Sunday 29 June 2008

Attention deficit hyperactivity disorder (ADHD)

Attention deficit hyperactivity disorder (ADHD) and attention deficit disorder (ADD) refers to a range of problems with behaviour. It is estimated that about 1.7% of the UK population, mostly children, have ADD or ADHD. Boys are more likely to be affected.


Symptoms
The symptoms may include attention difficulties, impulsiveness, restlessness and hyperactivity, as well as inattentiveness, and often prevent children from learning and socialising well, we have discussed some of these symptoms below.

Attention difficulties

In order for a child to be diagnosed with ADHD a child must have exhibited at least six of the following symptoms for at least six months to an extent that is unusual for their age and level of intelligence.

Fails to pay close attention to detail or makes careless errors during work or play.
Fails to finish tasks or sustain attention in play activities.
Seems not to listen to what is said to him or her.
Fails to follow through instructions or to finish homework or chores
Disorganised about tasks and activities.
Avoids tasks like homework that require sustained mental effort.
Loses things necessary for certain tasks or activities, such as pencils, books or toys.
Easily distracted.
Forgetful in the course of daily activities.


Hyperactivity

A child must have exhibited at least three of the following symptoms for at least six months to an extent that is unusual for their age and level of intelligence.
Runs around or excessively climbs over things. (In adolescents or adults only feelings of restlessness may occur.)
Unduly noisy in playing, or has difficulty in engaging in quiet leisure activities.
Leaves seat in classroom or in other situations where remaining seated is expected
Fidgets with hands or feet or squirms on seat.

Impulsivity

At least one of the following symptoms must have persisted at least for six months to an extent that is unusual for their age and level of intelligence.
Blurts out answers before the questions have been completed.
Fails to wait in lines or wait their turn.
Interrupts or intrudes on others, e.g. butts into others conversations or games.
Talks excessively without appropriate response to social restraint.
Pervasiveness of attention difficulties and hyperactivity


For a diagnosis or description of ADHD a child would be expected to show the above difficulties in more than one setting, e.g. at school and at home. Many of these symptoms sound like traits of every normal child but when they appear together it may be a little more than just laziness, being a little different, so if you are worried speak to your child’s school and see how they behave there and if you think there is a problem speak to a medical professional

Causes
The causes of ADND are still unclear it is thought that there may be both biological and environmental factors,

Biological factors
The child's temperament, as this contributes to their attitude and personality.
Deficiency of certain nutrients in the child’s diet
Studies of twins suggest a genetic link to ADHD. In 80-90 per cent of identical twins where one has ADHD so does the other.
Recent research also suggests there is a greater chance of inheriting the condition from male relatives such as grandfathers and uncles.
Brain injuries due to birth trauma or pre-birth problems.

Environmental factors
Family stress.
Educational difficulties.

Diagnosis

ADHD requires a medical diagnosis by a doctor, usually a child or adolescent psychiatrist, a paediatrician or paediatric neurologist or a GP. It will often be appropriate for other professionals such as psychologists, speech therapists, teachers and health visitors to contribute their observations to the assessment of a child with possible ADHD. There is no single diagnostic test for ADHD so different sorts of information needs to be gathered, it can often be a long road to getting a definite diagnosis

Treatment
The treatment given to a child with ADHD will vary depending on the individual child. It can sometimes be difficult to live with or cope with a child with ADHD. Both parents and teachers can follow general guidelines to manage a child's problematic behaviour but most need specialist support and advice to ensure that each child is being given the best treatment for their particular needs. The treatments available are,

Behavioural management
Behavioural management techniques are always important as is anxiety management, cognitive therapy, individual psychotherapy and social skills training. Every child is different and therefore the therapies used are different for each child

Medication
The most common and effective medications are amphetamine-like stimulants mainly Ritalin. Ritalin reduces hyperactivity and impulsiveness and helps to focus a child's attention. They become less aggressive, seem to comply with requests, and become less forgetful. Many parents say their child's behaviour has vastly improved as a result of Ritalin. Some of our parents swear by Ritalin others say it made the situation worse, finding the right treatment is a case of trial and error and persevering until you find something that helps your child.

Diet
Research suggests that diet is not a significant factor in ADHD for most children. Some children have particular food allergies that need investigation. Dietary changes need to be supervised by a doctor and nutritionist. In this approach all foods suspected of causing behavioural problems are removed from the diet then gradually reintroduced while the child's behaviour is monitored by the psychologist.

Fish oils
Many parents have noticed an improvement in their children’s behaviour when they have introduced a fish oil supplement, some have said that it has change their child sufficiently that no other coarse of action was necessary, sounds amazing but there is little scientific evidence to back the claims, the one thing that can be said is that it can not harm them so it has got to be worth a try.

Removing the artificial sweeteners and colourings
Equally removing all the artificial additives and preservatives from a child's diet has help some children improve hugely. Many manufacturers of children’s food products are starting to catch on the the fact the artificial additives do have an adverse effect in some children and are removing them from their products. Our advice always read the label!

For more information and support try www.adders.org or try this forum www.addforums.com/forums/index.php