What is ADHD?

 

At various stages of their lives most children appear to be unable to concentrate, be over active, or act without thinking. However some children show particular and exceptional difficulties with inattention, hyperactivity and impulsivity which can have a profound effect on their learning and behavior and which they seem to be unable to control.

There are numerous strategies for dealing with a child or teenager with ADHD and/or associated conditions. Medication and Behaviour Management Techniques are just two. It is however very important that parents/carers, relatives and teachers understand the condition and how it affects the child. Through an understanding of the condition they will find ways of coping and dealing with problems as they arise. A separate leaflet outlines various treatments and details the types of medication that are available.

 

Nobody knows what causes ADHD although 2010 research by scientists at Cardif University has found the first direct evidence that ADHD is a genetic condition. They found that children with ADHD are more likely to have small segments of their DNA duplicated or missing than other children. The team said that this has provided strong evidence that ADHD is a Neuro- developmetal disorder or in other words that the brains of children with ADHD differ from those of other children.

 

There is known to be a strong genetic component to ADHD. Research has shown that if a parent has ADHD there is a greater than 50% chance that at least one of their children will also have the condition.

Research also suggests that ADHD can be triggered by a neurotransmitter dysfunction, primarily in the frontal lobe area of the brain. The neurotransmitter chemical Dopamine is implicated.

ADHD is a developmental disorder that occurs in 1-3% of the population. It is more likely to be diagnosed in boys than girls. It is not related to intelligence; children with all levels of ability can have it and it affects those from all walks of life. ADHD cannot be caught or caused by environmental factors such as diet or parenting. However it must be remembered that these factors can influence a child. ADHD can have a huge impact on the whole family due to the stress of coping with the ADHD child.

Dr Geoffrey Kewley, Consultant Paediatrician, has written, “there is still widespread myth and ignorance surrounding ADHD, fuelled by personal bias and the media, leading to an assumption that ADHD is over diagnosed and over-treated in Britain.

The belief that poor parental discipline causes most children’s behaviour problems has been encouraged. Trite and simplistic explanations for the symptoms of the disorder are perpetuated, encouraging the view that merely naughty children are being diagnosed to absolve parental responsibility”.

This simply is NOT true.


The three types of ADHD:

 

1.ADHD Inattentive Type

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Has difficulty sustaining attention

Does not appear to listen

Struggles to follow through instructions

Has difficulty with organisation

Avoids or dislikes tasks requiring sustained mental effort

Is easily distracted

Is forgetful in daily activities

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2.ADHD – Hyperactive-Impulsive Type

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Fidgets with hands or feet or squirms in chair

Has difficulty remaining seated

 

Runs around or climbs excessively

Has difficulty engaging in activities quietly

Acts as if driven by a motor

Talks excessively

Blurts out answers before questions have been completed

Has difficulty waiting or taking turns

Interrupts or intrudes upon others

 

3.ADHD – Combined Type

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    • Meets both inattentive and hyperactive / impulsive criteria
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    • Whilst these are behaviours all children show from time to time, in children with ADHD the behaviours are also:
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    • Present for more than 6 months
    • Present before the age of 7 years
    • Evident in more than one setting, e.g. home, school and socially
    • Severe enough to interfere with normal functioning for children of their age
    • Not explained by developmental level or other condition/difficulty
    • Not explained by other factors such as laziness, lack of sleep, family problems etc
    •  

Dealing with these behaviours continually can push parenting and teaching skills to the limit which means children with ADHD often receive negative feedback and critical comments.

 

Co-Existing Conditions

 

Children with ADHD often have other conditions. Common co-exisiting conditions include:-

    • Learning Disabilities . About 20% to 30% of children with ADHD also have a specific learning disability such as Dyslexia and other associated speech and language problems
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    • Oppositional Defiant Disorder. Between 30% to 50% of children with ADHD have ODD. These children are often disobedient and prone to outbursts of temper
    •  
    • Conduct Disorder. Between 30% and 50% of ADHD children may develop CD, a pattern of serious antisocial behaviour. These children frequently lie or steal and disregard the welfare of others. They are often in trouble at school or with the police
    •  
    • Anxiety and Depression. Approximately 25% of children with ADHD have anxiety or depression. If this is recognised and treated they are better able to cope with the symptoms of ADHD
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    • Bipolar Disorder. A few children with ADHD will develop /Bipolar Disorder. This is marked by periods of intense highs or lows and they may have elated moods and feeling of grandiosity alternating with periods of depression or chronic irritability

 

    • Asperger’s Syndrome. An Autistic Spectrum Disorder (ASD) related to ADHD, characterised by social, communication and social imagination problems. Often accompanied by Anxiety Disorders and OCD
    •  
    • Other Disorders. ADHD can also be associated with Dyspraxia, Obsessive Compulsive Disorder, Hyperlexia, Austism, Tourette Syndrome
    •  
    • Sensory issues

Children with ADHD often show signs of Sensory Issues and research is beginning to recognise that these children cannot process a barrage of stimuli. They find it extremely hard to cope with everyday sounds, smells, sights and touch. They are often extra sensitive to certain textures of clothing or food, or may be unable to cope with loud noises or strong smells.

As their brains appear to be unable to cope this may result in tantrums, anxiety and problems in the classroom or in social situations which to most people will appear to be out of the blue or complete over reactions.

Sensory issues affect all senses including a sense of justice and injustice; proproception which leads to clumsiness; sense of humour or lack thereof; Heat and cold leading to issues, for example, with wearing coats in winter/ getting frustrated and angry when too hot in summer.

 

Social Issues

Those with associated disorders can be at a higher risk of drug and alcohol abuse and imprisonment. Adolescents with ADHD present a special challenge as academic and organisational demands increase. In addition they also face typical adolescent issues such as discovering their identity, establishing independence, dealing with peer pressure and have four times the incidence of car accidents and increased involvements with the police.

Young people with ADHD are particularly vulnerable individuals because of their poor communication and social skills. They have a particular need for understanding and support from the Criminal Justice System. They may find it difficult to explain what had happened after a car accident or giving a statement to the police as a witness.

They may not understand the wider implications of the situation or the kind of information that they need to give. A lack of understanding of ADHD can lead to certain behaviours being misconstrued as offending behaviour.

Young people with ADHD are often unaware of the effect of their behaviour on others and the consequences of their actions as they often do not link cause and effect. They may display extreme behaviour as a result of high anxiety levels.

They are also often socially naïve and could make inappropriate social approaches such as standing too close to others or intruding onto others conversations. They can also respond to a situation in a way that others find hard to accept or understand.They are often wound up by their peers and can be encouraged by others to do things that if they thought first would not do. For example they could be goaded into throwing an item across the classroom and will do it without thinking and although they know the behaviour or action is wrong they only realise after the event. They are unable to stop and think before acting due to their impulsiveness.

 

Children with ADHD are often picked on and/or bullied as their behaviour makes them stand out as different from their peers. This will also raise anxiety levels and can lead to them refusing to go to school.