What is ADHD?
ADHD stands for Attention Deficit Hyperactivity Disorder. ADD is a variation of ADHD, which describes Attention Deficit without the hyperactive/impulsivity symptoms . So both terms are used interchangeably
ADHD is the most common neuropsychiatric condition, affecting approximately 5% of children and adolescents and 4% of the adult population worldwide. In the UK, around 3% of the children and adolescent have been diagnosed with ADHD
ADHD is a heritable neuropsychiatric condition of biological origin, which affects the capacity of the child, adolescent and adult for:
a)Regulate their activity levels, so they present with hyperactivity
- b) Inhibit or stop their ideas, thoughts or behaviors, so they are impulsive.
- c) Pay attention to the actions they perform, so they suffer inattention.
How ADHD is diagnosed?
ADHD definition and diagnosis:
– A level of inattention, or hyperactivity and impulsivity that is inappropriate for the child’s age.
– Symptoms begin before the age of 12 years.
– Several symptoms must be present in at least two settings (at home, school, with friends)
– That lasts at least 6 months.
– That it is not due to another psychiatric problem (eg, anxiety, depression)
– It is neither a medical problem, nor caused by a substance (alcohol, drugs) or any medication.
– However, the presence of these symptoms is not enough to make a diagnosis. Symptoms have to produce a significant deterioration or negatively affects/impacts the child or adolescent or reduce the quality of life, academic, social or family function
ADHD can have a very negative effect on the child who suffers it. In the long term, and if it is not treated correctly, it can impact academic performance leading to school failure and drop out.
Furthermore, it can also affect the child’s social and emotional development. Due to the multiple problems in relationships with peers as a result of impulsiveness or other symptoms, children with ADHD tend to have few friends, or struggle to maintain social relationships.
Other children can develop negative behaviors that are generally observed at home, such as progressive disobedience, defiance to authority, and behavioral problems. So the disorder can have a profound impact on family function and family members around the child, not only parents but also their own siblings.
Finally due to repeated failures, frequent discussions with teachers and parents about poor grades and bad behavior, depressive and anxiety symptoms are not uncommon in young people with ADHD. In addition, it is not uncommon for the person who has ADHD to also suffer from dyslexia, dyspraxia or autism
What are the ADHD symptoms? How do I know if my child can have ADHD?
There are three main presentations:
- ADHD combined presentation : when the young person has the three core symptoms (hyperactivity, impulsivity, inattention)
- ADHD predominantly inattentive : when the inattention is the most important symptom
- ADHD predominantly hyperactive/ impulsive: when the hyperactivity is the most important symptom
How is hyperactivity recognized?
– They are in constant motion, on the go
– It is impossible for them to endure a whole class sitting still
– They get up and hang around, they don’t stop talking to class mates
-They are noisy; they are usually tapping on the table, making noises or humming
-, they are constantly moving arms and legs or rocking on the chair
– They nibble and break pencils and pens, take things apart
– If they don’t move, they say they feel restless or nervous
How is impulsivity recognized?
– Difficulties in inhibiting or modulating their responses or reactions. They interrupt when someone is talking, they blurt out answers
– They find it difficult not to do the first thing they want or think of
– They do not think about the consequences of their actions, they simply act without thinking
– They do not learn from the consequences of their actions
– In class, they answer even before raising their hands or even before the teacher has finished asking the question.
– They find it very difficult to wait their turn to do something, such as queuing
How is inattention recognized?
– Difficulties to carry out or maintain the same activity for a long time
– They get easily bored
– They need extra effort or extra motivation to finish routine actions
-They refuse doing any homework
– They have to be insisted several times, as it seems they don’t listen to instructions
– They forget what they were doing, they struggle to complete things
-They forget or misplace things constantly
These are the externalized symptoms, or symptoms we can easily observe, however there are other symptoms that are more difficult to be observed and the child is suffering. These “internalized” symptoms are usually related to cognitive difficulties, for instance problems with organizing and planning, and to difficulties for managing emotions, for instance, intense melt downs or mood swings, intense reactions to minimal frustrations
By Dr Maite Ferrin
Consultant Child and Adolescent Psychiatrist