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Attention deficit hyperactivity disorder

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VOL: 102, ISSUE: 16, PAGE NO: 19

What is it?


What is it?
- Attention deficit hyperactivity disorder (ADHD) usually presents in children in the preschool and early school years.



- Children with ADHD find it difficult to control their behaviour, have problems paying attention and are easily distracted. They may also be overactive and restless.



- It has an incidence of 5%, although not all these cases require treatment (NICE, 2006).



- ADHD can affect performance at school as well as impair the development of social skills.



- There are three main types:



- Predominantly hyperactive and impulsive;



- Predominantly inattentive (commonly known as attention deficit disorder);



- A combination of the two. Most cases come under this category.



- Precise causes are not known. There is thought to be a genetic component as it runs in families and is more common in males.



- Research suggests that the frontal lobes may be altered, affecting impulse control and concentration. There may also be a lack of dopamine in this part of the brain.



- Environmental factors such as watching too much television or poor parenting are not thought to be a trigger. Parental stress is thought to be a result of having a child with ADHD rather than being the cause of the ADHD.



- Symptoms vary depending on ADHD type. They can include:



- Continuous restlessness;



- Irritability;



- Aggression;



- Emotional immaturity;



- Disregard for danger;



- Lack of discipline;



- Clumsiness;



- Speech development problems.



- Antisocial behaviour becomes more common as the child becomes older.



- Beginning school can often expose ADHD. Learning can be hampered by attention and concentration deficits, although it is not linked to intelligence.



- Social skills can start to be a problem when the child begins to mix with other children and is exposed to authority figures.



- If ADHD is untreated, symptoms will persist into adolescence and even adulthood. This can result in social problems such as difficulties in sustaining employment and forming relationships.



- There is no definitive diagnosis. A specific list of criteria must be met:



- Symptoms need to occur in more than one environment, for example, at home and at school;



- The child must have six or more symptoms of inattention or six or more symptoms of hyperactivity/impulsivity;



- Symptoms must have begun before the child was seven;



- Symptoms must have persisted for at least six months.



- Medication is combined with behavioural therapies.



- NICE has issued new guidance on the use of medicines in ADHD recommending methylphenidate, atomoxetine and dexamfetamine for the treatment of children and adolescents (NICE, 2006).



- Behavioural therapies include:



- Cognitive behavioural therapy;



- Counselling;



- Social skills training;



- Parenting skills training.



- Research into the role of diet is ongoing.

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