Attention-Deficit / Hyperactivity Disorder

It’s normal for children to occasionally forget their homework, daydream during class, act mischievously, or get fidgety at the dinner table. However, inattention, impulsivity, and hyperactivity are also signs of attention-deficit/hyperactivity disorder (ADHD). ADHD can lead to problems at home and school and affect your child’s ability to learn and get along with others. The first step to addressing the problem and getting your child the help he or she needs is to learn to recognize the signs and symptoms of ADHD.

What is ADHD?

Attention-deficit/hyperactivity disorder (ADHD) is a behavioral disorder marked by an ongoing pattern of inattention, hyperactivity, and impulsivity that interfere with functioning and development.

ADHD was formerly known as Attention-Deficit Disorder or ADD. According to the National Institute of Mental Health (NIMH) there are three major signs of the condition:

Inattention: a person wanders off task, lacks persistence, has difficulty sustaining focus, and is disorganized; and these problems are not due to defiance or lack of comprehension.

Hyperactivity: a person seems to move about constantly, including in situations in which it is not appropriate; or excessively fidgets, taps, or talks. It may also appear as restlessness or wearing others out with unending activity.

Impulsivity: a person makes hasty actions that occur in the moment without thinking about them first and that may expose them to a high potential for harm; or a desire for immediate rewards or inability to delay gratification. This may also appear as excessively interrupting others or abruptly making decisions without full comprehension of long-term consequences.

Is ADHD in children different than ADHD in adults?

ADHD affects children and teens, and can continue into adulthood. Children with ADHD may be hyperactive and unable to control their impulses. Or they may have trouble paying attention. These behaviors interfere with school and home life. While, adults with ADHD may have trouble managing time, being organized, setting goals, and holding down a job. They may also have problems with relationships, self-esteem, and addiction.

ADHD is shown to be more prevalent with boys than girls.It is usually diagnosed during early school years, when a child begins to have problems paying attention.

Symptoms in Children

Inattention:

  • Easily distracted
  • Inability to focus on one activity
  • Trouble completing tasks before getting bored
  • Difficulty listening as a result of distraction
  • Problems following instructions and processing information
  • Easily gets bored
  • Forgets about daily activities
  • Has problems organizing daily tasks
  • Often loses things
  • Tends to daydream

Hyperactivity:

  • Often squirms, fidgets, or bounces when sitting
  • Being unable to sit still for calm activities like eating and having books read to them
  • Has trouble playing quietly
  • Is always moving, such as running or climbing on things (In teens and adults, this is more commonly described as restlessness.)
  • Talks excessively

Impulsivity:

  • Displaying extreme impatience with others
  • Refusing to wait their turn when playing with other children
  • Interrupting when others are talking
  • Blurting out comments at inappropriate times
  • Having difficulty controlling their emotions
  • Being prone to outbursts
  • Intruding when others are playing, rather than asking first to join in

ADHD Symptoms in Adults

Symptoms of ADHD may change as a person gets older.

  • Chronic lateness and forgetfulness
  • Anxiety
  • Low self-esteem
  • Problems at work
  • Trouble controlling anger
  • Impulsiveness
  • Substance abuse or addiction
  • Unorganized
  • Procrastination
  • Easily frustrated
  • Chronic boredom
  • Trouble concentrating when reading
  • Mood swings
  • Depression
  • Relationship problems

What causes ADHD?

The exact cause of attention deficit hyperactivity disorder (ADHD) is not fully understood, although a combination of factors is thought to be responsible. Researchers say several things may lead to it, including:

  • Genes. There’s strong evidence that ADHD is mostly inherited. Many kids who have ADHD have a parent or relative with it.
  • Chemical imbalance. Brain chemicals in people with ADHD may be out of balance.
  • Poor nutrition, infection, cigarette smoking, alcohol use, or drug use during pregnancy. These things can affect a baby’s brain development.
  • Exposure to environmental toxins, such as high levels of lead, at a young age.
  • Brain injuries. Damage to the front of the brain, called the frontal lobe, can cause problems with controlling impulses and emotions.

Certain groups are also believed to be more at risk of ADHD, including people:

  • who were born prematurely (before the 37th week of pregnancy) or with a low birthweight
  • with epilepsy
  • with brain damage – which happened either in the womb or after a severe head injury later in life

ADHD is more common in males than females, and females with ADHD are more likely to have problems primarily with inattention.Currently, medical researches hasn’t found a cure for ADHD, yet. But spotting it early, plus having a good treatment and education plan, can help a child or adult with ADHD manage their symptoms.

Is it really ADHD?

Signs and symptoms of ADHD typically manifest before age 7 and can be observed in a child as early as age 2 – 3. However, it can be difficult to distinguish between attention deficit disorder and “normal kid” behavior.

It is standard for children to be unable to sit still, to seem like they never listen, to be unable to follow instructions, and to blurt out inappropriate comments at inappropriate times. Sometimes kids who seem to operate like this at homes and in classrooms are being labeled as troublemakers, or being criticized for being lazy and undisciplined.

ADHD makes it difficult for people to inhibit their spontaneous responses. Spontaneous responses involve everything from an individual’s movement and speech to inattentiveness.

If only a very few of the signs and symptoms can be observed, or if these symptoms only occur on a certain place or situation, it is probably not ADHD. On the other hand, if a person manifests a number of ADHD signs and symptoms across all situations — at home, at play, at school, at work — it would be best to seek professional help.

Just because a child has symptoms of inattention, impulsivity, or hyperactivity does not mean that he or she has ADHD. Certain medical conditions, psychological disorders, and stressful life events can cause symptoms that look like ADHD.

Before an accurate diagnosis of ADHD can be made, it is important that you see a mental health professional to explore and rule out the following possibilities:

  • Learning disabilities or problems with reading, writing, motor skills, or language.
  • Major life events or traumatic experiences (e.g. a recent move, death of a loved one, bullying, divorce).
  • Psychological disorders including anxiety, depression, and bipolar disorder.
  • Behavioral disorders such as conduct disorder and oppositional defiant disorder.
  • Medical conditions, including thyroid problems, neurological conditions, epilepsy, and sleep disorders.

Once you have fully comprehend the reasons behind a person’s pattern of behavior, you can work together with the professionals to find creative solutions and to capitalize on strengths.

How is ADHD diagnosed?

If you think your loved one has ADHD, make an appointment with your pediatrician. He or she may perform a check-up, including visual and auditory, to be sure that these patterns of behavior are not being caused by another medical condition. Your doctor may refer you to a child psychologist or psychiatrist.

To diagnose ADHD, doctors start by asking about a child’s health, behavior, and activity. They talk with parents and kids about the things they have noticed. Your doctor might ask you to complete checklists about your child’s behavior, and might ask you to give your child’s teacher a checklist too.

After gathering this information, doctors diagnose ADHD if it’s clear that:

  • A child’s distractibility, hyperactivity, or impulsivity go beyond what’s usual for their age.
  • The behaviors have been going on since the child was young.
  • Distractibility, hyperactivity, and impulsivity affect the child at school and at home.
  • A health check shows that another health or learning issue isn’t causing the problems.

Many kids with ADHD also have learning problems, oppositional and defiant behaviors, or mood and anxiety problems. Doctors usually treat these along with the ADHD.

Is it possible to be diagnosed with another illness while I have ADHD?

Although it is not always the case, some children/adults may also have signs of other problems or conditions alongside ADHD, such as:

  • Anxiety disorder – which causes your child to worry and be nervous much of the time; it may also cause physical symptoms, such as a rapid heartbeat, sweating and dizziness
  • Oppositional defiant disorder (ODD) – this is defined by negative and disruptive behaviour, particularly towards authority figures, such as parents and teachers
  • Conduct disorder – this often involves a tendency towards highly antisocial behaviour, such as stealing, fighting, vandalism and harming people or animals
  • Depression
  • Sleep problems – finding it difficult to get to sleep at night, and having irregular sleeping patterns
  • Autism spectrum disorder (ASD) – this affects social interaction, communication, interests and behaviour
  • Epilepsy – a condition that affects the brain and causes repeated fits or seizures
  • Tourette’s syndrome – a condition of the nervous system, characterised by a combination of involuntary noises and movements (tics)
  • Learning difficulties – such as dyslexia

ADHD in adults can occur alongside several related problems or conditions. One of the most common is depression. Other conditions that adults may have alongside ADHD include:

  • Personality disorders – conditions in which an individual differs significantly from the average person in terms of how they think, perceive, feel or relate to others
  • Bipolar Disorder – a condition affecting your mood, which can swing from one extreme to another
  • Obsessive Compulsive Disorder (OCD) – a condition that causes obsessive thoughts and compulsive behaviour

The behavioural problems associated with ADHD can also cause problems such as difficulties with relationships and social interaction.

How is ADHD treated?

Although there is no cure for ADHD, currently available treatments may help reduce symptoms and improve functioning. ADHD is commonly treated with medication, education or training, therapy, or a combination of treatments.

Medication

For many people, ADHD medications reduce hyperactivity and impulsivity and improve their ability to focus, work, and learn. The first line of treatment for ADHD is stimulants.

Stimulants: Although it may seem unusual to treat ADHD with a medication that is considered a stimulant, it is effective. Many researchers think that stimulants are effective because the medication increases the brain chemical dopamine, which plays essential roles in thinking and attention.

Non-Stimulants: These medications take longer to start working than stimulants, but can also improve focus, attention, and impulsivity in a person with ADHD. Doctors may prescribe a non-stimulant if a person had bothersome side effects from stimulants, if a stimulant was not effective, or in combination with a stimulant to increase effectiveness. Two examples of non-stimulant medications include atomoxetine and guanfacine.

Antidepressants: Although antidepressants are not approved by the U.S. Food and Drug Administration (FDA) specifically for the treatment of ADHD, antidepressants are sometimes used to treat adults with ADHD. Older antidepressants, called tricyclics, sometimes are used because they, like stimulants, affect the brain chemicals norepinephrine and dopamine.

There are many different types and brands of these medications—all with potential benefits and side effects. Sometimes several different medications or dosages must be tried before finding the one that works for a particular person. Anyone taking medications must be monitored closely and carefully by their prescribing doctor.

Call your doctor right away if you have any problems with your medicine or if you are worried that it might be doing more harm than good. Your doctor may be able to adjust the dose or change your prescription to a different one that may work better for you.

Behavior therapy. Therapists can help kids develop the social, emotional, and planning skills that are lagging with ADHD.

Parent coaching. Through coaching, parents learn the best ways to respond to behavior difficulties that are part of ADHD.

Stress management techniques can benefit parents of children with ADHD by increasing their ability to deal with frustration so that they can respond calmly to their child’s behavior.

Support groups can help parents and families connect with others who have similar problems and concerns.

School support.Teachers can help kids with ADHD do well and enjoy school more.

The right treatment helps ADHD improve. Parents and teachers can teach younger kids to get better at managing their attention, behavior, and emotions. As they grow older, kids should learn to improve their own attention and self-control.

What can parents do?

There are many things parents can do to reduce the signs and symptoms of ADHD without sacrificing the natural energy, playfulness, and sense of wonder unique in every child.
Take care of yourself so you’re better able to care for your child. Eat right, exercise, get enough sleep, find ways to reduce stress, and seek face-to-face support from family and friends as well as your child’s doctor and teachers.

Establish structure and stick to it. Help your child stay focused and organized by following daily routines, simplifying your child’s schedule, and keeping your child busy with healthy activities.

Set clear expectations. Make the rules of behavior simple and explain what will happen when they are obeyed or broken—and follow through each time with a reward or a consequence.

Encourage exercise and sleep. Physical activity improves concentration and promotes brain growth. Importantly for children with ADHD, it also leads to better sleep, which in turn can reduce the symptoms of ADHD.

Help your child eat right. To manage symptoms of ADHD, schedule regular healthy meals or snacks every three hours and cut back on junk and sugary food.

Teach your child how to make friends. Help him or her become a better listener, learn to read people’s faces and body language, and interact more smoothly with others.

References

ADHD. (2017). Retrieved from https://kidshealth.org/en/parents/adhd.html

Attention deficit hyperactivity disorder (ADHD). (2018). Retrieved from https://www.nhs.uk/conditions/attention-deficit-hyperactivity-disorder-adhd/

Attention-Deficit/Hyperactivity Disorder (ADHD): The Basics. (2016). Retrieved from https://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder-adhd-the-basics/index.shtml

Bhargava, H. (2017). What Is ADHD?. Retrieved from https://www.webmd.com/add-adhd/guide/attention-deficit-hyperactivity-disorder-adhd#1

Is it ADHD or typical toddler behavior? Ten early signs of ADHD risk in preschool age children. (2012, June 28) kennedykrieger.org/overview/news/it-adhd-or-typical-toddler-behavior-ten-early-signs-adhd-risk-preschool-age-children

Mayo Clinic Staff (2016, March 11). Attention-deficit/hyperactivity disorder (ADHD) in children mayoclinic.org/diseases-conditions/adhd/home/ovc-20196177

Robinson, L., Segal, J., & Smith, M. (2018). ADHD/ADD in Children: Recognizing the Signs and Symptoms and Getting Help. Retrieved from https://www.helpguide.org/articles/add-adhd/attention-deficit-disorder-adhd-in-children.htm