What is ADHD?                                              

Attention Deficit Hyperactivity Disorder (ADHD)  is a disorder affecting the learning & the behaviour of the child.

What causes ADHD?

The cause of ADHD has not been firmly established but there are two things that are strongly held beliefs.

Firstly, there is no doubt that genes play a part in the inheritance of ADHD. Many children with ADHD see to have a close relative with a similar presentation of behaviours. However, the reason why one child in a family rather than another is still unknown !

Secondly, ADHD problems result from a subtle difference in the fine tuning of the brain. There is an under functioning of those areas of the brain that control concentration, attention and that modulate & inhibit inappropriate or irrational behaviour.

 Mainfeaturesof ADHD are :

Inattention
The child appears easily distracted, has difficulty concentrating, dawdles when starting tasks or has little or no ideation or initiation, [this is often misinterpreted as laziness]. The child may have difficulty listening to and following instructions, often daydreams or wanders aimlessly.

Impulsiveness                                                                                                                                        The child may act without thinking, has difficulty waiting in turn, moves from one unfinished task to another, calls out inappropriately or makes remarks that are inappropriate to the situation, rushes into a task, engages in dangerous activities without considering the consequences.  

Hyperactivity                                                                                                                                    Overactivity where the child may appear to be ‘movement driven’ or fidgety or restless. There may be finger drumming or feet tapping or the child may engage in non-task related activities and is often accident prone, talks excessively and may have difficulty playing quietly.  

   

Social Skills      

The child appears immature, has a lack of awareness and sensitivity to those around them, demands attention, is aggressive, argumentative or overreacts to minor problems, often interrupts or sabotages games.  

 

Movement Difficulties

The child may display movement difficulties; many ADHD children have terrible handwriting, poor coordination and movement planning which makes tasks like tying laces, throwing and catching a ball, using scissors, riding a bicycle, etc., very difficult to learn. Many ADHD children can often appear clumsy !

         Other associated problems include:  

         Academic under achievement      

  Aggressive Behaviour
  Poor peer relationships 
Family dysfunction

With so much current interest it may be easy to think of ADHD as an ‘epidemic’ but it is occurring no more frequently than in the past, it is just more widely recognised & accurately diagnosed.  

Contrary to belief, children ‘Do Not Grow Out Of It !’   Although it can be seen that the more overt signs of hyperactivity may recede with maturity & presenting in the older child / adult as fidget behaviour.

However, it is now becoming more recognised that children do not always have to display hyperactivity to have an attention deficit. Rather these children can seem more ‘dreamy’ than usual.

ADHD shows no socioeconomic clustering & research shows that it is approximately 4 times more present in males than females.  

Can Diet or Food Additives Cause ADHD?

Although there is some evidence that diet can be a factor in ADHD for some individuals, recent UK research has identified that only a small proportion of children may respond to dietary help & modifications.  

Can Poor Parenting or ‘Confused Home Backgrounds’ Cause ADHD?

There is little evidence that socioeconomic & environmental factors or poor parental management cause ADHD Children with ADHD often behave badly & cause stress for parents and other siblings. Normal methods of discipline & behavioural management do not work well & parents can feel very inadequate or give in for a ‘quiet life’.  

The ADHD child, however, will benefit from a consistent approach & routine. They require more structure than other children & do not cope well with chaos or change !  

Is there a test for ADHD?

There is no specific diagnostic test for ADHD and accurate diagnosis can only be made after a comprehensive series of assessments, reports and clinical / situational observations.   There are many other conditions that produce similar difficulties and behaviours and it is therefore important that a thorough assessment from a multidisciplinary professional perspective takes place prior to a diagnosis.

                                                                                       

Important points to remember.......   

Early diagnosis & treatment are important a collaborative approach between home, educational and healthcare professionals is essential there is no ‘cure’ as such but intervention from a ‘team’ of professionals can help to manage the difficulties.

ADHD is not a disease entity like, for example, diabetes. The normal population of children has a wide variation of abilities to concentrate and stay still.  The extreme end of this normal variation is known as ADHD and is defined as pathological, because it frequently leads to educational failure, social distress and long term consequences. 

Many parents seem to prefer ‘ADHD’, perhaps because much of the literature available for parents uses this American terminology.

   

Children with ADHD have problems with attention, hyperactivity and impulsivity. 

These behaviours are extreme, have been obvious since an early age and affect most areas of life – home, school and friends.  Most children with ADHD are of normal intelligence.  These children tend to be unpopular with their teachers because their impulsivity leads to behaviours such as blurting out answers at inappropriate times, and fiddling with things during class. 
They may also struggle maintaining relationships with their peers and can be easily picked on.   For example, if they are provoked they will not be able to control the impulse to retaliate until the teacher is looking the other way.  They always seemed to be the children who are caught. 

  

Self-esteem inevitably suffers, and in the worst situation these children give up on trying to keep up academically and drop out of learning.

At home, they are more difficult to parent than a child without ADHD and receive more negative critical comments and less praise and affection.  Therefore life at school and home may be hard for them; they frequently fail, feel different from their peers, develop low self-esteem and may give up and drop out.  This may, in turn, lead to involvement in antisocial behaviour and substance misuse, so they get even further into trouble.

Views and treatments 

There is a wide range of views on the best way to treat people with ADHD. Some approaches are based on very specific theories as to the possible causes of Attention Deficit Hyperactivity disorders.

The Dorset ADHD Support Group cannot make recommendations as to the effectiveness of individual therapeutic approaches. While we appreciate the eagerness of parents to try out new treatments, we feel that any new approach must be fully scientifically evaluated so as to ensure that there are no undesirable side-effects. The policy of the ADHD group Helpline is to provide an impartial service. Therefore we aim to provide people with as much information as possible about any particular therapy to enable them to form their own opinion.

There are now a great number of approaches and treatments available for people with ADHD and parents and professionals may find it difficult to decide which approach is best-suited to their individual circumstances.

It is important to remember that although different approaches have been known to work for some people with Attention Deficit Disorders, they have not been evaluated on a long-term basis. Before using any particular approach it is best to find out as much information as you can about it. Any approach should be positive, build on people's strengths, and help to discover their potential, increase motivation and provide opportunity.

Here are some questions to consider before choosing an approach.

About the approach

What does the approach claim to do?

How does it work?

How was it developed?

How long has the approach been in existence?

How many people have been treated and what was the outcome?

How long is the course of treatment?

Does the approach focus on one particular skill or does it offer more general treatment?

Are treatment goals individual (ie, based on the needs of each individual)?

Exactly what involvement is required from the person with ADHD, their family, and professionals working with them?

Is there a brochure or other written information?

Credentials of staff

What is the background of the programme?  

What are the qualifications of the individual delivering the programme?

What is the experience of the programme staff  and that of individuals with ADHD?

Have those delivering the programme worked with people who have similar needs to my child before?

Costs

How much in total does the programme cost? This total cost might include enrolment and registration fees, course fees, the cost of course materials and your travel costs.

Can costs be refunded if the approach is not effective?

Facilities, equipment and modifications

When and where will the treatment take place?

Will special equipment be needed?

Will we have to suspend other treatments?

Will we have to suspend or modify other family activities?

Effectiveness of the approach

Is there supporting evidence for the programmes effectiveness from other parents and professionals, or any research available on its use?  

Can I talk to other parents who have tried the programme? 

Are there any known side-effects?

Are there many cases where the programme has not worked and what were the circumstances?

Are there many cases where the programme made things worse and what were the circumstances?

Is there a complaints procedure?

And remember:

Be sceptical about any approach that claims to 'cure' ADHD. Parents whose child has just received a diagnosis may be particularly susceptible to trying anything. ADHD is a lifelong condition and although certain approaches may help control and manage characteristics behaviours and/or enhance particular skills that make life for the individual much easier and more enjoyable, they will continue to require some level of support and assistance throughout their life.

Do not rush judgement about any particular approach if you have only been using it for a short period of time. Changes in behaviour at the beginning may be temporary and settle back into a usual pattern so it is best to test effectiveness in the long-term to decide whether the individual benefits from any particular approach.

Every person is different and what works for one person with ADHD may not necessarily work for another. You may also find that the individual may improve to a certain extent without the implementation of any professional approaches. Interventions are mainly used as additional tools to help aid development more quickly and easily.

Be wary of any method which suggests it is the only/best approach to use and cannot be used alongside other approaches. Many approaches are compatible and can be used alongside others to give the most comprehensive support to an individual with ADHD.