May 17

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Attention-Deficit Hyperactivity Disorder is a neurodevelopmental disorder that is usually first diagnosed in childhood with a larger percentage of children who have ADHD being boys . The child with ADHD might have trouble paying attention and focusing while struggling to control impulsive behaviour.

Most children get excited and are active and easily distracted or have trouble focusing and behaving appropriately at times. People with ADHD have difficulty with working memory while the hyperactive and inattentive symptoms of kids with ADHD causes disruptions in their lives. These children do not grow out of these behaviours like their peers do.

Signs and symptoms of ADHD.

Other problems like anxiety, depression, some learning disabilities and sleep problems could show similar symptoms as Attention-Deficit Hyperactivity Disorder. Diagnosis of ADHD involves ruling out these issues first. Once this is done a checklist for rating ADHD symptoms is used in conjunction with questions about the history of the behaviour.

Usually the parents and teachers of the child are questioned and at times the patient might be interviewed as well. The level of inattention and hyperactivity or impulsiveness in people with ADHD is higher than that expected for their age. It often causes issues with functioning and could cause distress in the person who shows signs or symptoms of ADHD.

Only mental health professionals like psychologists and psychiatrists and primary care providers can diagnose Attention-Deficit Hyperactivity Disorder. They use a set of criteria found in the American Psychiatric Association’s Diagnostic and Statistical Manual, Fifth edition (DSM-5).

Here is a shortened version of the criteria for diagnosing ADHD:

Patterns of inattention and/or hyperactivity/impulsivity interferes with normal functioning and development.

Children up to 16 years should meet 6 of the following criteria while people aged 17 and older should meet 5 criteria. The behaviour should be present for 6 months or longer and be disruptive and/or inappropriate for their development level. Several of these symptoms should be present before age 12

Inattention:

  •         Inability to focus on details and make careless mistakes.
  •         Inability to stay focused on tasks including playing.
  •         Does not seem to listen even when spoken to directly.
  •         Inability to follow instructions and finish tasks.
  •         Struggles to organize tasks and activities.
  •         Evades or hesitantly participates in tasks that require longer periods of mental effort.
  •         Misplaces or loses things needed to complete tasks.
  •         Gets distracted easily.
  •         Forgets daily activities.

Hyperactivity and Impulsivity:

  •         Fidgets a lot.
  •         Leaves their seat in situations where sitting still is expected and appropriate.
  •         Runs around and climbs or is active in situations that are not appropriate. Older people might experience feelings of restlessness.
  •         Struggles to quietly take part in leisure activities.
  •         Is often ‘on the go’ and behaving as if they are ‘driven by a motor’.
  •         Talks too much.
  •         Cries out answers before the questioner has completed the question.
  •         Struggles to wait their turn.
  •         Interrupts or intrudes on others.

In conjunction with the above symptoms the following conditions need to be met:

  •         Numerous inattentive or hyperactive-impulsive symptoms present before age 12.
  •         A number of symptoms are present in 2 or more settings, situations or environments.
  •         Symptoms clearly interfere or impair the quality of social, school or work functioning.
  •         Symptoms are not caused by other mental disorders.

The different kinds of Attention-Deficit Hyperactivity Disorders.

Predominantly Inattentive Presentation: If enough symptoms of inattention, but not hyperactivity-impulsivity, has been present for the past 6 months. The person finds it hard to pay attention, they get distracted and forget details, or do not pay attention to them. They find it difficult to be organized and finish tasks. 

Predominantly Hyperactive-Impulsive Presentation: If enough symptoms of inattention have been present for the past 6 months – with no symptoms of inattention. The person finds it difficult to sit still, they fidget and talk a lot. They are impulsive and are constantly busy or moving around a lot.

Combined Presentation: This is when the person shows enough symptoms of both criteria inattention and hyperactivity-impulsivity has been present for the past 6 months. The person shows signs of both inattentiveness and hyperactive or impulsive behaviour.

Treatment for ADHD.

There are different treatment options for people with Attention-Deficit Hyperactivity Disorder. This includes behaviour therapy and medications.

The first treatment option (especially for children under 6) is behavioural therapy which focused on the child’s behaviour. This involves training the parents in behaviour management – a treatment option that helps to reduce behaviour sprouting form ADHD. The goal is to encourage positive behaviours while reducing negative or disruptive behaviour from the child (or adult) who has ADHD.

 Behavior therapy gives the parents and caregivers the tools to help the child and it is most effective when consistently being used both at home and at school. This option is as effective for treating ADHD in (younger) children as the use of medication.

Behaviour therapy for children aged 6 and older could involve the child’s parents, teachers and friends as well as teaching them organizational skills. This could also be combined with medication to help the child manage their symptoms.

How ADHD affects the child.

ADHD can affect children (or adults) in the following ways:

  •         They might be doing poorly at school and experience judgement by peers and adults.
  •         They tend to have more accidents and injuries than other people.
  •         Difficulty interacting and being accepted by other people.
  •         Have low self-esteem.
  •         Have an increased risk of substance abuse and participation in delinquent behavior.

The causes of ADHD are still not clear but research shows that disorder could be caused by mild traumatic brain injury or exposure to environmental toxins.

Although ADHD does not cause other mental health conditions, it could coexist with other disorders like Oppositional defiant disorder and conduct disorder.

ADHD not only affects the patient but also the lives of those around them. While there are medications that can treat the symptoms of ADHD behavioural therapy is advised, especially for younger children. By learning skills to manage their symptoms people who have ADHD can live fulfilling lives.