, even for a parent who has excellent parenting skills and no ADHD. Children with ADHD typically don’t pay attention, they don’t remember things, they may be more active, and they typically act without thinking of the consequences, despite what their parents may have taught them. They are often less fearful of negative consequences because they do not consider those consequences at the necessary time. Not all children react the same way to parental instruction.
Why is diagnosis important?
- To get to know the child better; A diagnostic assessment looks at all the things a child is good at and where they need help. It gives health professionals, parents, carers, family members, teachers and the child a better understanding of how to manage and or care for the child.
- To access services that can help the child; a diagnosis may help you access services in the community that best meet the child’s needs.
- To answer your questions; A diagnostic assessment helps you understand more about the child. If you are wondering why the child has challenges in some areas of their life (for example, school, behaviour, memory) the diagnosis will help answer your questions.
- To improve the quality of life; a diagnosis and management plan can contribute to positive long-term outcomes for the child and their family.
There is no doubt that ADHD can cause significant emotional, social, and educational problems. Although some children appear to grow out of their ADHD as they reach their adolescent years, for others the disorder remains a lifelong problem. With the help of timely and targeted interventions, most children with this condition learn how to cope with their disorder effectively as they get older. When ADHD is diagnosed and treated early, the condition can be effectively managed, so that children with ADHD will grow to have productive, successful and fulfilling lives.
If you have concerns, your GP may refer you to a developmental paediatrician or diagnostic assessment service in your area.
More information can be found in the following websites.
ADHD Australia www.adhdaustralia.org.au
Q. How many children have ADHD?
About 5% of school-age children worldwide meet diagnostic criteria for ADHD. This equates to about 200,000 children in Australia. ADHD affects boys about 3 times more often than girls.
Q. What causes ADHD?
There is no one cause for ADHD. ADHD is caused by both environmental and genetic factors. Many children with ADHD have somebody else in their family that has ADHD. Children with ADHD are found in all socioeconomic and ethnic groups.
Q. What other difficulties do children with ADHD experience?
Most children with ADHD will also have one or more co-existing problems including specific learning difficulties, language impairment, oppositional defiant disorder, anxiety, depression, conduct disorder, and/or tics. Children with ADHD can find themselves socially isolated. Other children don’t understand their impatient behaviour, their inability to follow classroom and playground rules or the way they rapidly change from one activity to another.