Attention-Deficit / Hyperactive Disorder (ADHD)
Attention -deficit/hyperactivity disorder (ADHD) is one of the most common mental disorders affecting children. The symptoms of ADHD include
inattention (not being to sustain focus)
hyperactivity (excess movement that is not appropriate to the settings), and
impulsivity (hasty acts that occur in the moment without thought)
Some people with ADHD mainly have symptoms of inattention, others mostly have symptoms of hyperactivity-impulsivity. Some people have both types of symptoms. Many people experience some inattention, unfocused motor activity, and impulsivity, but for people with ADHD, these behaviours:
are more severe
occur moter often
interfere with or reduce the quality of hot they function socially, at school, or in a job
Signs and Symptoms
INATTENTION
People with symptoms of inattention may often:
have difficulty sustaining attention during play or tasks, such as conversations, lectures, or lengthy reading
not seem to listen when spoken to directly
find it hard to follow thorough on instructions or finish schoolwork, chores, or duties in the workplace, or may start tasks but lose focus and get easily side-tracked
be easily distracted by unrelated thoughts or stimuli
overlook or miss details and make seemingly careless mistakes in schoolwork, at work, or during other activities
have difficulty organising tasks and activities, doing tasks in sequence, keeping materials and belongings in order, managing time, and meeting deadlines
avoid tasks that require sustained mental effort, such as homework, or for teens and older adults, preparing reports, completing forms, or reviewing lengthy papers
lose things necessary for tasks or activities, such as school supplies, pencils, books, tools, wallets, keys, paperwork, eyeglasses, and cell phones
be forgetful in daily activities, such as chores, errands, returning calls and keeping appointments
HYPERACTIVE-IMPULSIVITY
People with symptoms of hyperactive-impulsivity may often:
fidget and squirm while seated
talk excessively
have difficulty waiting one’s turn
leave their seats in situations when staying seated is expected, such as in the classroom or the office
run, dash around, or climb at inappropriate times (in teens and adults, they may often feel restless)
be unable to play or engage in hobbies quietly
be constantly in motion or on the go
answer questions before they are fully asked, finish other people’s sentences, or speak without waiting for turn in a converstation
interrupt or intrude on others, e.g in conversations, games, or activities
For a person to receive a diagnosis of ADHD, the symptoms of inattention and/or hyperactivity-impulsivity must be chronic or long-lasting, impair the person’s functioning, and cause the person to fall behind typical development for their age.
Do note that stress, sleep disorders, anxiety, depression, and other physical conditions or illnesses can cause similar symptoms to those of ADHD. Therefore, a thorough evaluation is necessary to determine the cause of the symptoms.
ADHD symptoms can appear as early as between the ages of 3 and 6 and can continue through adolescence and adulthood. Symptoms of ADHD can be mistaken for emotional or disciplinary problems or missed entirely in children who primarily have symptoms of inattention, leading to a delay in diagnosis.
Most children with ADHD receive a diagnosis during the elementary school years. For an adolescent or adult to receive a diagnosis of ADHD, the symptoms need to have been present before age 12. Adults with undiagnosed ADHD may have a history of poor academic performance, problems at work, or difficult or failed relationships.
ADHD symptoms can change over time as a person ages. In young children with ADHD, hyperactivity-impulsivity is the most predominant symptom. As a child reaches elementary school, the symptom of inattention may become more prominent and cause the child to struggle academically. In adolescence, hyperactivity seems to lessen and symptoms may more likely include feelings of restlessness or fidgeting, but inattention and impulsivity may remain. Many adolescents with ADHD also struggle with relationships and antisocial behaviours. Inattention, restlessness, and impulsivity tend to persist into adulthood.
Cause and Risk Factors
As of now, the cause of ADHD is still unknown, although many studies suggest that genes play a large role. Like many other disorders, ADHD probably results from a combination of factors. In addition to genetics, researchers are looking at possible environmental factors that might raise the risk of developing ADHD and are studying how brain injuries, nutrition, and social environments might play a role in ADHD.
ADHD is more common in males than females, and females with ADHD are more likely to primarily have inattention symptoms. People with ADHD often have other conditions, such as learning disabilities, anxiety disorder, conduct disorder, depression, and substance use disorder.
Therapies and Treatment
While there is no cure for ADHD, currently available treatments may reduce symptoms and improve functioning. Treatments include psychotherapy, education or training, medication, or a combination of treatments.
Psychotherapy and Psychosocial Interventions
Several specific psychosocial interventions have been shown to help individuals with ADHD and their families manage symptoms and improve everyday functioning. For school-age children, frustration, blame, and anger may have built up within a family before a child is diagnosed. Parents and children may need specialized help to overcome negative feelings. Mental health professionals can educate parents about ADHD and how it affects a family. They will also help the child and his or her parents develop new skills, attitudes, and ways of relating to each other.
All types of therapy for children and teens with ADHD require parents to play an active role. Psychotherapy that includes only individual treatment sessions with the child (without parent involvement) is not effective for managing ADHD symptoms and behaviour. This type of treatment is more likely to be effective for treating symptoms of anxiety or depression that may occur along with ADHD.
Behaviour Therapy is a type of psychotherapy that aims to help a person change their behaviour. It might involve practical assistance, such as help organizing tasks or completing schoolwork, or working through emotionally difficult events. Behavioural therapy also teaches a person how to:
Monitor their own behaviours
Give oneself praise or rewards for acting in a desired way, such as controlling anger or thinking before acting
Parents, teachers, and family members also can give feedback on certain behaviours and help establish clear rules, chore lists, and structured routines to help a person control their behaviour. Therapists may also teach children social skills, such as how to wait their turn, share toys, ask for help, or respond to teasing. Learning to read facial expressions and the tone of voice in others, and how to respond appropriately can also be part of social skills training.
Parent skills training (behavioural parent management training) teachers parents skills for encouraging and rewarding positive behaviours in their children. Parents are taught to use a system of rewards and consequences to change a child’s behaviour, to give immediate and positive feedback for behaviours they want to encourage, and to ignore or redirect behaviours they want to discourage.
Specific behavioural classroom management interventions and/or academic accommodations for children and teens have been shown to be effective for managing symptoms and improving functioning at school and with peers. Interventions may include behaviour management plans or teaching organisational or study skills. Accommodations may include preferential seating in the classroom, reduced classwork load, or extended time on tests and exams.
Cognitive behavioural therapy (CBT), a subset of behavioural therapy, helps a person learn how to be aware and accepting of one’s own thoughts and feelings to improved focus and concentration. The therapist also encourages the person with ADHD to adjust to the life changes that come with treatment, such as thinking before acting, or resisting the urge to take unnecessary risks.
Medication
For many people, ADHD medications reduce hyperactivity and impulsivity and improve their ability to focus, work, and learn. However, sometimes several different medications or dosages must be tried before finding the right one that works for a particular person. Anyone taking medications must be monitored closely by their prescribing doctor.