Attention Deficit Hyperactivity Disorder (ADHD or AD/HD) is a neurological condition characterised by inattentiveness, impulsive behaviour and hyperactivity. You may also hear it referred to as Attention Deficit Disorder (ADD). ADHD can be categorised into three different types according to which symptoms are strongest in the individual: predominantly inattentive; predominantly hyperactive-impulsive; and combined.
ADHD usually starts at about 18 months of age and becomes more noticeable by the age of three years. It is often diagnosed at seven or eight years of age when many symptoms are apparent. ADHD may improve around puberty but continues into adult life, although usually with a reduction in symptoms if treated appropriately. Although ADHD does not start in adulthood, some people may have had symptoms in childhood that were not diagnosed correctly until later in life. Boys are more likely than girls to be diagnosed with ADHD.
ADHD is largely misunderstood. Sufferers tend to be intelligent and have normal to high IQ levels. They are often creative and intuitive but if the condition is not recognised and treated, the child will underachieve and may never realise his or her full potential. This can have a significant effect upon their achievements in adult life.
ADHD is found in all social classes and can affect children of any nationality or ethnic background. It affects children all over the world.
What causes ADHD?
ADHD is thought to be an inherited or genetic disorder. Some experts believe that it might also be caused by damage to a child's brain either during pregnancy, at birth or after birth. Alcohol and tobacco use during pregnancy are also considered risk factors, in addition to premature delivery and low birth weight. In most cases a combination of factors will have contributed to its development.
In the past it has been suggested that ADHD may be caused by bad parenting, social class or by diet - these factors are no longer considered to contribute to the development of ADHD.
What are the symptoms of ADHD?
Most children with ADHD will have a range of symptoms. These symptoms will often vary in severity from one child to the next. Symptoms include:
- Inattention and becoming easily distracted - children with ADHD often fail to finish tasks and may flit from one thing to the next. Often they will forget what they are supposed to be doing or will lose things such as books or toys. Their short-term memory is poor and this, combined with a short attention span, can often cause learning difficulties such as dyslexia or problems with speech and co-ordination. This all happens despite the child having a normal IQ level.
- Difficulty socialising - children with ADHD may also have difficulties in socialising, both with their own peer group and with adults. This can present in various ways. They may act silly among other children and become the classroom clown. They may try to intrude upon others' conversations and ask incessant questions. Most of their actions are impulsive and may be inappropriate as the child does not think before speaking or acting. They may be constantly fidgeting and restless and are often prone to temper tantrums. Unfortunately, as a result of their behaviour, children with ADHD are often criticised and do not do well at school. This can lead to low self esteem and eventually to depression in older children.
Children with ADHD are often very creative or athletic. They are sensitive to their surroundings and may appreciate art, music and nature. If a child is not diagnosed and treated, other problems may develop as the child reaches puberty. Compulsive, obsessional and emotional disorders may be added to the problems already suffered by the child or adult with ADHD.
What treatment is available?
Children with ADHD need one-to-one help at school to help them learn how to learn. It is a condition that the local education authorities (LEAs) are obliged to identify and make provision for as a special educational need.
Children may also need counselling to help them understand their condition and to boost their self-esteem. Parents and teachers of affected children may be able to help in a number of ways, such as creating a daily routine for the child, always speaking to them on a one-to-one basis, or using rewards to persuade them to listen or concentrate.
Medication may be prescribed if psychotherapy and extra support are not successful in controlling a child's behaviour. This will be given in capsule or tablet form and may be taken on a long-term basis until about the age of 10. Five drugs are currently used in the treatment of ADHD: dexamfetamine, guanfacine (Intuniv®), lisdexamfetamine (Elvanse®), methylphenidate (eg, Concerta® XL, Equasym® XL, Matoride® XL, Medikinet®, Ritalin®, Xenidate® XL) and atomoxetine (Strattera®). Atomoxetine may also be initiated in adults and lisdexamfetamine is available as a separate product for use in adults; in both cases the presence of symptoms in childhood must be confirmed. Guanfacine may be used when dexamfetamine, lisdexamfetamine and methylphenidate have not been effective, if these drugs are not suitable for a patient or if the patient cannot tolerate them.
Close supervision is required when these drugs are used. If possible GPs will usually refer children with ADHD to a specialist with an interest in the condition.
Further information available from:
Premier House 112
Middlesex HA8 7BJ
Tel: 020 8952 2800
For details of local ADD support groups visit the following web site: www.adders.org
Fact sheet provided by MIMS
Date last reviewed: July 2014