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;
- Emotional immaturity;
- Disregard for danger;
- Lack of discipline;
- 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;
- Social skills training;
- Parenting skills training.
- Research into the role of diet is ongoing.