What is Attention Deficit Hyperactivity Disorder?

The term ADHD describes children who are inattentive, impulsive, and frequently also very active at levels higher than expected for their mental and chronological age. It is mostly hereditary, although it can occur in families with no prior history of the disorder. It appears to be immaturity in part of the brain and may cause difficulties in:

Not all children with ADD are hyperactive; nonetheless, these children may still show these symptoms.

Diagnostic Criteria for ADD/ADHD

Any eight (8) of the following fourteen (14) symptoms present over a minimum of six months is necessary for a diagnosis of ADHD. The symptoms should be present prior to age seven (7) (i.e. during pre-school years) to ensure these behaviours are not simply a reaction to school.

1. Often fidgets with hands/feet or squirms in seat (in adolscents, may be limited to subjective feelings of restlessness).
2. Has difficulty remaining seated when required to do so.
3. Is easily distracted by extraneous (external) stimuli.
4. Has difficulty following through on instructions from others (not due to oppositional behaviour or failure to comprehend) e.g. fails to finish chores.
5. Has difficulty awaiting turn in games or group situations.
6. Often blurts out answers to questions before they have been completed.
7. Has difficulty sustaining attention in tasks or play activities.
8. Often shifts from one uncompleted activity to another.
9. Often talks excessively.
10. Has difficulty playing quietly.
11. Often interrupts or intrudes on others, e.g. butts into other children's games.
12. Often does not seem to listen to what is being said to him/her.
13. Often loses things necessary for tasks/activities at school/home (e.g. toys, pencils, books, assignments).
14. Often engages in physically dangerous activities without considering possible consequences (not for the purpose of thrillseeking) e.g. runs into street without looking.

Treatment of ADHD

There is no cure for ADHD but certain options can be pursued to seek improvement in the child's ability to concentrate and/or gain some control over their behaviour.

Given the difficulties associated with ADHD and its long terms nature, a variety of interventions need to be provided by parents and professionals, implemented across home and school. No single intervention method alone is sufficient to produce short or long term behavioural change. It is a multi-modal approach to treatment. These include:

• Counselling in behaviour management at home and school in order to devise a program which can be developed with the child.
• Diet - eliminating the offending foods.
• EEG Biofeedback - a new non-drug alternative treatment for ADHD and those with specific learning disabilities. The same training protocol is usually appropriate for both conditions.
• Long term special education support - private tutoring or school program.
• Medication to improve the child's ability to concentrate and gain some control over their behaviour and help with learning problems. (Requires close monitoring with the cooperation of the school, doctor and child.)
• Occupational therapy.
• Special education in a school setting with additional support teachers to help in the regular classroom.
• Speech therapy (if associated with a language disorder).

How common is ADHD?

There is much debate over the incidence of ADHD. It appears to affect roughly between 6 - 10% of all children. It is generally agreed that the disorder occurs more frequently in boys than girls with a ratio of 6:1.

Characteristics of ADHD

• Marked Hyperactivity and Restlessness - Rocks, jiggles legs, dances, wiggles hands. In infancy this may be manifested by crib rocking and head banging.
• Compulsive Agression - Disruptive at home and in school; compulsively touches everything and everybody; disturbs other children; cannot be diverted from an action; commits acts dangerous to the safety of self and often others.
• Excitability, Impulsive - Unpredictable behaviour; panics easily with temper tantrums which are usually an expression of frustration.
• Tolerance of Failure, Frequent Frustration - Demands must be met immediately; cries often and easily.
• Short Attention Span - Flits from one project to another. Unable to concentrate; unable to complete school projects; unable to sit through a meal or a TV program.
• Exceptionally Clumsy - Poor muscle co-ordination. Eyes and hands do not seem to function together. Has trouble buttoning; difficulty with writing and drawing; difficulty with playground activity.
• Poor Sleep Habits - Difficult to get to bed, hard to get to sleep; wakes easily and early.
• Normal or High IQ - yet fails at school!

Note: The above symptoms could all be valid in any child/adult. All may appear in varying degrees over a period of 48 hours, after which none may show for 12 hours, then half may reappear over the next 24 hours. Any four may apply for one child and not another, though both would be competently diagnosed as ADHD. Due to this wide variability, it is difficult to describe the typical pattern.

Is ADHD a new condition?

ADHD has been recognised for at least 50 years. It has been referred to as Hyperactivity, Hyperkinetic Impulse Disorder, Hyperkinetic Syndrome, Minimal Brain Dysfunction, Specific Learning Disability, Dyslexia, or a combination of the above.

Will they grow out of it?

Recent studies have shown that ADHD does persist into adulthood, but if managed effectively, the impact on the person's behaviour, social relationships and life skills can be minimised and a positive outcome can result. Early diagnosis and management can reduce potential social and psychological damage.