Introduction
Attention Deficit Hyperactivity Disorder (ADHD) is a neuro-behavioural condition that typically emerges in early childhood before the age of seven. Children with ADHD have difficulty paying attention, sitting still and thinking things through before acting. If left untreated, ADHD can cause major disruptions in day-to-day life for both the affected child and their family. Children with ADHD often struggle at school and later, as adults, at work. ADHD can also seriously hamper them in their relationships and cause significant parent/child conflict.
Between three to five per cent of children are estimated to have ADHD. These children face difficult, but not insurmountable, challenges. To achieve their full potential, they need special help, guidance and understanding from the adults around them.
Symptoms
The main symptoms of ADHD are inattention, hyperactivity and impulsivity. These appear early in a child's life, typically in the preschool and early school years. Many normal children display such characteristics at a low level or as symptoms of another disorder. But when the child's hyperactivity, distractibility, poor concentration or impulsivity affect their performance in school, their social relationships or their behaviour at home, ADHD may be to blame. It's essential that the child receive a thorough examination and appropriate diagnosis by a well-qualified professional, especially since ADHD is a difficult problem to diagnose.
According to the most recent version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), there are three patterns of behaviour that indicate ADHD:
1. The predominantly hyperactive-impulsive type (does not show significant inattention)
2. The predominantly inattentive type (does not show significant hyperactive-impulsive behaviour) sometimes called ADD, an outdated term for this entire disorder
3. The combined type (displays both inattentive and hyperactive-impulsive symptoms)
Hyperactive children always seem to be "on the go" or constantly in motion, trying to do several things at once. Sitting still at dinner or during a school lesson or story can be a difficult task. They squirm and fidget in their seats or roam around the room. Or they may wiggle their feet, touch everything or noisily tap their pencil. Hyperactive teenagers or adults may feel internally restless.
Impulsive children seem unable to delay gratification of their needs, curb their immediate reactions or think before they act. They will often blurt out inappropriate comments, display their emotions without restraint and act without regard for the later consequences of their conduct. They may not take turns in games, grab a toy from another child or hit when they�re upset.
Children who are inattentive have a hard time keeping their minds on any one thing and may get bored with a task after only a few minutes. If they're doing something they really enjoy, they have no trouble paying attention. But focusing deliberate, conscious attention to organizing and completing a task or learning something new is difficult. They find doing homework a particularly tough challenge. They"ll forget to bring it home, forget to do it or race through it, making many careless errors.
Symptoms of ADHD will appear over the course of many months, often with the symptoms of impulsivity and hyperactivity preceding those of inattention, which may not emerge for a year or more. Different symptoms may appear in different settings, depending on how much the situation demands the child's self-control. A child who "can't sit still" or is otherwise disruptive will be noticeable in school, but the inattentive daydreamer may be overlooked.
Causes/Risk Factors
The cause of ADHD remains unknown. Currently, however, heredity is considered the greatest risk factor: the disorder runs in families. Researchers have also discovered a possible connection between ADHD and brain structure, specifically differences in areas of the brain that influence attention and impulse control and the brain chemicals that regulate attention and activity (dopamine and norepinephrine).
Stress can exacerbate symptoms and if a child feels guilty about the problems their symptoms cause, they may develop other problems, such as anxiety. Research also shows that a mother�s use of drugs or alcohol during pregnancy can increase the risk of her child developing ADHD. Exposure to lead may potentially be another contributing factor.
What You Can Do
If your child is taking medication to treat their ADHD, watch for mood changes, appetite loss, trouble sleeping, headaches, stomach aches and other side effects. If these last for more than a few weeks, check with your doctor.
Explain your child's diagnosis of ADHD to their teachers and school principal. Try to find ways together to help support your child in school. Most public and private schools will have an educational psychologist and other specialized resources on hand.
Ensure your child has a nutritionally balanced diet, based on Canada's Food Guide.
Encourage your child to be physically active.
Learn about ADHD and the behaviour management skills that can help you teach your child how to manage themselves and make you a more effective parent. Look for a program that teaches parents of children with ADHD specific techniques for giving commands, reinforcing positive social behaviour and decreasing inappropriate behaviour.
Look after yourself. It can be draining and stressful to raise a child with ADHD. Taking care of your personal health and building your stress resilience will give you the strength and energy you need to help your child and family.
Some conditions have symptoms similar to ADHD, including learning disabilities, Tourette�s, conduct disorder, oppositional defiant disorder, depression, anxiety, developmental disorders and asthma. This may mean that your child has this disorder and not ADHD, or that they have both disorders.
What Your Child Can Take
Your doctor may suggest a stimulant like amphetamine (Dexedrine or Adderall XR) or a methylphenidate (Ritalin or Concerta). It may seem odd to administer a stimulant to a child who is hyperactive, but these medicines can reduce symptoms in approximately 70 per cent of ADHD cases.
However, parents need to closely supervise the use of such drugs. Watch for side effects such as loss of appetite, nervousness, tics or twitches and problems sleeping. Closely monitor your child for these or other problems, and consult your doctor if you have concerns. These side effects will probably decrease after a few weeks. If not, the dosage can be adjusted.
Contrary to popular beliefs, food with sugar and additives has not been shown to cause ADHD. The U.S. National Institutes of Health reviewed the research and found that specialized diets appeared to help only five per cent of children with ADHD, usually very young children and those with food allergies.
Further Resources
Contact the Canadian ADHD Resource Alliance at www.caddra.ca, CH. A.D.D. Canada at www.chaddcanada.org or the Learning Disabilities Association of Canada at www.ldac-taac.ca or 1-877-238-5322.
