All young children can experience challenges with sitting still, paying attention, forgetfulness and following directions. Generally, these challenges improve as children develop and grow. However, for children with Attention Deficit Hyperactivity Disorder (ADHD), these challenges can be significant and persist beyond early childhood.
ADHD in children can be difficult to identify, which can sometimes lead to these children being labeled as lazy or troublemakers. Without appropriate support, this can result in low self-esteem, poor academic performance and difficulty making friends. If your child is consistently struggling with their attention, memory, emotions and behaviour, they may need additional support to cope.
What is adhd?
Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterised by persistent difficulties with inattention and or hyperactivity-impulsivity that impacts daily life. ADHD affects a person’s ability to self-regulate, focus, remember information and plan – a group of cognitive skills known as executive functions. Difficulties in these areas occur in more than one setting such as at home and school.
Signs of ADHD in children can begin to appear in the early school years and can persist into adulthood. ADHD ranks as the most common neurobiological disorder in children, affecting about five percent of school children.
Types of ADHD
ADHD is a complex condition that presents differently in all children. Some children display noticeable challenges with inattentiveness but may not present with hyperactivity-impulsivity challenges. Others may experience challenges in both areas. ADHD can also present differently in girls than it does in boys. While each child experiences their own unique set of challenges, there are three main subtypes of ADHD according to the ‘Diagnostic and Statistics Manual of Mental Disorders’ (DSM-5).
Inattentive presentation – characterised by challenges predominantly relating to concentration, memory and organisation.
Hyperactive/impulsive presentation – characterised by challenges predominantly in self-control, restlessness and sitting still.
Combined presentation – characterised by challenges in a combination of inattentive and hyperactive/impulsive symptoms
Signs of ADHD in children
ADHD is often recognised in children before the age of 12 years. There are a number of signs and symptoms to look out for that could indicate your child may be struggling with ADHD.
Inattentive symptoms may include:
- difficulty staying focused
- trouble with organisation and planning
- challenges with initiating and completing tasks
- forgetfulness and trouble remembering information
- avoidance of tasks requiring sustained focus
- difficulty following instructions
Hyperactivity-Impulsivity symptoms may include:
- excessive fidgeting, tapping or squirming
- moving around at inappropriate times
- talking too much or too loudly
- difficulty taking turns
While children with ADHD face a number of challenges, it is important to recognise their strengths. Harnessing these strengths can have a beneficial role in the strategies used to help manage ADHD. Some children with ADHD may display strengths in the following areas:
- Creativity and inventiveness
- Abstract, out-of-the-box thinking
- Mastery of passions
Diagnosing ADHD in children
There is currently no single definitive medical or psychological test to diagnose ADHD.
Diagnosing ADHD requires a comprehensive assessment conducted by a paediatrician, psychiatrist or clinical psychologist. The professional conducting the assessment uses multiple methods and instruments to gather the information needed.
The most common assessment includes:
- Interviews with the child (if appropriate) and their carers to determine the nature and scope of a their difficulties and rule out other causes such as medical, emotional or family problems;
- direct observation of a child in various settings ( to confirm a diagnosis of ADHD,the symptoms need to be present in more than one setting);
- achievement and psychometric tests; and
- feedback from parents, teachers, carers and others about a child’s behaviour in various situations (several behavioural rating scales have been developed specifically for the identification of ADHD).
After collecting information from all sources, a professional analyses the results to determine if a child’s behaviour meets the diagnostic criteria for ADHD outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
To meet these criteria, behaviour must be problematic and inconsistent with a child’s developmental level in two areas: (a) Inattention and/or (b) Hyperactivity and Impulsivity. The problematic behaviours must have appeared before twelve years of age, remained persistent for at least six months, been present in two or more settings, and not better explained by another disorder. Children and adolescents require a minimum of six symptoms in either the Inattention and/or Hyperactivity domains before a diagnosis can be made.
Some researchers and practitioners have observed neurobiological differences in individuals with ADHD so they are incorporating new techniques into their assessments as an added part of their diagnostic protocol. Some use electro physical indices of brain functions (such as EEG and ERP assessment) to assist diagnosis, while others use continuous performance tests (such as TOVA computerised assessment).
Early diagnosis is essential. Early identification and intervention can help children with ADHD avoid negative outcomes such as school failure, inappropriate social skills and deflated confidence.
Treatment of ADHD in children
ADHD cannot be cured but education and treatment can help children cope and succeed at home and school.
Most experts believe that ADHD is best treated through a multi-modal approach that involves parents, teachers, and medical and mental health professionals.
This approach involves educating parents, teachers and the child about ADHD, training parents and teachers to use appropriate behavioural and academic interventions at school and at home, accommodating the child in the classroom and possibly providing medication, counselling and social skills training.
There are many prescription medication options currently available for the treatment of ADHD. These prescription drugs act to normalise the imbalance in the brain’s neurotransmitter chemicals. Stimulants such as ritalin and dexamphetamine are the most common forms of medical treatment.
Medication does not cure ADHD in children but can help to control the symptoms. In most children, it can provide a short-term decrease in the characteristic behaviours of inattention, impulsivity and hyperactivity, but does not increase knowledge, improve academic skill or social adjustment.
Medication combined with educational and/or psychological intervention such as organisational and skills development, time management and behaviour modification appear to produce improvements in behaviours and associated issues related to ADHD.
Causes of ADHD
Research indicates that ADHD is likely to be caused by biological factors that influence neurotransmitter activity (or chemicals that transmit messages) in certain parts of the brain.
Slight imbalances in the brain’s neurotransmitters affect the parts of the brain that control reflective thought and our ability to control poor or ill-considered behaviour.
Evidence also suggests ADHD is hereditary, indicating a strong genetic basis. ADHD can persist in adulthood with two and a half percent of adults affected by ADHD. There is a gender bias found in children and adults, with twice as many boys diagnosed with ADHD than girls, a similar bias persists in adults (1.6:1, men to women).
How does ADHD affect children?
ADHD can cause mild to severe disruptions in a child’s life depending upon the severity of the behaviours and the effectiveness of intervention.
It is generally agreed that ADHD does not have a significant effect on an individual’s intelligence. Despite natural ability, a child’s inattentiveness, impulsivity and hyperactivity unfortunately often result in failing grades.
An inability to control behaviour increases the risk of school failure for any child.
ADHD is not a learning disability but may co-exist with one and approximately 30% of individuals with ADHD have some type of learning disability. A student diagnosed with ADHD is highly likely to experience learning difficulties due to the influence of attention problems, their impulsivity and hyperactivity.
Untreated, ADHD can lead to poor self-esteem and social adjustment. Children with ADHD commonly experience interpersonal difficulties, peer rejection and difficult relations with family members.
How can parents best support children with ADHD?
Children with ADHD experience difficulties in many aspects of their lives – at home, school, in peer relationships and social activities. While every child is unique with different needs, there are a number of ways you can support them:
- set clear, firm expectations but allow flexibility
- create predictability and structure with routine
- encourage skills development through their passions
- reward positive behaviours and achievements
- minimise potential distractions
- break tasks down into smaller steps
How Learning Links can help
Learning Links offers a range of services that can support with the diagnosis and treatment of ADHD in children.
Assessments – Learning Links’ Psychologists conduct assessments to evaluate problem behaviours in children and adolescents and can make a formal diagnosis of Attention Deficit Hyperactivity Disorder. Read more >
Psychological Therapy – Children who present with ADHD may benefit from well researched intervention such as cognitive behavioural therapy. Learning Links’ Psychologists can support children and help with strategies and ways to cope. Read more >
Specialist Tutoring – Learning Links’ specialist teachers provide individualised literacy and numeracy programs that cater for your child to re-teach areas your child may have missed in class and utilise strategies to promote ongoing learning. Read more >
Social Skills Programs – Learning Links offers a range of small group interventions such as Superflex® and Zones of Regulation to support children with ADHD. Our group programs are available during school terms and during the school holidays. Each program teaches children practical strategies to cope with their ADHD and regulate their behaviours and emotions.
Speech Therapy– Learning Links’ speech pathologists can help your child communicate their needs correctly and follow classroom instructions. Read more >